Thyroid Levels after stopping Eltroxin

[ReeceCoetzee]

I have for the past 5 months gradually suffering from high anxiety levels and decided that I needed to have a check up on my thyroid again. Well it turns out to be hyper thyroid. 4 and a half years ago I had surgery for a nodule which they removed, the right side of my thyroid. It was encapsulated in the thyroid so they did not feel it was necessary for Kemo.They then put me on a dose of 0.05mg of eltroxin to check if that would be the right dose for me. 3 years all was good.  I have been clear ever since, with regular checkups. About a year ago I was forced to go to a public hospital for check up which the doctor decided that I should go on a higher dose which was doubled to 0.1mg. I was told by the pharmacist that this was a high dose and decided to not take it to regularly which I did not for approximately 6 months. Then the past + - 5 months I thought I best start taking it regularly as I don’t want to go against what the doctor had told me. Big Mistake! Since then I was very anxious but tolerable. The last month however has been a nightmare! Went to a different doctor who took blood and pulled a report a month and a half prior to us meeting where I landed up in hospital due to a huge panic attack. He pointed out to me that my TSH level was 0.01! The emergency room did not see this. He then immediately told me to stop taking the eltroxin and go for blood test. Went for blood tests the following day (Bering in mind I was still taking the eltroxin just before giving blood) my results came back and this is how it was. T4 was 15.7 (normal ranges 7 - 16) T3 was 5.0 (normal ranges 3.8 - 6) it has been exactly 14 days since I stopped the eltroxin and have been feeling better but very up and down still with the panic attacks still frequent. I’m taking Xanor 0.5mg s/l to cope. My question is how long before my levels balance out and feels back to normal again???? Any one please help!! The doctor is saying I should be over the symptoms of hyper thyroid but does not completely feel that way...

[goolarra]

Three weeks is a little early.  It will give you an indication of where labs are going, but you have to take into account that it will still be a few more weeks before you are totally meds free.

So, the trend I see here is that FT4 continues to rise as does FT3.  Since FT3 and FT4 are what determines your symptoms, it's perfectly logical that you wouldn't be feeling better.  Your labs are continuing to get more "hyper" despite discontinuing meds.  Three weeks after discontinuing meds is a little short, but you should be seeing improvement.  TSH causes NO symptoms.  Until you see your FT3 and FT4 levels starting to fall, you will not feel better, no matter what your TSH is.  I disagree completely with your doctor...you should NOT have started to feel better already, because your FT3 and FT4 continue to get "worse".  

If you would rather, you can send me old labs in a PM.  Just click on my name at the top of this comment to get to my profile page and click "send message".

Once again, you do not have to be out of reference range to feel hyper.  We all have a personal reference range, and once outside of that, we will feel hypo or hyper, no matter what the population range is.  I've been hyper with FT3 and FT4 much lower than yours.

[Red_Star]

Has the doctor tested for thyroglobulin serum? I forgot to add that I had another two month bout of Hashitoxicosis (due to antibodies seen with Graves disease) causing far worse hyperthyroid symptoms than my build of thyroxine (the hyperthyroid lab I posted above).

Of great surprise, my labs showed a TSH was 6mU/L and my free T4 was 13 pmol/L while I was sitting in the doctor's office with raging hyperthyroid symptoms! But of note, my thyroglobulin serum was high.

"The 34 patients with Graves 's disease were followed for an extended period of time before, during, and after various forms of therapy. All hyperthyroid patients had elevated serum thyroglobulin (HTg) levels before therapy, regardless of cause."

"Serum thyroglobulin levels may have utility in distinguishing Graves' disease from factitious thyrotoxicosis. In Graves' disease, the level of serum thyroglobulin is increased, whereas in factitious disease the levels are decreased."

[ReeceCoetzee]

The doctor says he is not to concerned about the FT4 but more of the TSH right now and that I should have started to feel better already...I have to take meds 3 times a day now just to cope with the symptoms.

[ReeceCoetzee]

Hi

Need I be concerened about this, as I don't really feel well anymore..my heart rate goes up and down and I just don't feel as though I'm coping....I'm going for another blood test Monday to check again...

[Red_Star]

Interesting that your free T4 isn't very high considering your TSH is very low.  These are my labs to give you a comparison...

Optimal:
TSH - 1.5 mU/L (0.20 - 4.00)
Free T4 - 16.6 pmol/L (10 - 20)

Hyperthyroidism:
TSH: <0.05 mU/L (0.20 - 4.00)
Free T4: 25 pmol/L (10 - 20)
Free T3: 8.0 pmol/L (2.8 - 6.8)

[ReeceCoetzee]

Hi There

I hope you had a good Thanksgiving. Well i have received my results back and here is how it goes. I'm not sure if this is good but seems like its on the rise (T4 and T3) but TSH rising at the moment. Possibly as you mentioned that the meds are still in my system...as its only been 3 weeks almost to the day since i stopped the meds.

The thing which bugs me is when i wanted to go earlier for tests (as i have gone now) because i am leaving soon. His reply was that its too soon(which would probably be correct). I then said i was not feeling any better so he decided he wanted to have them done(sooner, the date i wanted to go). Then after seeing the results he said that he is pleased to see the TSH has gone up slightly but the T4 had gone slightly up and he was not concerned about the T4 but more on the TSH result. I then asked him, might it be that it is to soon as the meds might still be in system. His reply was he does not believe that it could, but possibly because of my stress and i should stop overanalising all of this....The contradiction is that the first time we discussed going for the tests "sooner" he said no its too soon but went earlier as i was not feeling better. I believe he did not remember his own words to me.....but anyway. Im hoping you could shed some light on this.

Im including the previous results i posted with the latest one at the bottom.

(This is when i landed up in the emergency room)
Dated: 15-09-2013                         Reference/Ranges:
           Free    T4 :13.2                   7.2 - 16.4   pmol/L
           Free    T3 : none was done          
               S-TSH : 0.10                   0.37 - 3.50 mIU/L

Dated: 15-10-2013                          Reference/Ranges:
           Free    T4 :14.3                    7.2 - 16.4   pmol/l
           Free    T3 :none was done
                S-TSH: 1.12                    0.37 - 3.50 mIU/L

Dated:  07-11-2013                          Reference/Ranges
           Free    T4 : 15.7                    7.2 - 16.4   pmol/L
           Free    T3 : 5.0                      3.8 - 6.0    pmol/L
                 S-TSH: 0.68                    0.37 - 3.50 mIU/L
(latest results)
Dated: 25-11-2013                           Reference/Ranges
           Free    T4: 16.3                     7.2 - 16.4   pmol/L
           Free    T3:  5.1                      3.8 - 6.0    pmol/L
                 S-TSH: 1.12                   0.37 - 3.50  mIU/L

Thanks In advance.

P.s As mentioned previously i acquired all my previous results from way back and would like you to take a look at them. Can i possibly email then to you??