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1446211 tn?1285698733

Positive TSI for Graves disease

my endo's office just called and told me my TSI was positive and that i have graves disease. she also hadblood drwan again and my results were:

Free T4: 3.42 [0.89 - 1.76]
Free T3: 9.57 [2.3 - 4.2]
TSH: 0.008 [0.550 - 4.780]

she prescribed me methimazole (which i havent picked up from the pharmacy yet) and im already on Inderal. both times my blood was taken my liver enzymes came back abnormal but she going to go ahead with the methimazole anyways and order my labs again in a month to check on my thyroid and liver. im concerned about taking medication that may damage my liver if i already have something going on there and dont know what it is yet.

anywho, what are the odds of going into remission once on medication?
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649848 tn?1534633700
COMMUNITY LEADER
I don't have Graves and I can't answer your question about remission, but I certainly do feel for you.  With levels like that, you must feel horrible.

There are quite a few on this forum who have Graves, so I'm sure someone will be able to answer your question soon.

Helpful - 0
1446211 tn?1285698733
funny thing is that i dont feel horrible at all. i went to my doctor for a checkup, she noticed my goiter, sent me for tests, and referred me to an endo. the endo suggested RAI, and i thought, uh, no. got a 2nd opinion and here i am , with graves. i thought i was healthy aside from being overweight and having some insomnia. guess you never know.
Helpful - 0
393685 tn?1425812522
Its very interesting that your liver is already abnormal and now you have a confirmation of Graves disease.

The liver is such a filtered organ for us with hormones and it makes perfect sense since your labs came back odd there - to look at how the liver is really processing all this causing your thyroid hormones to be so excessive.

HAve you thought about getting information on how to balance back out your liver to see if that fixes the thyroid issue?

As for the antithyroid medication - in ethic medical treatment - only long term therapy with these drugs will damage the liver but you bring up some very interesting thoughts for me thinking if the liver is sick and now you are adding more to make things possible worse could this not be the right treatment for you?

Let me as what took you to the doctor in the first place to find the Graves?
Helpful - 0
393685 tn?1425812522
I think another strong theroy here could be an iodine issue for sure. Even though you are high on thyroid labs the goiter is present so low iodine may be something to read about.

It sounds like the network of doctors you have wouldn't even look at liver cleansing or iodine issues so you may find better information and suggestions looking at Integrative Medicine to get more possibilities. .. for sure.
Helpful - 0
1446211 tn?1285698733
im so confused. so you think theres a posibility that my liver is causing my thyroid issue? even with graves present? i am also exhibiting some TED(look at my profile pic, you can tell). i have an appointment with an opthomalogist in 2 weeks.

i just feel like im damned if i do and damned if i dont at this point with all the options. RAI, cant see my kid for 4 days and it could aggravate TED. Meds, can affect my already funky liver and may just be a short term solution anyways. Surgery, could have damage to my vocal cords and leave a terrible scar on my neck. which is the lesser of all these evils? i dont know. all of this is just so confusing,

are you saying my iodine can be too low? or that i should try lowering my intake and seee if that helps?
Helpful - 0
393685 tn?1425812522
If you have TED and that has been confirmed? - then RAI would NOT even be a thought regarding the removal and they would go to surgery if the gland is in a critical state causing more issues like this?

Yes in a sense the liver can be one of the reasons why things are out of control - so can the immune system and other things.

You didn't express anything but a routine appointment and them finding Graves in your blood with a goiter =- prior when I commented. Now you have onset Thyroid Eye Disease and that changes things some too - but definately RAI is not an option based off what you say here so far.
Helpful - 0
1446211 tn?1285698733
sorry, i have to remember that you probably read a hundred new posts a day and would not remember my previous posts. i didnt think to re-post my whole story.

