How Fast is Too Fast?

[liyalyn]

My TSH level is 0.07.  I realize that means I have hyperthyroidism.  My primary care physician examined my neck, looked at my eyes, and listened to my heart.  She said that my blood pressure and heart rate were consistent with what they'd been over the past few years.  My CBC came back normal.  My fasting glucose was 109 on one day, but about 5 days later, it was 94, about two hours after eating lunch.   I am in my late 30s.  I have a sister who has Hashimoto's disease.  Once, she had to be cardioverted because her thyroid caused her heart to beat so rapidly, and the medicine they used didn't slow it down.  My PCP still wants me to see an endocrinologist, even though this isn't cancer.  Could it be Hashimoto's?  She mentioned they will need to either give me medication, or do something else--I didn't catch the term.  Does anyone know if how I might be treated?  I wonder if it was a fluke test.  I feel fine, just exhausted.  I thought hyperthyroidism was supposed to make you have a lot of energy, not feel exhausted.  I don't want them to slow my thyroid down so much I gain weight.    

[liyalyn]

Nyxie63 and rayneweather -- thank you both so much for your feedback.  It was very helpful.  I have an appt. w/10 days w/an endocrinologist, and he's chief of staff, so I trust that to mean he'll be well informed.  Your responses have helped me prepare for the appt.  I still think the test must be an error, but maybe that's just denial.  I have gained a lot of weight in the past 3 years, and I'm out of shape (previously was a long distance runner), so I've been blaming my breathlessness and excessive sweating on the fact that I'm out of shape and fat.  My pcp didn't find any large nodules on my thyroid, so I feel kind of silly.  I know 0.07 is supposedly a low reading (meaning hyper), but because of my own bad habits, I can't help but think this is somehow a false reading.  If the endo doesn't find any other signs of hyperthyroidism, I will ask to re-take the blood test.  I am trying to take your advice to heart though, and to accept it that not everyone has symptoms at first.  thanks again so much for your feedback--it helps so much to have input from people who have been there!

[rayneweather]

Welcome to the board.  Nyxie is right on.  1 TSH by itself cannot determine what is causing your hyper state.  Hashi's is an autoimmune disorder and autoimmune disorders run in families - not necessarly the disorder itself but the likelihood of having any autoimmune disorder.  You asked about the treatments for hyperthyroidism and there are 3 - medication (anti-thyroid meds methimazole and PTU), radioactive iodine (RAI) and thyroidectomy (partial (PT) and total (TT)).  The decision on which to use is based upon the cause of the hyper state and any findings of cancer.  I had many nodules through my entire thyroid and although none of them showed up as cancer on the fine needle aspiration (or biopsy) (FNA) I grew a goiter (swelling of the thyroid itself) which was pushing on my windpipe.  This was after having been on medicine for 1 year, going into remission & coming off the medicine and then becoming hyper ago 3 1/2 years later.  By that time my goiter could be seen by anyone.  I also have a mild case of Grave's disease (the autoimmune disorder that causes you to be hyper) and in rare cases (but it happened to another of my endo's patients) the RAI can make the Grave's worse.

It is more common for people who are hyper to have a lot of energy & be able to lose weight but that's not always the case.  Some who are hyper never see those symptoms.  In fact, when I came out of remission my joints & muscles ached and I was so tired that I thought I had lupus.  Very different symptoms from the first go around.  It always is a concern about going too low and having difficulty losing weight, I know it was a big one of mine.  It may be something that you may go through but for most people once they get their thyroid squared away on a therapeutic level of whatever medicine they're on they find that it's not any more difficult to lose weight than it was prior to the thyroid acting up which, unfortunately, is still difficult for some of us :-)

The thing that I always strongly urge everyone who is going to see an endo for the first time for thyroid issues is to make sure the endo sees *lots* of thyroid patients.  Many endos see mainly people w/ diabetes and really are not good at caring for people w/ thyroid issues.  I found this out the hard way myself when my first endo would never explain anything and would treat me like an idiot if I asked any questions.  She was more concerned about me losing weight so that I didn't go from pre-diabetic to diabetic.  It wasn't until I switched to someone else & started getting great care that I realized why I was so unhappy and why the first one was so bad.  

Like any disease not everyone has a lot of symptoms when they're first diagnosed but it's important to receive proper care because any disease left untreated can cause a lot of problems.  The thyroid affects so many parts of the body and so many other symptoms that it's really important to get treated.

Welcome to the board and please feel free to ask any questions.  :-)

Rayne

[Nyxie63]

The only way to find out if you have an autoimmune thyroid disease is to get your TPO and Tg antibodies tested.  I'm surprised your dr hasn't done this already, considering your family history.  You could be in a hyper stage of Hashi's, which can fluxutate between hypo and hyper.  You could have Graves.  You could have hyperthyroidism without the added autoimmune disease bonus.  Treatment will depend on what they find in the antibodies test results as well as other tests they'll run.   Go talk to the endocrinologist.

Please keep us posted. :)