For 15 years I have had terrible symptoms of hyperthyroidism (heart arrhythmias, racing and pounding heart and palpitations, anxiety disorders, heat intolerance, weight loss despite increased appetite). I have not seen an endocrinologist but once in the ER had my TSH checked and it was 1.5 which I know is normal so I didn't pursue it further.
The funny thing is that my symptoms sometimes come and go. I've had stretches of time where I've felt ok and stretches of time where my symptoms return full force with no identifiable trigger. Also, my symptoms seem to increase during PMS time.
My questions: Could I have hyperthyroidism despite having had a normal TSH level? Should I see an endocrinologist? Can hyperthyroid symptoms be episodic or increase with PMS?
I was in the same position as you were. I had hyperthyroidism for 4 years and I tried to hold off until my pills made my liver enzymes go crazy. At this point my doctor has suggested 2 options? Surgery to remove the gland or RAI and stop the antibodies in the organ and thus making me hypo.
The endocrinologist recommended me to do RAI and after months of researching I felt it was the best option for me too. I had the same symptoms you had and I also had heat flashes. I couldn't take it anymore either.
Some days I felt great and some days I woke up sweating meaning I would have a horrible day of symptoms for hyperthyroidism.
I recommend you see the endocrinologist immediately. Thyroid disease is an auto immune disease so if you think you have had it for 15 years, it wont go away anytime soon. The doctor will recommend you are put on pills and if that doesn't work you have the 2 options I had.
Yes - PMS will effect your thyroid and it's levels. All hormones work together -like a connected puzzle and if one is off (TSH) then others will spiral too.
What is your doctor saying? I think- if you can monitor when your PMS usually starts - try to plan a visit to your doctor during pre PMS - duing PMS - post PMS. If your doctor is willing do a TSH check during each stage. You may notice that at one time a med may help you stabilize during that time. whether T4 or Armour or other hormone therapy.
This is truely a gamble - but it may be helpful - prior to getting on permanent meds - if you get a TSH level where YOU know WHEN you feel right. Then down the road if you find you need thyroid meds - you and your doctor will have a sure bet level (TSH) where you feel good at and can work to getting you there if you fall short later down the road.
Graves-Hashi and some others attack the thyroid and classify out as autoimmune disease. I think jumping into a permanent situation with RAI or TT is something that needs to be thought out - not jumped into and most endo's find that only to be the recourse of treatment. Remember - these treatments alters you permanently.
You say they come and go - and not constant. I think the approach of finding out during the course of the month (s) for you is your best option and if your doctor is willing - stay with him until a specialist is needed. If you find that he is not helping and your symptoms are not improving or become worse and are regular - you will have the need to see a specialist and your doctor will refer you if needed. AND you will have a track record of blood tests to help determine where you feel at your best.
Not to be controversal with this poster above - just my thought. I believe I was also a hyperthyroid patient 10-15 years prior to my Dx of Graves. I jumped on RAI and think back - I wish I followed the above recourse prior to permantely changing my body.
I tried everything to not have a permanent issue for the rest of my life. For the past 2 years I tried to watch for my hyper thyroidism. It got really bad for that last year and that was when my endo told me I had 2 options.
I have been on PTU for the past 2 years and my doctor warned me that if my condition got worse, I would have to stop all this and go forth to save my life.
I had frequent blood works for the past 6 months. The doctor said my thyroid levels were high and manageable but my liver enzymes went crazy high. My endo told me that I cannot carry forth with taking my PTU 3 times a day in safety of my liver.
I knew my options 2 years prior to the ATD's but that is how it happened.
To the OP, don't regret any decision you make. I have learned to live life without regret.
I have been diagnosed with Graves'...
For the past 3 years, my symptoms came in like waves, and then went into remission. I cannot stay on Tapezole daily, as it makes me pretty lethargic, increasingly moody, and causes weight gain.
Interestingly, at my last appointment, my T3 and T4 levels were normal (without any drug intervention), but my TSH was very low at .01. This should not even be! So, I think I don't have Graves' - rather, I think it's Hashimoto.
I am currently researching natural remedies, and I agree that RAI or surgery should be a last resort. The thyroid meds can cause liver damage and blood problems if taken in excess, but natural remedies can't hurt to try..
BTW - anyone else have low TSH and normal T3 and T4 levels????
