Thyroid/Graves Disease

[mom_of_amn]

Symptoms: exhaustion (extreme), poor memory, anxiety, depression, complete loss of sex drive, slight hair loss, brittle nails, moody.

Have been diagnosed with "graves disease". I underwent RAI treatment. 10 weeks post RAI my TSH is .006, T3 is 5.4, T4 is 2.24. I feel no better, have been back to my Endo and nothing. No medication. My symptoms persist. I have also begun experiencing occasional palpatations of the heart. Nothing is better.

What can I do, what is going on with my body? any insight would greatly be appreciated. I feel as if my symptoms are debilitating.

[Samanthah44]

I have Graves disease so my thyroid is all messed up. I was diagnosed in 2015 at 16 with TSH levels at about 420. I went into remission for the last 2 years after taking Methimazole but my thyroid levels have reached over 200 so I'm taking a radioactive iodine pill in the fall before I go back to college. From my understanding being on no medication after the thyroid has been stopped can be the reason for your exhaustion. Your thyroid is directly related to your heart. I mean it literally tells your heart how fast to pump blood. Because all this is happening can cause the "side-effect" of anxiety, depression, etc. The mostly known medication to make up for this loss of hormones due to the RAI, is synthroid.

[gimel]

Samantha, I just wanted to give you this information in preparation for the aftermath of your RAI.  Of course you will need a full daily replacement amount of thyroid hormone, and most doctors only prescribe T4 meds like Synthroid, which frequently  results in inadequate conversion of the T4 to T3 and thus less than optimal levels of Free T3.  Many doctors prescribe just enough T4 med to bring TSH back to a level that suits them.  This does not work because typically  Free T4 will remain too low and Free T3 even lower in its range.  

Hypothyroidism correctly defined is not just insufficient thyroid hormone, but instead it is  "insufficient T3 effect in tissues throughout the body, due to inadequate supply of, or response to, thyroid hormone".  Inadequate Free T3 results in hypothyroid symptoms.   In fact, a recent excellent scientific study concluded that,  "Hypothyroid symptom relief was associated with both a T4 dose giving TSH-suppression below the lower reference limit and FT3 elevated further into the upper half of its reference range. "  To achieve these levels frequently requires both adequate T4 as well as a source of T3 in your med.  

In addition, the tissue response to thyroid hormone is affected by a number of variables including Vitamin D, B12 and ferritin, so you should make sure to get those tested and supplement as needed to optimize.  D should be at least 50 ng/mL, B12 in the upper end of its range, adn ferritin should be at least 100.

So please keep this info handy as a reference for discussion with your doctor, in order to try and get the treatment that will be needed.  If the doctor resists, and only wants to pay attention to TSH for treatment then you will have to change his mind or find a good thyroid doctor that will treat clinically by adjusting your Free T4 and Free Te levels as needed to relieve hypo symptoms.   Symptom relief should be all important, not just test results.  If you want to confirm what I say and also have a paper you can give the doctor, then click on my name and scroll down to my Journal and read at least the one page overview of a full paper on Diagnosis and Treatment of Hypothyroidism: A Patient's Perspective.  

[stella5349]

RAI - is definately an adjustment and your labs do not indicated needing any medication at this time to giv you more function. Are you still on antithyroid medication? or any beta blockers>?