thyroiditis v. thyrotoxicosis v. t3 toxicosis

[Gabbiela]

Dr. Lupo,

I've been sweating, having diahrrea, insomnia, fatigue, and breathlessness.  I blamed all of this on gaining weight (30 lbs in one year).  I am 40, and haven't had any children.  My sister has Hashimoto's, and went into thyroid storm, for which she had to be cardioverted.  Scary stuff.  I don't want that to happen to me.  

On 9/7/07, I had some blood work done;

TSH level - 0.07 (range .3 to 5.5)
T4 = 2.0 (range .9 to 1.8)

at that time, the only other blood work abnormalities were:
ALT:  85  (8-40 U/L range)
AST:  87 (6-35 U/L)

On 9/11/07, through more blood work, my liver enzymes were back to normal with ALT being 32, and AST being 22.  

My BP and heart rate are slightly elevated, but within the range that normally occurs when I go to the MD.

My PCP sent me to an endo, who didn't feel an enlarged thyroid glad, nor did he notice any eye abnormalities.  He said it could be thyroiditis, and that I am only slightly hyperthyroid.

He had me retake the tests.  The results are as of 9/27 are:

TSH = 0.1 (0.5 to 5.5)
FT4  = 1.5 (0.9 to 1.8)
T3, Total = 173 (70-170)

He is going to have me retake these same tests in two weeks.  He said that will tell us if it's thyroiditis, which he isn't saying it is, he's just saying that it's a possibility.

My question is, if it's not thyroiditis, what else could it be?  And also, doesn't it seem like a good sign that my Ft4 has returned to normal, and my TSH is getting closer to normal?  

Or, are thyroid/TSH levels not supposed to fluctuate that much?

thank you for your input!

[GravesGirl]

Hey Gabby, My thyroid  labs were a lot like yours. I was told I had t-3 toxicosis, but I still have Graves, an auto-immune disease. I have no nodules either. Did you have an uptake scan? That can show Graves and rule out thyroiditis, which is short lived. My endo watched me and took labs and did the scan and in about 4 months from seeing him I was put on a small dose of Tapazole,2.5 mgs. Don't let it go on for too long, as it can be dangerous. Mine was mild, but I still felt like ****!

[1jitterbug]

Be aware that hyperthyroidism can wax & wane (come & go).

[Mark Lupo, M.D.]

Labs appear to be improving -- certainly it's hyperthyroidism but cause is unclear -- could be Graves vs Thyroiditis vs an over-active nodule.  Would follow closely as the endo appears to be doing.