Must have uptake and ablation next week

[accessn12]

While you're gathering info, I'd love to know the exact results of your t3, t4 and tsh. Did you get a copy of the labs? You should always request one. You'll want a copy of the uptake and scan too. It's easiest just to get copies as you go along instead of trying to get them later. Write down on each one whatever medication and what dose you were taking at the time the blood was drawn. It comes in handy sometimes to have the info at your fingertips.

I'll stay tuned for the 24hr results. I assume they're going to do a scan too. If you wanna impress em with all your newfound knowledge, ask em what the "scan time" is and whether the texture is homogeneous.

[hypfranh]

Good news I think. My 24 hr result was 45. The nurse said the normal range is 10 - 30 which I know all of you know. So I am hyper and I'll just wait for the doc to look his report over and let me know what meds I'll be taking.

Access, I can't remember my tsh, but I'll try my best for T3 and T4. I know I was 4x normal and I think the T3 range is .6 - 1.5 and mine was over 4, then the T4 range was like 1 - 4 and mine was 12. I did leave the doc office with my labs. The nurse said I should take them with me now. She said if I decided to do ablation six months from now, the specialist will need them and and I won't have to order them from the doc office and pay for it.

I'll let you know what I find out, hopefully this afternoon.

[accessn12]

Yep, you're hyper. You may have to wait a couple days for the radiologist to get the report of the scan to your doc. That'll describe the texture and uptake pattern of the rai. Sometimes that can tell a lot too.

I'll wait til you have paper copies of the results of you tsh and t's in your hands. Exact numbers are pretty important when you're dealing with the thyroid. Unless you have obvious protrusion of the eyes, you'll need a TSI test too in order to confirm graves disease. The type of thyroid disease you have is important too.

You'll most likely be put on tapazole. You'll need your beta blockers for a while too cause it takes over a month for the anti-thyroid meds to stabalize. You need blood drawn 4-6 weeks from the time you start taking them. TSH, FT4 and FT3 to see how things are going and whether the meds need to be adjusted up or down. Anti-thyroid meds can take up to 2 years to produce remission if remission is going to be achieved but if you're doing ok on them, there is nothing says you can't keep taking them as long as you need to. 6 mos is an arbitrary timeline and I think it's mainly cause docs just don't like to mess with hypers. You're going to find that we hypers are pariahs in the medical world. It's one of the reasons we have to educate ourselves so thoroughly. Most docs either don't know the first thing about it or are terrified of it. But that doesn't really matter as long as we know about it and aren't afraid of it.

Have you started learning yet?

[hypfranh]

Okay, based on the findings in my scan, it looks as if I don't have graves disease. I don't have an enlarged thyroid and no hot or cold nodules. The doc has no idea why I'm hyper. He thinks it's just some autoimmune disorder that can hopefully be controlled and possibly fixed with meds.

Because my heartrate is still at 100 or higher, he's going to up my propanolol from 80 milligrams to 120 milligrams and put me on Tapazole. Not sure yet of the Tapazole dosage but I'll find out tomorrow. He wants to see me back in two weeks.

He asked me today if we had checked my thyroglobulin antibodies and I was like "how am I supposed to know?". He only told me my TSH, T3 and T4 numbers. Oh, and I found out my TSH was less than .004. My T3 and T4 numbers exactly were 12.2 and 4.64.

Thanks access, you knew I'd be on Tapazole. I guess this means there's hope!

[accessn12]

There is hope but you're going to have to keep a close eye on this doctor. Looks like you'll be able to teach him a lot. Graves cannot be diagnosed from a scan. A scan can only give you a kinda blurry picture of the thyroid, tell you whether it's hot or cold, homogeneous or inhomogeneous and whether it contains nodules. I was told I had graves based on a radiologist's diagnosis from a scan. Wrong. I do not have graves. Radiologists have no business making a final diagnosis. There job is to report what they see and possibly suggest further testing based on what they think if their opinion is asked for.

Graves is diagnosed based on antibodies. TSI or TSAb's are the most specific tests for graves. A few people with graves also have TPO and/or thyroglobulin antibodies, which, if the doc's willing to order, aren't a bad idea to have too.

Minus any nodules, the three most possible diagnosis are graves, post-partum thyroiditis or the hyper phase of hashimoto's thyroiditis. If your doctor would run a TSI antibody test and a TPO antibody test, it would narrow things down even further. It would give you an idea of what you're looking at down the road and tell you if anti-thyroid meds are appropriate or whether beta blockers alone should be used. It wouldn't hurt to start the anti-thyroid meds regardless but it would be better if you knew for sure what you're dealing with.

When you report lab results, it helps if you also put the lab reference ranges for the lab that ran the test so that the results can be put in perspective. Each lab can have slightly different ranges and what's normal for one lab may not be the same at another.

There's only two approved meds for treating hyper in the US. PTU's the other one but you have to take it more often so the docs almost always go for the one that's more convenient for the patient. I had a 50/50 chance of being right from the get-go. Made me look pretty smart though, didn't it?

How are you taking the propranolol? One trick a gp passed on to me about beta blockers is that hypers require higher doses and more frequent dosing intervals than normal people do cause we metabolize it quicker. I had been prescribed like 40mg/day of the regular stuff by another doctor and he upped it to 160mg of the long acting stuff and split it into 80mg twice a day instead of once a day like it's supposed to be taken. It was like a miracle.