Aa
Aa
A
A
A
Close
Avatar universal

First appointment

6 months ago had a eandom blood test for back came back hyper which was a shock as felt well. My tsh was 0.01 (0.1 -4) t4 was 36 (7-24) t3 was 19(3-6). I felt fine normal no pulse   6 months later my results tsh 0.01 t4 24 t3 12 tpo negative.           Was pleased my results seem to have gone down in medicated.      Seen today for first appt. the endo  wants to start on 40 mg and when I  questioned dose being high. Since I have no symptoms .  He said I will probably have mood swings and feel agigatated I would probably gain weight and feel tired .its wouldalso e likely that I would be hypothyroid  I am worried about these effects since I work full time and lone parent of 3 I really do t have any symptoms other than feeling a bit tierd.    I do t want to come across as-ignorant but I  think all they are thinking about is numbers not my symptoms.  He didn’t ask if I had any symptoms.I have made some changes eating clean and gluten free is there anything else I can try  
1 Responses
Sort by: Helpful Oldest Newest
Avatar universal
Doctors don't understand that a person's thyroid status is a result of T3 effect in tissue throughout the body due to both the supply of, and response to, thyroid hormone.    Except at extreme levels TSH has only a negligible correlation with TISSUE TE EFFECT, and thus is inadequate as an indicator of thyroid status.    Free T4 and Free T3 have only a weak correlation with TISSUE T3 EFFECT, and are useful mainly to support clinical evaluation for symptoms that occur more frequently with thyroid issues than otherwise.    Since there is no direct measure of TISSUE T3 EFFECT, and associated thyroid status, an integrated approach is best, including a full medical history and a clinical evaluation for symptoms, supported by  expanded biochemical testing.  

I am sure your doctor's diagnosis and proposal for prescribed antithyroid med was primarily based on concern for hyperthyroidism, due to the TSH result, combined with high levels of  Free T4 and Free T3.   Your lack of any identified symptoms was obviously ignored in this diagnosis.  It seems to me that more tests should have been done to identify the possible cause for those test results.  To assess the possibility of Graves' causing hyperthyroidism, a test for  Thyroid Stimulating Immunoglobulin (TSI) could have been done.   To find out if the problem was due to nodules on your thyroid gland causing leakage of thyroid hormone faster than normal,  since TPO ab was negative a test for   Thyroglobulin antibodies should have been done to check for Hashimoto's Thyroiditis.  

Especially in view of having no symptoms, and also your personal situation, I certainly would not want to immediately go on antithyroid med at a dose like that, which as mentioned might quickly cause you to become hypothyroid, with all the unwanted symptoms.   I would take a more cautious approach and get the additional tests done and then consider options.   If you can get those tests done and you would like our opinion of results, please post them here, along with reference ranges shown on the lab report.  

There are also several types of thyroiditis which may start with a hyper phase, and then go to a hypo phase.  Have you had any discomfort or irritation in the thyroid gland area?
Helpful - 0
Have an Answer?

You are reading content posted in the Thyroid Disorders Community

Top Thyroid Answerers
649848 tn?1534633700
FL
Avatar universal
MI
1756321 tn?1547095325
Queensland, Australia
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.