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Which goes down first?
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida Sarasota - FL
Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

Which goes down first?

by Musela, Jul 24, 2008 01:19PM
I am currently on PTU (started Tues night), but was on Methimazole for almost 3 weeks prior (got allergic to it so had to change ATD).

My results on 22 July 2008:
T4 - 22.4 (0.5-10.4)
T3 - 36 (15-38)
TSH - 0.01
Last year my T3 was elevated.

My results on 20 Jun 2008:
TSH - 0.01
FT4 - 2.82

I don't remember what the ranges were for the results on Jun 20th, but my TSH definitely hasn't changed. I know that it'll probably be the last thing to change.

Also are my results considered mild, middle, or very hyperactive? My doctor does not seem to give me enough info when I ask him. He says that my thyroid is "very" hyperactive and that I have Grave's disease. And for the life of me, I don't know how he came up with that diagnosis, because he hasn't done any kind of uptake to determine that.

by Mark Lupo, M.D., Jul 25, 2008 05:43AM
Graves is the most common cause of hyperthyroidism - it can be diagnosed often by labs and ultrasound and the pattern of thyroid function.

The T4 levels are about 2x normal - so this is moderately hyperactive and certainly needs treatment.  If the PTU does not work or is not tolerated then I-131 or surgery would be the next step.
Member Comments (4)

by Musela, Jul 24, 2008 01:20PM
Oops... I hit the button too quickly... I also wanted to say, "Thank you for any help and info!"

by Musela, Jul 25, 2008 09:19AM
To: Mark Lupo, MD
Thank you, Dr. Lupo.  I don't feel as anxious now. I will keep trying the PTU and see what happens. I've also just started a steroid to help with the hives that happened while on methimazole. If I end up getting hives again after the steroid, I know I'm also allergic to PTU. One question though, isn't itching and rash a side effect of methimazole and PTU? When would it be considered an allergic reaction?

Thank you again for the prompt answer to my questions.

by Musela, Jul 25, 2008 09:37AM
To: Mark Lupo, M.D.
Thank you, Dr. Lupo.  I don't feel as anxious now. I will keep trying the PTU and see what happens. I've also just started a steroid to help with the hives that happened while on methimazole. If I end up getting hives again after the steroid, I know I'm also allergic to PTU. One question though, isn't itching and rash a side effect of methimazole and PTU? When would it be considered an allergic reaction?

Thank you again for the prompt answer to my questions.
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