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Low TSH high Free T4 & T3 uptake = Thyroiditis?
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Low TSH high Free T4 & T3 uptake = Thyroiditis?

Ok, I was reading another post regarding the T3 level.  It sparked curiosity within my own situation.  I go back to see the Endro tomorrow.  The last time I was there, he didn't want to run anymore blood work.  Anyway, in the post I was just reading (I realize now that it was Free T3 whereas mine is not Free), there was a reply from mtkst13 that stated:

"you have t3 thyrotoxicosis/hyperthyroidism.  you must be very anxious and have heart palps?
you need to have further testing to determine the cause...graves vs thyroiditis vs hot nodule.
did you have any other blood work done?  you'll need more blood work done (antithyroglobulin, antiTPO, TSI, etc) and an iodine uptake scan (high uptake indicates graves, low uptake indicates thyroiditis, or you could have hyperfunctioning nodule) "  (yes, I have the anxiety (easily aggitated mostly) and heart palps)

As I stated earlier, my Endro doesn't want to run any more blood work (the most recent was done in Feb.).  He went straight to suggesting RAI treatment, stating that I had Hyperthyroidism.  

These are my labs:  (images of my scans and US are in my profile)
May 26, 2005:
   TSH - 1.82 (0.350-5.500)
   T4 - 8.0 (4.5-12.0)
   T3 Uptake - 30 (24-39)
   Free Thyroxine Index (T4?) 2.4 (1.2-4.9)

Feb. 20, 2009:
   TSH - 0.05 L (0.40-4.50)
   T3 Uptake - 39 H (22-35)
   T4 (Thyroxine), Total - 18.2 H (4.5-12.5)

Feb 26, 2009
   4 hour uptake - 16.2% (5-15%)
Feb 27, 2009
   24 hour uptake - 51% (12-35%)

May 21, 2009
   4 hour uptake - 13.9% (5-15%)
May 22, 2009
   24 hour uptake - 41.1% (12-35%)

My scan and uptake results have come down since February but are normal to high.  It was stated that no nodules, cysts nor goiters were seen/detected.  The readings at this point do not suggest Graves but lead more towards Thyroiditis.  What is your take on these results?  Would you have the RAI treatment or opt for oral meds first?  (I'm leaning towards the meds myself, if for not reason other than I want to know more before doing something permanent and because my results appear to be better on their own in a 3 month period.)
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442 Comments Post a Comment
Avatar n tn
Sorry to hear about that man.  I'm going through some really crappy stuff too with similar results.  Bad part for me is it has been two months after I took the I-131 radiation treatment and my tsh is rock bottom low, and both my free t3/4 are 2-300% the normal rate.  

...just heard I need to take off work for a minimum of four weeks and want to punch a wall....I cant take this **** forever.  Going crazy...
393685 tn?1425816122
How do you know you don't have Graves? I see the uptake scan results but you have no blood labs supporting anything.

I cringe when I read someone "care provider" ( endo) wants to immediately ablate the gland without trying medication first.

That really steams me....

No one can "tell" you what's best - but I would like to point out that if you move towards RAI without even trying the meds - you might regret it.

I'd like to also point out to the above poster, First - I am sorry to here how frustrated you are. I can tell you that after 6 weeks - post RAI - that is not long enough to get your thyroid in die off yet. Usually you will see stability start 3 to 6 mths after the procedure and it can take a year or so to expect where you could be at permantely.

RAI is not a quick fix for either situation ( hyper or Graves).  It's a process and can take some time.
393685 tn?1425816122
About the T3 t3 thyrotoxicosis. That "could' be an issue for you. But it seems like the endo treating you - ran minimial testing and that diagnoises will not be made - based off what you had done so far.
877337 tn?1249848050
Yup, I agree.  Not enough testing.  I have put in for a referral to another doctor for a second opinion.  The current Endro did say that he would treat me with meds if that was my choice but I don't think he wants to .  I hope and pray they will do the antibodies test.  Thanks for the input.
Avatar f tn
Tell your Endo to put you on PTU, Carbimazole or Methimazole to BLOCK the thyroid until you find out if you have Graves.
DONT go with 'the flow' and do as he asks with RAI.
If your Endo was any good, he wouldve had you on antithyroid meds as soon as he got your labs.
The ATDS give you time to research ALL options.
And I am a surviving RAI patient who is 11 months down the track doing well.

