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Old 03-01-2007, 06:32 AM   #1
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Pituitary or Thyroid problem?

I've asked this question before, but I'm back again with a little extra info.
I had RAI in 2002 to treat Graves. IT was a rollercoaster for a while. Actually, it was more like a bad trip, but that's a whole different post I finally got to a good place and felt good and got pregnant. I was on 200mcg of Levoxyl and 5-10mg of Cytomel a day throughout my pregnancy and gave birth in January of 2006. By the end of my pg, my TSH was 0.0 but my Free T4 & T3 were both normal in their range. my Free T3 has always been in the lower part of normal. Of course, I've been fighting my doctors like mad for the last year to not drop my Levoxyl. (I did let my endo convince me to drop the Cytomel WAYYYY back in January of 2006 because she swore that was what was supressing my thryoid). Over the last year, I've seen 4 different doctors and all of them wanted to drop me to 150 of Levoxyl. I found ONE who was willing to drop me to only 175 based on my labs. I'm still completely supressed with normal Free's and NOBODY can tell me why? I don't think the drop to 175 has been good for me as I'm on Weight Watchers and my weight is not budging (before I got pg, I lost 50 pounds on WW so I know how to do it!). I don't want to go to another flipping doctor with another script for LESS Levoxyl.

I'm frustrated and I know this is long and I know it's technical, but I'm hoping someone out there might have some insight or something I might ask my doctor to check into so they won't continue dropping my meds based on my lack of TSH. In doing a bit of research, it looks like this might also be a sign of a pituitary disorder. Does anyone have experience with that? What type of disorder? I could do some research and take it to my doctor.

UGH. Again - I'm just frustrated. Thanks if you read my whole post.

 
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Old 03-01-2007, 10:53 AM   #2
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Re: Pituitary or Thyroid problem?

I doubt you have any pituitary problem. For one thing, your gland is now dead. TSH is absolutely meaningless to someone without thyroid function. Only the levels of your free thyroid hormones matter now.

If you felt well at your previous doses of Levoxyl and Cytomel, your regimen should not have been changed as long as your FT4/3 didn't exceed their ranges. The suppressed TSH meant nothing then, since Cytomel (and Armour) are known to do that. That's why it's imperative to watch the FTs during treatment, to make sure they don't get too high.

You don't say if all those MDs have been endos or not; but if they are, look for another type of MD. An osteopath or an old-timey sort of general practitioner who treats lots of thyroids would be better. You really ought to be allowed to return to the med regimen that made you feel best. That's what this is all about, you know?

 
Old 03-01-2007, 10:07 PM   #3
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Re: Pituitary or Thyroid problem?

I agree with Midwest in that your TSH is meaningless now. The antibodies which CAUSE your Graves (called Thyroid Stimulating Immunoglobulin) mimic TSH rendering it a totally useless test. RAI did not get rid of the antibodies...you still have them. Most likely it is these antibodies that are suppressing your TSH.

If they try to base your dose on your TSH result then they will make you HYPOthyroid. You should be dosed based on the Free T4 and Free T3 test results. Hope this helps!
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Dx Graves 4/99, tx w/Tapazole & Atenolol - Remission 7/03; Relapse 1/06, back on Tapazole, remission & off meds again 11/06.

 
Old 03-02-2007, 05:49 AM   #4
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Re: Pituitary or Thyroid problem?

I appreciate both of your responses tremendously! Finally something about my current situation makes sense! I've been digging through my thyroid books and trying to research the net, but just couldn't find anything related to supressed TSH post-RAI.

I was initially seeing an endocrinologist, but when she started pressing me to lower my dosage (after convincing me to stop the Cytomel) I decided to see my PCP about my thryoid. He wasn't much help either. I also saw another PCP, but he wasn't much help either.

I've made an appointment with a specialist who is over 2 hours away. I have high hopes that he can help. I've heard that he treats based on symptoms and is very knowledgable regarding the thyroid.

Thanks again!!

 
Old 03-03-2007, 05:57 PM   #5
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Unhappy Re: Pituitary or Thyroid problem?

The doctor is telling my Mom it appears that her thyroid is supressing her pituitary gland completely. Can anyone tell me much about this problem? I type in this problem in my search engine and all I see are the functions of the glands and pituitary tumor also pops up. Help?

Pamela , SC

 
Old 03-03-2007, 09:20 PM   #6
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Re: Pituitary or Thyroid problem?

The only thing I can think of...what he possibly meant by "thyroid suppressing the pituitary" is this:

When things work properly the pituitary gland signals the thyroid to either "make more" thyroid hormone or "make less" thyroid hormone via the hormone called TSH. When we are hyperthyroid due to Graves disease we have an antibody called "TSI" which overrides the TSH signaling and tells the thyroid to make more thyroid hormone regardless of what the pituitary is saying. This is what makes us hyperthyroid.
__________________
Dx Graves 4/99, tx w/Tapazole & Atenolol - Remission 7/03; Relapse 1/06, back on Tapazole, remission & off meds again 11/06.

 
Old 03-04-2007, 07:48 AM   #7
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Re: Pituitary or Thyroid problem?

hi glad you are near the rigth dose and i agree it can be tough weight wize on thyroid meds how much is it harder after the tt and loosing weight than when you had a thyroid love from pursie and i hope thye dont knock you down anymore sounds like you ahve it under good manage mentlove pursiexxxxxxxxxxxxxxxxxx

 
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