Is being hypo better or rather, less dangerous than being hyper?

[Lis163]

Ok,
After reading quite a few posts here I am a little concerned.
I have Graves disease and I am about to have RAI in about 6 weeks time or so, once I am euthyroid.  However, after reading some of your posts I am a little worried.
There is the risk of a thyroid storm or heart problems and other staying hyper.  My heart beats per minute are in the vicinity of 95-100, done two days ago. I am having no stimulants and basically have just stopped doing everything apart from running my kids around.  I have been resting for six weeks and still my heart rate is a little high.  Hence, after fighting for my thyroid for 9 years, I am frightened into having my thyroid ablated.  I am told that the anxiety and panic attacks will go away once I have this done, and all other hyper symptoms will go away.
Is it really any better in the long run?  There is the risk of too slow a heart rate, hypoglycemia, menopausal sypmtoms, high blood pressure and it seems the list just goes on and on.
What should I do?  Any advise please from anyone would be most appreciated.  I know that nobody can decide for me, but to just hear your stories would help.  

Cheers, Lisa

[gimel]

Many people find that they are inadequately medicated after a thyroidectomy or RAI to relieve Graves' Disease.  So I wondered if you have a similar result?  We would be very happy to help interpret your current thyroid related test results if you will post them, along with reference ranges shown on the lab report.  Also, what thyroid med are you taking and what is the daily dose?  Please tell us about any symptoms you have.

[Sasheika]

Hello I was diagnosed with Graves disease thyroid(hyperthyroidism) last year  I bearly made it through it at some point but after the doctor told me the problem I tried to be as consistent as possible when taking my meds luckily now I dont have panic attacks anymore (rearly) anxiety has decreased lost alot of my hair my skin has not been back to normal although the doctor said it would and the last Ecg I took my heartbeat was at 142 bpm andi was told twice am on death road!! Hence I feel much better just slight chest pains now and then I've gained weight etc and thats good try to take the pills as prescribed dont miss any days and you'll be fine .

[Lis163]

Hi,
Thank you for your help.  I will ask that this will be included in my next blood test.  To date, I have not come across any doctors or specialists talking to me about Free T3 or Free T4, only T3 & T4.
I am currently reading Elaine Moore's book: Graves disease - A practical guide and find that researching more about the disease helps.  
I can't deny that I am becoming more afraid of any treatment to destroy my thyroid.  In particular RAI as there can be a very serious side effect.  From what I have read, myxedema coma is the opposite to a thyroid storm and if encountered, the mortality rate  is as high as 60% as it is a lot harder to get out of if it happens.  My understanding is that if you become too hypo too quickly after treatment it can be very dangerous to get out of and there are no quick fixes like there is if you happen to enter a thryoid storm.
Have you heard about myxedema coma before?

[gimel]

Since we only hear from patients who are  having problems, it is hard to say what the usual experience might be, but it seems that very few run free T3 unless the patient is knowledgeable enough to push for it.  Doctors always run TSH and some will run FT4 if the TSH is high, but  they want to assume that since T4 converts to T3, knowledge of the T4 level is enough.  Many doctors we have heard about have resisted, or even refused to run FT3 tests.  Even when doctors specify FT3 and FT4, sometimes the labs don't notice that the Frees were requested and they automatically run total T3 and total T4.  So it is a good idea to double check in the lab to be sure the request is clear.  

So I guess that the short answer to your question is yes, you should specifically request and insist on FT3 and FT4, and then check to make sure the lab recognizes the request.

[Lis163]

When blood tests are run, do the specialists run actual biological active thyroid hormones or do you have to specifically request this?

Thank you for your input.

[gimel]

My personal experience is with Hashi's, not Graves; however,  many posts I have seen on this Forum were strongly of the opinion that they would choose hypo before hyper, any day.  From what I've read,  meds to offset the effects of Graves, seemed to be only a relatively short term solution, so a permanent solution becomes necessary.  

Most of our members who have suffered from Hashi's, or the aftermath of RAI or a TT for Graves, seem to find Hypothyroidism much easier to live with, once they get the proper care and medication.  The most important part is to find a good thyroid doctor that will treat your hypo symptoms by testing and adjusting the actual, biologically active thyroid hormones, free T3 and free T4, with whatever type of medication is necessary to relieve symptoms, without being constrained by resultant TSH levels.