Aa
? for graveslady
Hi there, I have seen a lot of your posts and it seems you believe a lot in the lab ranges it seems like others don't- they want to go by symptoms. I would like your opinion on my situation. My endo is saying Im subclinical, she is one of the few endos I guess that believes in treating when there are high antibodies present. My tsh before meds was only 2.62, my free t4 was right on the low end of normal at .89 and my free t3 in the middle of normal. My TPO antibodies were 560 but they have been as high as 790 and as low as 193. I have known for 10 years that I have the antibodies. My other tests are always in normal range although on a few occasions I have had low t3 with normal tsh? Anyway as for right now all my tests were normal and she wanted to treat me. I have been taking levo 1/2 of 25mcg for 9 days now and I am having panick attacks at night, something I have never had before. I wouldn't even call them panick attacks, they are just pure adrenaline rushes all night long. My endo is the one that said they are panick attacks and she thinks it is becasue my body has become used to low levels of thyroid and likes it there, even though she believes despite the reaction to the meds I need to take them and increase them soon. I would really appriciate your opinion on this. After how many days of these nightly "panick attacks" would you finaly say "forget it, I don't need it"? I do have a lot of hypo symtoms, fatigue, sometimes extreme, always cold, constipation always, puffy face and water retention. But like you said that can all be atributed to many things. sorry for the long post and thanks for your opinion.
Yes, we will always have Graves' and Hashi.
RAI treatment for Graves' doesn't necessarily mean the whole thyroid is ablated. This depends on the dose given per what the doctor has/had in mind, although now days doctor will give large enough RAI dose to avoid possibility of any furtur RAIs.
Or it may take years to reach total nonfunctioning thyroid gland, regardless.
Thyroid surgeons tend to leave a portion of the thyroid intact, in order to avoid damaging parathyroid's or the nerve that runs through the thyroid that works the vocal chords. Even with the most meticulous surgery, small amounts of thyroid tissue are often left behind to help preserve the integrity of critical structures that lie beneath the lobes of the thyroid. Also there is a chance in the future for the thyroid to grow back after surgery. That is why after cancer surgery, RAI is done, that is, to ablate the remaining tissue left behind.
In either of these case, (with the exception of cancer surgery and RAI, possibily) as long as there is the tiniest thyroid tissue left, antibodies can still attack. However, possibly not with the vengeances and symptoms as before.
How do we know when thyroid is totally nonfunctioning. When reaching a med. dose of 250 to 300 or beyond, thyroid will be totally dead/nonfunctioning.
Until then, in autoimmune, antibodies can still attack the thyroid gland. Once completely dead/nonfunctioning, antibodies are still around except there is nothing for them to attack so they may go dormant.
GL
RAI treatment for Graves' doesn't necessarily mean the whole thyroid is ablated. This depends on the dose given per what the doctor has/had in mind, although now days doctor will give large enough RAI dose to avoid possibility of any furtur RAIs.
Or it may take years to reach total nonfunctioning thyroid gland, regardless.
Thyroid surgeons tend to leave a portion of the thyroid intact, in order to avoid damaging parathyroid's or the nerve that runs through the thyroid that works the vocal chords. Even with the most meticulous surgery, small amounts of thyroid tissue are often left behind to help preserve the integrity of critical structures that lie beneath the lobes of the thyroid. Also there is a chance in the future for the thyroid to grow back after surgery. That is why after cancer surgery, RAI is done, that is, to ablate the remaining tissue left behind.
In either of these case, (with the exception of cancer surgery and RAI, possibily) as long as there is the tiniest thyroid tissue left, antibodies can still attack. However, possibly not with the vengeances and symptoms as before.
How do we know when thyroid is totally nonfunctioning. When reaching a med. dose of 250 to 300 or beyond, thyroid will be totally dead/nonfunctioning.
Until then, in autoimmune, antibodies can still attack the thyroid gland. Once completely dead/nonfunctioning, antibodies are still around except there is nothing for them to attack so they may go dormant.
GL
In your previous reply you said that:
Graves and Hashimotos are autoimmune disorders caused by antibodies. Antibodies are not treateable nor cureable due to the immune system creating them - there is nothing that can be done about them nor the immune system.
