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Thyroid (Expert Forum)
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Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
Questions in the Thyroid forum are answered by Dr. Mark Lupo. Topics covered include goiter, graves disease, Hashimoto's thyroiditis, hyperthyroid, hypothyroid, thyroid cancers, thyroiditis, and thyroid stimulating hormone (TSH).
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by OSamPeabody, Sep 05, 2007 10:34AM
I am a 53 y/o woman with who was treated with synthroid 0.5mcg for 2 years for hypothyroidism. My TSH was very mildly elevated and I had antibodies. My T3 and Free T4 were normal. My levels were monitored every 6 months and recently my TSH decreased to 0.005 so my doctor discontinued my synthroid. After 2 months off medications, my labs essentially remained unchanged. My most recent studies demonstrated a TSH of 0.004, a T3 of 5.3 and a Free T4 of 2.01. I also have receptor antibodies of 2.5. Except for anxiety, I did not think I was having much in the way of symptomatology...until my tests came back....now I am a little more sensitive to any little symptom. My internist wants to meet with me to discuss options. I prefer a more natural approach, but realize that may not be realistic. What would a reasonable option be for a person presenting with these findings?
Doctor's Answer
by Mark Lupo, M.D., Sep 05, 2007 08:30PM
, Sep 05, 2007 08:30PM
Looks like you have auto-immune thyroid disease that has transitioned from borderline hypothyroidism to overt hyperthyroidism (Graves Disease) OR you have a thyroiditis that will be transient and then you will likely go back to hypothyroidism.
To sort this out would do an I-123 uptake and scan -- in thyroiditis the uptake is very low while in Graves it is normal or elevated.
In thyroiditis, no treatment (except for symptoms) is indicated. In Graves the options are anti-thyroid drugs vs I-131 for surgery -- given the history of hypo/hashi, would try anti-thyroid drugs first in this case (after discussing risks/benefits w/ your doctor).
No alternative/natural options that are great -- avoid "thyroid support" type meds -- these have iodine which could be used by your thyroid to make even more thyroid hormone. Selenium 200mcg/day is the only "natural" approach that has a proven effect but this is in combination with the other therapies.
To sort this out would do an I-123 uptake and scan -- in thyroiditis the uptake is very low while in Graves it is normal or elevated.
In thyroiditis, no treatment (except for symptoms) is indicated. In Graves the options are anti-thyroid drugs vs I-131 for surgery -- given the history of hypo/hashi, would try anti-thyroid drugs first in this case (after discussing risks/benefits w/ your doctor).
No alternative/natural options that are great -- avoid "thyroid support" type meds -- these have iodine which could be used by your thyroid to make even more thyroid hormone. Selenium 200mcg/day is the only "natural" approach that has a proven effect but this is in combination with the other therapies.