What you have shared sounds like Hashimotos auto-immune disease. I too had times in my life when I was HYPER....and then would go into periods of hypo. Sometimes blood tests are very deceiving! Hashimotos and Graves involve the thyroid, but they are auto-immune diseases, not truly a thyroid condition.The immune disorder begins somewhere else in the body, but attacks the thryoid - why is a not known. Unfortuntaely, the only treatment is the same as what is prescribed for hyper or hypo thyroid - T4 or T4/T3 drugs.
I am reading a book called "Why Do I Have Thyroid Symptoms When My Labs Tests Are Normal? by Datis Kharrazian. Its a real eye opener (for people with Hashis) and explains why thryoid med dosages often have to be increased and adjusted many times.
Maybe its time to be tested for Graves (test is called TSI) and find out what you really have.
I still say its Graves as levels can fluctuate even with Graves Disease.
Its only when left untreated that the antibodies then fully attack the thyroid.
Either way...if it was me,,,I would want to know,
This is an old thread so I hope my post gets scene. I have had the same question. I have had really fast metabolism my whole life. I can eat and eat but never really gain weight. If external reasons cause me to only eat once a day (stress/pain/medication) I drop weight fast. Before my spine surgery I was 97 pounds, I should be 115. Other symptoms I get off and on heart palpitations, shaky hands, muscle twitches all over body, low blood sugar symptoms (dizzy when standing, almost passing out and seeing stars), leg pains that come and go, vision problems, insomnia (tired all the time but can never sleep), hives and itchy spots under the skin, very enlarged glands (today I started choking when trying to take morning meds). I am recovering from cervical spine surgery still (7 months; arm went paralyzed for 3 days after surgery and have dealt with extreme nerve issues in hands and arms, numbness/buzzing, pain and dropping things), have frequent migraines and horrible allergies (started allergy shots). When I had the last MRI before spine surgery they noticed enlarged thyroid. I have had a bunch of blood work over the last 6 years but nothing has looked abnormal. I have been tested for everything they can think of and most recently MS but nothing fits. So all my symptoms have been excused away as the neck injury/nerve damage, migraines and allergies. I'm getting frustrated as these symptoms are still present and I have no answers. I have scheduled blood work for tomorrow to recheck again. Any suggestions?
Yes, hyperthyroidism can come and go... that's usually in the early stages of Hashimoto's, which ultimately ends up as hypothyroidism at some point. With Hashimoto's, hyperthyroidism can alternate with periods of hypo or normal; they can last for weeks, months or years.
Symptoms of hyper also mimic Type I diabetes so if you haven't been tested for that, you should be...
If you have recent thyroid hormone test results that you can post, please do so, so we can better assess your situation. Please be sure to include reference ranges with any test results posted as ranges vary lab to lab and have to come from your own reports. For thyroid testing you should be getting Free T3, Free T4 and TSH, at the least. You should also have been tested for thyroid antibodies to test for, both Graves Disease, which is always associated with hyperthyroidism and Hashimoto's, both of which are autoimmune conditions.
The antibodies to confirm Hashimoto's are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb)... you need them both. The definitive test for Graves Disease is Thyroid Stimulating Immunoglobulin (TSI).
I don't know how long you've had these symptoms, but I'm appalled that you would have been tested for MS and not for, either, Hashimoto's or Graves Disease...
There can be a link between thyroid conditions and peripheral neuropathy, but other things can also cause PN... for instance, have you ever had vitamin B-12 tested? Long standing B-12 deficiency can also cause peripheral neuropathy... I'm proof of that.
Without thyroid hormone test results and reference range, there really isn't a whole lot I can tell you... Have you ever had your thyroid tested?
Once I see the test results the thyroid test results you have I'll be able tell whether they tested adequately (most likely not), and what those results might indicate...
Just because a B-12 test result was in the normal range, doesn't mean it was good... anything under 500 can cause symptoms of deficiency.
If you're having trouble with hair, nails and skin, that can be a thyroid condition - often hypothyroidism or iron deficiency.
Vitamin D deficiency can also cause a lot of thyroid-like symptoms, as can magnesium deficiency.
Most people (including doctors) don't even consider vitamin deficiencies when they have like these.
Both, iron and vitamin D are necessary for adequate metabolism of thyroid hormones. Deficiency of both, is often present in hypothyroidism/Hashimoto's... IF you have a thyroid condition, it sounds more likely that it's early (hyper) stages of Hashimoto's than Graves Disease, because it seems to come and go.
You need "all" 3 of the antibody tests I mentioned above in order to confirm or rule out either/both of those conditions. A few people have them both, with one or the other dominate at a given time.
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