But I might add......a lot who dont do well are those who dont understand their condition or who know nothing about Hyperthyroidism/Hypothyroidism and Graves.
You are hyper at present and need to research it all THEN research Hypo as thats where you are headed after RAI until you balance out yr meds and stabalise your levels.

Dont get 'swept away' by the old saying....'But you will only have to take one pill a day after RAI".
That is utter bull.
Get on the antithyroid meds for a while and see how you go.
As I said, it gives you time to read, read and more read.
Take control of your its you who has to suffer the side effects of Hyper/Hypo/Graves.

It is your body and your desision.
If there is just 1% doubt about RAI...hold off.
You must be 100% sure to proceed with it.
Harsh words from me, but I say it as I see it.
Good Luck :)
877337 tn?1249848050
No harsh words at all!  You put my thoughts to voice.  Thank you.  I have requested a referral to another Endro.  If that doesn't work out as hoped, I will request the meds.  Either way, I plan to request meds and give it plenty more time before seriously considering RAI.

Thanks again!

No, on the meds, do they help with the symptoms as well?  Now that I have some names of them, I will look them up as well.
393685 tn?1425816122
""""To shay Deb""""""

I luv her!  :)

Both Deb and I have very similiar backgrounds with Graves. We both had RAI.

She did fairly well --- I did awful.

Regardless - it alters you after the ablation. It's not a quick fix and I believe "only the strong willed" take the time to figure THEMSELVES out and learn how to get back on track after that procedure.
Avatar f tn
It takes a lot of hard work, a very PATIENT partner and a lot of tears.
But you CAN get there.
When on antithyroid meds...just watch as you can go hypo very quick.
Learn the symptoms, learn what your body is telling you and LOG EVERYTHING down as brain fog is a b*mmer lol.
Many times I would refer back to my 'notebook' to see if I was hyper or hypo as I just wasnt sure because of both hyper/hypo symptoms.
I now call my 'notebook' ...My Bible :)
You will become 'obsessed' so to speak about yr thyroid and symptoms but if thats what it takes to achieve WELLNESS, then so be it.
I know my kids thought I was 'possessed' at one stage , they even thought I had OCD as I spent hours, days, months on the net reading everything I could get my hands on.
Yeah sure a lot of people will turn their backs on you, a lot will say yr a 'moody snappy c@w' but wouldnt they be if they was fighting for their sanity??

You will come out good in the end.........
Just take baby steps, tell your Endo to go have the RAI for you and if you do need the RAI, then at least you will have gemmed up on it all and understand every symptom you have.
Let us know how you go and send my regards to your Endo and ask him..."Would you have RAI if it was you?"
Watch his him NOT look you straight in the eyes, wait for his hesitant answer.
There will be your answer.

RAI is not bad, it saved my life but you MUST be prepared for it to get through it.
You must know it 'inside out' just as you must know about hyper/hypo.
Until you do...sit on the ATDS and take your time.
Take Care :)
Avatar f tn
I went to hell and back Stella before RAI...I wont lie here as I dont need too.
I was determined after RAI ...NOT to go to hell and back like before.
It was a lot easier for me after RAI but I still read up on Graves and HyperT and I still research.
Knowledge is POWER.
And like most of us here, wouldnt wish thyroid problems on anyone.
No-one can see the debilitating effects that it can have on your life.
People look at you and think....'whats she on about? She looks ok."
Yet deep down inside is a person struggling for their life, their sanity and the 'old you'.

I got back 99% of WHO I am and was.
99% is good enough for me.
Stella you are amazing how you are here helping others.
Dont ever leave this site as you and AR-10 were my lifesavers.

Hugs x

I have my one year anniversary of Divorcing my Thyroid on the 27th June lol :)
649848 tn?1424570775
All of that was very well said, Deb -----------

A lot of us are in he// and hoping to get out soon......... Am so thankful for you, Stella and everyone else on here for all your help getting through all this.........
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