DX Graves 1 yr, Close to normal levels but mre symptomatic than ever??

[gravesguy]

I was DX Graves disease April 2015 and was put on Methimizole. My thyroid levels have been within range for the past 6-7 months with methimizole. I have been on it for a year and my levels are now normal, (actually a little hypo right now I think) and I am now feeling more hyper than ever. Super strong heart palpitations racing heart extreme anxiety with racing thoughts etc. Sometimes if my heart rate gets to high I pretty much shake.



My current labs from 4/1/2016

TSH W/REFLEX TO FT4 – 5.67, range  0.40-4.50

FREE T4 – 1.3, Range 0.8-1.8

FREE T3 – 2.9, Range 2.3-4.2



What I do not understand is how I can feel so hyper when my levels are normalized?  


I am working with a cardiologist to make sure it is not my heart and thus far has found nothing wrong with my heart.

I was stable on 10mc of meth for the past couple months and then crept up hyper barley and then was put on 15mc meth one day and then 10mc the next to equal out to 12.5mc. was on this for about 5 weeks and have now went a little hypo (according to TSH). which has lead me to opt for a total TT because I simply cannot function and am basically house-ridden


Any input would be MUCH Appreciated Thanks

[gravesguy]

And yeah now I see how you got the percent sorry just had to read that a couple times.

[gravesguy]

Ok I see thanks for the explanation. I guess I still don't know the math equation to do lol. No I only had a total T3 in Jan,
Yeah I was starting to fell hyper in Jan yes, but nothing compared to this last month as far as strong heart palps, racing heart and extreme anxiety etc.

Having a total TT in a week to take care of my graves. I am not sure if the the methimizole I am taking now has caused symptoms as well. I know after having the TT it will be a journey and hoping to get my replacement meds and dose right soon as I can.

Thank you for the info

[goolarra]

The range on your FT4 is 0.8-1.8, so the breadth of the range is 1.8 -0.8 = 1.0.  Your result is 1.3, so your result is 1.3 - 0.8 = 0.5 into the range.  0.5 / 1.0 * 100 = 50%.  

PR = (YR - LLR) / (ULR - LLR) * 100, where:

PR = percentage of range
YR = your result
LLR = lower limit of range
ULR = upper limit of range

We all have to find where we feel best.  50% of range for FT4 and upper half of range for FT3 is a guideline, a place to start only.  Once we have our own numbers, we can compare what our numbers are now to what they were when we were feeling well (neither hypo nor hyper).  

Did you feeling hyper back in January, or are your basing being hyper on your labs?  You can see that both FT4 and TT3 have dropped since January, which is expected due to your increase in meds.  Was FT3 run in January?

In my personal opinion, stability of hormones is absolutely key, especially when it comes to heart symptoms.  I had tachycardia through most of my first year on meds for hypo, as meds were being increased.  At the time I was convinced that my tachy was going to get worse the higher my FT3 and FT4 got.  However, when I found a good dose and my numbers stabilized (at their highest in quite a while), the tachy resolved.  So, I think you're right...when they're moving is not good.

[gravesguy]

This might sounds a little dumb, but how did you get that number 50% and 32%? and do you want your Ft4 and Ft3 numbers to be like 50-75% of range to feel the best?

Well yeah the more I am reading around forum I guess you can get heart palps from being hypo as well.
I was put on the 15mc back in Jan because I was going a little hyper on the 10mc. here are some labs from Jan and Mar


JAN 12 2016:
TSH – 0.25 , Range 0.40-4.50
FREE T4 – 1.5 , Range 0.8-1.8
Total T3 - 101 , Range 76-181
Also had a FERRITIN taken this day, that was - FERRITIN  - 131, Range 20-345


3/8/16
TSH – 4.11 ,Range 0.40-4.50
FREE T4 – 1.3 , Range 0.8-1.8
Total T3 - 88 , Range 76-181

I have reduced for 5 days now to the 10mc and even only did 5mc for two of the days and today the heart palps and racing are less. So I am not sure if when my levels are moving it causes more heart palps?

All I know is this last month has almost been the worst and feels like I am super hyper,

Thank you for the reply :)

[goolarra]

Your FT4 is right where it belongs, smack dab at 50% of range.  FT3 is a little bit low.  It's 32% of range, and the guideline for FT3 is upper half of range.

You're right, your numbers don't say you should be feeling hyper.  Have you considered that some symptoms "cross over" and can be symptoms of both hypo and hyper?  Perhaps you didn't need the increase.  Do you have labs from before your meds were increased for comparison?