i went to my regular doctor for a check-up. upon examination she noticed my goiter. she sent me for labs to check my thyroid and also ordered a thyroid ultrasound. the u/s results came back multinodular goider and the labs came back hyperthyroid. she then referred me to an endochronologist. i went to the endo and he just gave me a prescription for inderal and a print out on RAI. i noticed one of the symptoms could be "staring" or appearing wide-eyed. i expressed my concern to the endo that i thought i could have graves because my mother kept asking me what my problem was and why i was staring at people like i was. she also said " whats up the the carol burnett eyes" i had not even noticed that anything was up with my eyes until she mentioned it. so i asked endo if RAI would clear up the eye issue, to which he replied "yes". then i get online and start reading and researching for myself and read that RAI can aggravate TED. this endo took no time to explain anything to me and i thought that was ******. so i came on here and posted some questions. based on what some of you guys advised about my labs i decided to get a 2nd opinion. so i went to another endo who was very knowledgeable and who took the time to explain everything in detail. she also had my blood drawn again, this time testing both Free T3 & T4 and TSI. she stated that she could tell i was exhibiting some TED, especially in my right eye and that she was going to refer me to an opthomalogist. so i have an appointment scheduled for 10/20. i just got a call yesterday from the endo office stating that my TSI was positive for graves. surprise surprise. so i just started methimazole 10mg twice a day, even though my liver labs are abnormal. so yeah

im just frustrated cause i didnt realize all this stuff was happening in my body(like i said i thought i was healthy) and i feel like my options are limited. im really concerned about my eyes but i figure ill have wait and see what the opthomalogist says before i start freaking out about it.
Helpful - 0
Avatar universal
Stella - look up marine lenhart syndrome (multinodular goiter and grave's together).  I am similar to your story.  My PCP dx me with hyperthyroism 2 years ago (0 tsh, borderline high t3 and t4).  At that time I was having wt loss, fast HR, insomnia and was sob with exertion.  I went to an endo who wanted to watch me since myt3 and t4 were borderline.  Within a few months, my ths was completely normal and my t 3 and t4 were low normal. The endo recomm I continue to check my tsh every 3 to 6 months.  I checked it again this past July (it had been about 6 months) and my tsh was 0 again and my free t3 was high and my free t4 was 2.09.  This time I have absolutely no symptoms exept some insomnia sometimes.  I went back to the endo who did a RAI uptake test (DID NOT HURT THE THYROID - just to check the uptake/scan).  The scan showed multiple nodules and an uptake of 61% and my TSI (grave's antibodies were 290 - nl to 175).  My endo gave me tapizole in Sep (no liver tests were done at all) but I decided to wait another month before startin tapazole (see if I go into remission like I did 2 years ago).  I was also told to take inderal.

Is your heart normal?  What is your heart rate per minute?   we'll have to keep each other informed.  
Helpful - 0
Avatar universal
I have Graves and was on Carbimazole for 12 months.
My Liver enyzymes were HIGH due to the Graves antibodies being high (over 4000).
This was before treatment of anti-thyroid meds were even started.

Anti-thyroid meds also upset the liver as does a lot of other medications.
The enyzmes have to be well into the 1000's for any long lasting effect on the liver.

I am now 2 yrs 3 months post RAI and 2 yrs Post TT and my antibody levels are 4 and my liver enzymes within range.
My antibodies went into remission 4 months after RAI.

Just have regular testing done on the ALT and AST enzymes.

It may be worth mentioning to you...even antibiotics cause the liver enzymes to rise.
I hope thats of some help to you.

Helpful - 0
393685 tn?1425812522
I am so glad that the board helped you make a decision to get a second opinion and this doctor really saw the TED starting. So many patients find that they get pushed into a quick RAI and then TED rears its head - there is little to stop it after the RAI was already done.

I don't know what else to really suggest here since you are still in the beginnings of finding out everything still with other doctors ( ie TED) but there is evidence you are having an autoimmune hyper attack going on and you really need to dig deep learning to make a good decision down the road.

One thing is cardiac is a concern for many hyper patients. It should be for hypoT's too but really the T3 hormone in hyper is very powerful and needs to be checked. Make sure who ever does your thyroid treatment is checking the Free T3 and Free T4's every single time.

There is suppression information out there that you can look at. Very little research but worth checking into. Vit D and Selenium could be helpful.

There is so much that goes into the metabolical panel of hyperthyroidism ( hypo too) but you need to really learn so much to make a decision on how to proceed.
Helpful - 0
393685 tn?1425812522
I don't understand. Why are you asking me if my heart rate is good?
Helpful - 0
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