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Graves Disease with High TSH and Low Platelet Count?

I was diagnosed 2 years ago with Graves (I had the testing done at 6 months postpartum and my TSH was 0.01 but my antibodies test came back negative.. they then did a thyroid ultrasound which showed graves on there)

I got my Graves under control through natural supplements, homeopathics and lifestyle / diet changes.

Now, I'm 6 months postpartum after giving birth to twins and in addition to my TSH and other thyroid levels being out of the normal range, my platelets are low . (I have an appointment to see a specialist for this on the 7th)

Here is what my labs look like;

TSH    45.770
T4     3.6
T3 Uptake    21
Free Thyroxine Index   0.8
TPO      <10
Platelet      63,000
(all other blood counts are normal)

I started taking NP thyroid on Thursday, I already feel as though my energy levels are restoring, but how is it that I have "Graves" but now my levels are showing hypothyroidism?

Second Question: My weight hasn't been shooting up, but despite clean eating and exercising, my weight hasn't budged after the initial drop of having my sons. Will I see a change in my weight with NP Thyroid? I can't exercise right now because of the platelet issue, but what should I expect overall from this medication as far as my weight, brittle nails and hair dryness?

Thank you so much!
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There is much to discuss, but first I am not clear about you being diagnosed with Graves' , but then you mention testing for antibodies.  What tests were done and what were the results compared to reference ranges?  Also, I don't understand how an ultrasound can show the presence of Graves'.  For example note this info in the following link.  "Our findings indicate that sonography has high specificity but low sensitivity in the diagnosis of either Graves’ disease or Hashimoto’s thyroiditis. It is therefore not possible to differentiate between these two diseases using sonography alone. Confirmation by laboratory data is also needed."


Why didn't the doctor just run a TSI test for Graves'?   Seems like it could have been postpartum thyroiditis, rather than Graves'.  That would better explain the hyper followed by a hypo phase you are going through.  

Next thing to note is the whoever ordered your tests did not do the right ones.    The Total T4, T3 Uptake and Free Thyroxine Index are outdated and not nearly as useful as testing for the biologically active thyroid hormones, Free T4 and Free T3.   Since the correct definition for hypothyroidism is "insufficient T3 effect in tissue throughout the body due to inadequate supply of, or response to, thyroid hormone, there are a number of important variables that affect response.  Those include Vitamin D, B12 and ferritin.  So you need to also get those tested and then supplement as needed to optimize.  D should be at least 50 ng/mL, B12 in the upper part of its range, and ferritin should be at least 100.

Along with that, in order to relieve the hypo symptoms you have, you need to increase your med dosage as needed to raise Free T4 to at least mid-range, and Free T3 into the upper third of its range.   What dosage of NP Thyroid are you taking daily?  

Another important thing to note is that in the future you should defer your morning dose of thyroid med until after the blood draw, in order to avoid false high results.  

Most important of all is to have a good thyroid doctor.  By that I mean one that will do the necessary testing and then medicate you adequate to relieve symptoms, without being influenced by resultant TSH levels.  Symptom relief should be all important, not just test results.  
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Thank you so much for your response! The information about the ultrasound makes sense to me, I had both antibodies tests done, both were negative (for hashimotos and graves) and I've always thought that it would be postpartum thyroiditis instead of autoimmune, but now they are thinking that my low platelets are from an autoimmune disease - now I wonder if it could be one that is undiscovered?

I am on 1 grain 65MG 1x per day. So I take that when I wake up in the morning and I don't eat until 1-2 hours after taking the medication. - good tip about the next set of labs and when to take the medication, I will write that down to remember.

I will go and have my vitamin levels checked as well, I just started taking a methylated b complex but have yet to start D.

I don't have insurance because I'm self employed, so all of this has that added layer of stress involved.
Avatar universal
One grain of NP Thyroid is not going to be nearly enough for you.   The average daily output of natural thyroid is 100 mcg of T4 and 10 mcg of T3, which equates to 130 mcg of T4.  The 130 is equivalent to 2 grains of NDT like NP Thyroid, and that doesn't take into account the loss from lack of absorption of the med.   So the expected amount of replacement NDT is 3-5 grains.    Of course everyone is different and gets different results.  That is the reason that thyroid med should be adjusted as needed to relieve hypo symptoms, without creating any hyper symptoms, rather than based on test results only, and especially not TSH.   Since you are limited in resources for testing I would start with Free T4 and Free T3, and Vitamin D and ferritin.   When you have additional test results please post here and we will be happy to help interpret and advise further.  
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