Antibodies can and do fluctuate, that is to say, they wax and wan. They go up, they go down, and they go dormant only to reappear again at some later date.
If the thyroid is removed/killed, either by surgery/RAI do you still have Graves/Hashimotos? Are the anti bodies still there? I was diagnosed with Hashis and had my thyroid removed due to cancers and then had RAI. My question is - Do I still have Hashimoto's disease? If so what do the antibodies attack now that I don't have a thyroid?
Leanne
Graves and Hashimotos are autoimmune disorders caused by antibodies. Antibodies are not treateable nor cureable due to the immune system creating them - there is nothing that can be done about them nor the immune system.
Antibodies can and do fluctuate, that is to say, they wax and wan. They go up, they go down, and they go dormant only to reappear again at some later date.
If the thyroid is removed/killed, either by surgery/RAI do you still have Graves/Hashimotos? Are the anti bodies still there? I was diagnosed with Hashis and had my thyroid removed due to cancers and then had RAI. My question is - Do I still have Hashimoto's disease? If so what do the antibodies attack now that I don't have a thyroid?
Leanne
She is not treating you for Hashi per se, no more than I am treated for Graves'
per se. These are autoimmune disorders caused by antibodsies. Antibodies are not treateable nor cureable due to the immune system creating them - there is nothing that can be done about them nor the immune system.
Antibodies can and do fluctuate, that is to say, they wax and wan. They go up, they go down, and they go dormant only to reappear again at some later date.
So, its the hypo or hyper side that we are treated for. You could be centeral hypo. as well as Hashi. Your levels show Hashi yes, but levels are also relating to central hypothyrodism. I might be wrong, so I'd discuss it with your doctor. But I wouldn't stop meds. because of the low FT-4 could get worse and go even lower, which might make it harder to get back to a steady normal.
GL
per se. These are autoimmune disorders caused by antibodsies. Antibodies are not treateable nor cureable due to the immune system creating them - there is nothing that can be done about them nor the immune system.
Antibodies can and do fluctuate, that is to say, they wax and wan. They go up, they go down, and they go dormant only to reappear again at some later date.
So, its the hypo or hyper side that we are treated for. You could be centeral hypo. as well as Hashi. Your levels show Hashi yes, but levels are also relating to central hypothyrodism. I might be wrong, so I'd discuss it with your doctor. But I wouldn't stop meds. because of the low FT-4 could get worse and go even lower, which might make it harder to get back to a steady normal.
GL
Thank you for all of your help and time! Is central Hypothyroidism the same as Hashimoto's. She says she is treating me for subclinical Hashimoto's Hypothyroidism.
Thanks
Thanks
Hi!
Your doctor might be treating you by your low FT-4 and not your TSH.
With your FT-4 low, almost out of Lab reference range, and with a TSH normal, and if your treatment is based on central hypothyroidism, then TSH values are not reliable as an accurate reflection of thyroid status, and a
free T4 must be used to adjust your replacement dose.
FT-4 level in the upper third of the reference interval is the therapeutic target for the L-T4 replacement dose used to treat central hypothyroidism.
The daily dose of L-T4 meds. should be withheld on the day of the FT-4 measurement/blood test, because Serum FT4 is increased above baseline for 9 hours after ingesting L-T4 pill.
Good Luck and thank you for your faith and confidence.
GL
Your doctor might be treating you by your low FT-4 and not your TSH.
With your FT-4 low, almost out of Lab reference range, and with a TSH normal, and if your treatment is based on central hypothyroidism, then TSH values are not reliable as an accurate reflection of thyroid status, and a
free T4 must be used to adjust your replacement dose.
FT-4 level in the upper third of the reference interval is the therapeutic target for the L-T4 replacement dose used to treat central hypothyroidism.
The daily dose of L-T4 meds. should be withheld on the day of the FT-4 measurement/blood test, because Serum FT4 is increased above baseline for 9 hours after ingesting L-T4 pill.
Good Luck and thank you for your faith and confidence.
GL
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