Thyroiditis Phases

[lellie1]

I was on Methimazole because I was hyper due to thyroiditis.  Stopped taking Methimazole because I was feeling like I was no longer hyper, but hypo.  The test results came back and have changed.  Do you think I am hypo now?  I was told that these blood results could be the result of methimazole and it's possible that I may not be hypo.  How long will the hypo phase last? and will I gain all my weight back plus some?  Still waiting for all of my labs to be normal, then the doctor will do a repeat ultrasound to see if the nodules have shrunk/disolved. Below are my labs.   I included 9/15/09 and 8/26/09, as well.  
9/25/09                                                                                        9/15/09                   8/26/09                                                              
.FT4..............................0.7      (R)0.8-1.8 ng/dl............................. 1.3...........................2.3
THROID PANEL
T3 Uptake.....................34      (R)22-35%......................................39
T4 (Thyroxine), total....4.1      (R)4.5-12.5 mcg/dl.........................7.1
.
TSI...............................102      (R)125 or less % baseline                                          
Thyroid Peroxidass Antibodies.....................................................................................less than 10  (R)less than 35 IU/mL
TSH 3rd Generation 4.55      (R)0.40-4.50....................................2.8..........................0.03
CBC
Absolute Moncytes...154      (R)200-900 cells/ul

[Mark Lupo, M.D.]

The current labs indicate early hypothyroid. If this was thyroiditis, then it is a self-limited disease that does not require methimazole.  That is likely the case, so with this story, would monitor without methimazole and re-check in 4 weeks.

The hypo phase may last 1-3 months and sometimes requires levothyroxine at least for a few months until the thyroid normalizes.

If the weight loss was due to hyperthyroid, most patients go back to about the pre-thyroid disease weight.

[lellie1]

ATTN:  DR. LUPO  Please read the questions I posted in the 1st post above.  However, I really botched up the blood work....looks too confusing.  SORRY!  So, I want to restate it below for easier reading..  I was trying to rush through while dealing with kids at the same time.  I was afraid that my question would not be accepted due to the limited quantity of questions you take daily.  So, here goes for easier understanding:

9/25/09
T4, Free-------------------------   0.7  (Range 0.8-1.8 ng/dL)
TSH 3rd generation-------- 4.55   (Range .4-4.50)
T3 Uptake  ---------------------34   (Range 22-35%)
T4 (thyroxine) total----------4.1   (Range 4.5-12.5 mcg/dL)
Free T4 Index (T7)----------1.4    (Range 1.4-3.8)
TSI-------------------------------102 ( Range 125 or less % baseline)
TPA--------------------------   <10   (Range <35 IU/mL)

Below I included the entire CBC lab which includes Diff/PLT and the previous Thyroid labs

White Blood Cell Count----4.8     Range 3.8-10.8 Thousand/uL
Red Blood Cell Count-------4.64   Range 3.8-5.10 Million/uL
Hemoglobin---------------------14.5   Range 11.7-15.5 g/dL
Hematocrit----------------------42.8   Range 35.0-45.0%
MCV-------------------------------92.3   Range 80.0-100.0 fL
MCH------------------------------31.3    27.0-33.0 pg
MCHC----------------------------33.9    32.0-36.0 g/dL
RDW------------------------------14.1   11.0-15.0%
Platelet Count------------------368    140-400 thousand/dL
Absolute  Neutrophils-------2419   1500-7800 cells/uL
Absolute Lymphocytes-----2050   850-3900 cells/uL
Absolute Monocytes--------154     200-950 cells/uL   (LOW)
Absolute Eosinophils-------163     15-500 cells/uL
Apbsolute Basophils-------14        0-200 cells/uL  
Neutrophils--------------------50.4%   No Ranges for the remaining were given
Lymphocytes-----------------42.7%    "                 "                    "
Monocytes---------------------3.2%      "                "                      "        
Eosinophils--------------------3.4%      "                "                     "
Basophils-----------------------0.3%     "                 "                    "

9/15/09
T4, Free-----------------------------1.3    Range 0.8-1.8 ng/dL
TSH---------------------------------0.02  .40-4.50 mIU/L
T3 Uptake--------------------------39   Range 22-35%
T4 (Thyroxine) total -----------7.1   Range 4.5-12.5 mcg/dL
Free T4 Index (T7)--------------2.8   Range 1.4-3.8


8/17/09
T4, Free---2.3   Range 0.8-1.8 ng/dL

[lellie1]

CORRECTION:   1st column is for 9/25/09 and the 3rd column is for 8/17/09
(TPA was done on 8/26/09)