TSH and hyperthyroid

[TTandnowhyper]

Hi, I have been hyper or 4 months now and I am 9 months post TT for thyroid cancer. My last TSH  was .02 and I have been on 100 thyroxine daily. Iv been off work because my symptoms are very bad. What should my levels be? I'm in Australia and won't see my Endo til December .
THANKYOU

[TTandnowhyper]

Hi again, I just got some bloods back and was hoping you can help with what they mean???
My octor is away and I'm waiting on an earlier appointment with the Endo bc I am still feeling I'll.
I know I need to have a suppressed  she said undetectable but can't function when I'm on a higher dose. Could I be allergic to thyroxine tabs I'm taking??
Here goes
TSH 0.03.    Ref 0.05- 4.0
Ft3 4.8.               3.5-6.5
Ft4 20.3.             10.0-19.0

They seem alright?? Although I don't really know if my results are ok

[TTandnowhyper]

Heap... Had my RAI and it went well. No more camcer so that's great news.
Didnt realize how hard it would be with meds :(

What are your symptoms, are you doing ok with it? I hope you get there. A lot of these sites have stories and info that is always insightfull. It can be a long time but there is always the time of when you will get there.

I have realised to monitor my hyper, every time my tsh is low I need to reduce my meds. Mine has been undetectable because it needs ro be suppressed post surgery for at least a year so trying to find the right dose is a nightmare.

You will get there it's just trying to be patient. Take time off if tou need, your health is more important ;)

[firefly7]

Sorry to hear about your thyroid cancer - that's got to be rough.  Do you have to have radiation treatment on top of the thyroidectomy?    About anemia, I take iron all the time but it doesn't seem to get absorbed, my red blood cells remain tiny.   And yes, Graves makes you hyper....I'm taking meds for it and it is a long road to remission but I hope to get there.   Have you seen the Dearthyroid website?  There's a lot of really moving submissions there from people who had thyroid cancer among other thyroid maladies, you might like. Be well!

[TTandnowhyper]

Yeah I'm quite new to all this also... I didn't know much about any of this til I was accidentally found to have stage 2 Thyroid cancer.
When we were doing blood work before the surgery I found out I had it. It automatically makes you anemic :(
Every time I have ended up in emergency they also tell me once my bloods are done and apparently there isn't anything you can do. I am just going to take supplements daily and see if there's a change.
I don't know much at all about graves, but are you being treated? Does it make you hyper??
Hope your doing well :)

[firefly7]

Hi Ttandnowhyper, I've read about other people having delayed effects with replacement hormone so I hope it works out for you.  It's so frustrating to have one's wellbeing jerked around with these hormones.   Still I don't know much about the post-thyroid end of things as I'm still a relative newbie with Graves.  ATD's are antithyroid drugs like methimazole and propylthiouracil.  How did you get diagnosed with thalasemia?   For a while my docs thought I had it but then changed it to microcytic anemia instead.  

[TTandnowhyper]

Hi firefly,
I was GREAT on 100 per day a few months ago. When it was increased to 150 then down to 125 and now back to 100 I'm assuming because this is my 3rd week on this dose I am still getting hyper symptoms??? Until it settles in??
I don't want to be on beta blockers as my doctor suggested because I have very low blood pressure anyway. So I may just avoid that for now and see how I go the next few weeks.
I'm soooo tired all the time too but this just may be due to me having thalasemia which makes me aneamic.

What are ATDs??

[firefly7]

A question for you as I'm still learning all this.    TTandnowhyper's symptoms sound like straight up hyperthyroid symptoms to me - why couldn't 100mcg just be too much for her/him?    Just curious where you see the hypo in this.   I find a lot of confusion for myself as my levels change due to ATD's getting a mix of hyper and hypo symptoms.  

[gimel]

Sorry, I can't suggest anything on that subject.  Was your doctor fully aware of your low blood pressure when he prescribed the beta blocker?  

[TTandnowhyper]

So I went to see my GP today due to a cancelation.. Great.
I had a new set of TFTs done and will get results next week.....
He has decided to put me on a beta blocker because of my symptoms. After checking my blood pressure he said he wants me to take half a tablet 2 times a day.
My loos pressure is slightly lower then low so I am not sure if it's a good idea to start taking this?
I have been trying to research about them and they seem to be very dangerous.
Having low blood pressure already should I just avoid them and take half a Valium instead?

Hope I can get some advice :)

[TTandnowhyper]

Thanks again for that. I will ask for those tests.
I know I have thalasemia, there for I am aneamic and all,doctors say that isn't an issue to be effecting my bloods.
Its a nightmare and like I said I was soooo good before, it's just been these last few months have been a nightmare.

I'll post my labs when I can :)

THANKYOU for already giving me an insight.

[gimel]

Many times hypo patients starting on thyroid meds find that they have reactions to the meds.  It can be due to the dosage itself, or other factors.  In your case, the 100 mcg of thyroxine would not seem to be even a full daily replacement value.  So the reactions you have make me think there may be other things involved.  

We occasionally hear from members who have started on thyroid meds only to find they have some reaction related to either adrenal fatigue and associated low Cortisol levels,or else they have low ferritin levels.  It is highly recommended that either issue should be addressed before starting on thyroid meds.  Not sure how things work in Australia, but if possible, in advance of your Endo appointment, I would try to get your GP to go ahead and test for ferritin, and a full iron test panel.  I would also suggest a 24 hour saliva (or urine) test for cortisol levels at different times during the day.  And of course, you should make sure to get tested for Free T3 and Free T4, along with TSH.  Since hypo patients are frequently low in other important areas, I would also test for Vitamin D and B12.

If you are successful in getting those done, then please get a copy of the lab report and post results and reference ranges and members will be glad to help interpret and advise further.  

[TTandnowhyper]

Thank you for your response. My last labs that I have are TSH <0.01  and Ft4 25.4 that was early October. Since then I only have TSH 0.02. A specialist I saw last week said that my meds were too high as my TSH  was undetectable. I am extremely hot all the time even if it is cold outside. I have heart palpitations, fast heart beat, shortness of breath, dizziness and feeling like I need to vomit all the time. Tremors are a nightmare. I am always sooooo tired yet am wide awake when I try to sleep. I also find it hard to concerrntrate, I have to take a second to even think of what I was talking about.
My next Endo app is in December and I'm seeing my GP in a couple of weeks to see if maybe the cancer has come back. I think I might try having 75 four days a week and 100 three days??
I just don't know how I was ok post surgery for months on 100 and now I can't even cope with driving to the doctor.

Hope this helps :)

[gimel]

Many thyroid patients taking large doses of thyroid meds often find that their TSH becomes suppressed.  This does not automatically mean that you are hyper, unless you do have hyper symptoms caused by excessive levels of the biologically active thyroid hormones, which are Free T3 and Free T4.  Have you even been tested for Free T3 and Free T4 (not the same as Total T3 and T4))?  If so, please post results and their reference ranges shown on the lab report.  

Also, please tell us about any symptoms that you have.  I'd be more inclined to think you have hypo symptoms, rather than hyper symptoms.  I say that because frequently patients taking T4 meds find that their body does not adequately convert the T4 to T3, resulting in a Free T3 level that is too low in the range, and hypo symptoms.  Many of our members, myself included, say that relief from hypo symptoms required free T3 in the upper third of its range and Free T4 around the middle of its range.