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Old 08-22-2004, 03:54 PM   #1
Join Date: Oct 2003
Location: Clearwater, FL, US
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hypodude HB User
K9Mom, others - a few Graves questions....

I was curious when treating graves and/or Hashis, is it possible to take Thyroid blockers and Synthroid at the same time if you are all over the boards with your numbers swinging from Hypo to Hyper several times during the course of a day?

How does the Tapazole play with your blood work numbers with regard to TSH and the Free T's. I would think if you're blocking your Thyroid from producing hormone, would that not put and keep you in a HypoThyroid state? If so, does the normal Rx for Graves and Hashis usually include Synthroid/thyroid replacement as well as thyroid blockers in conjunction with one another?

In the last 2 months my TSH numbers have been 15.5, 15.2, 9.8 and 6.3 WITH NO MEDS AT ALL and my T3's has always been at the very top of the range and sometimes abnormally over the upper range. T4's are always normal.

I was wondering if it is possible to take Synthroid to get your normal thyroid into your system and then sort of self-medicate with the thyroid blockers only as you go Hyper or to avoid the thyroid overload activity I seem to be experiencing? I just cant see how I will ever get regulated when I seem to switch back and forth so quickly sometimes...Im mean like within hours I can switch 2 or 3 times.

Old 08-22-2004, 08:10 PM   #2
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Location: Georgia, USA
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K9Mom HB User
Re: K9Mom, others - a few Graves questions....

There is a protocol called "Block and Replace" which is where a hyperthyroid person is given BOTH antithyroid meds (Tapazole/PTU/methimazole) and also taking thyroid hormone replacement (synthroid/levoxyl, etc.). It is a therapy that is used much more in Japan than here. There are rigid protocols regarding timing of taking of the meds that one must follow.

The problem that some run into with this protocol is that the antithyroid med must be given in higher doses. ATD's in higher doses pose more of a risk for a adverse reaction to them.

I think it would be an uphill battle to try to argue for this particular treatment based on your numbers. Most Graves/hyperthyroid patients that take antithyroid meds have thyroid hormone levels that are way over the normal range....the medication is adjusted as thyroid levels come down to normal so that the patient is not overmedicated and made hypo...but sometimes we are overmedicated and sent hypo and have to cut the dose some more.

Regarding the high T3...have you cut out all high iodine foods? Like iodized salt, seafood, sushi (kelp), multivitamins with iodine? Something is causing you to convert more T4 into T3.

I can tell you that *for me* when I was hypo due to being overmedicated, my FT4 was low and my FT3 went UP to the high end of the range. It was explained to me that this was my body trying to make up for the low T4 so it was converting more into the more potent T3 in an effort to protect itself.

I would think that you need some thyroid hormone replacement and close monitoring to see what that does to you.

So many of the symptoms of HYPO and HYPER overlap. I know that I had palpitations, anxiety and insomnia when I was hypo from overmedication and I never thought that hypo would cause those, but they did in me.
Dx Graves 4/99, tx w/Tapazole & Atenolol - Remission 7/03; Relapse 1/06, back on Tapazole, remission & off meds again 11/06.

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Old 08-23-2004, 06:20 AM   #3
Join Date: Oct 2003
Location: Clearwater, FL, US
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hypodude HB User
Re: K9Mom, others - a few Graves questions....

Thank you very much for that information. I have had anxiety problems for years. I know I have high Perox Antibodies. My biggest fear is that thyroid release I seem to get where my T3 seems to go high and I get real shaky. Of course, it could all just be panic attacks from mental/thyroid issues, but they seem to be worse when I feel hyper. In the past - 10 years ago - when I would get a panic attack, it would last about an hour and then I would be exhausted. Now when I get these attacks, they last for like 20 hours of high heart rate and high blood pressure. These attacks also correlate very well with the swelling and shrinking of my goiter. I can actually feel my goiter shrink and swell within a few minutes of a change and at that time I usually toggle between hyper and hypo. When my neck is swollen and bothering me, I get a lot of Hypo symptoms (muscle cramps, cold, slow heart rate) and then out of the blue, usually after eating something, my thryroid starts shrinking. It gets easier to swallow and breathe and the swelling physically goes down and at that time, it seems I start getting panicky/hyper heart rate will go up and stay there and my body temp will rise, etc. Every once in a while throughout the day I get "moments of clarity" where for once, I feel totally fine, like nothing is wrong at all. Those moments unfortunately usually only last a few minutes to an hour or so each day until the next wave hits. I have an endo appointment next week after waiting for almost 3 months to get this appointment and I want to make sure I get fixed this time....whatever it takes.

Did you have all sorts of swings as I described them above when you were first diagnosed?

Old 08-23-2004, 04:16 PM   #4
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Location: Georgia, USA
Posts: 662
K9Mom HB User
Re: K9Mom, others - a few Graves questions....

You said that you feel like your thyroid is swollen and you have hypo symptoms....then you EAT and after you eat you can feel the thyroid shrink.

Okay, here's what I'm thinking about that....the typical American diet is high in iodine. We get WAY more than we need, especially if we eat junk and fast food. I've also noticed that I get hyper-like symptoms from eating msg and anything that contains "flavorings" as well as red sauces. (I learned later that red dye #2 has iodine in it)

So, if you're feeling hyper after eating and your goiter shrinks...perhaps it's the iodine in the food you are eating that is doing this??

Iodine is the fuel for the thyroid gland. Thyroid hormone is made out of iodine atoms. T4 takes 4 iodine atoms and T3 takes 3 iodine atoms.

I definately have food triggers...maybe you can keep a little food diary for a few days and try to correlate your symptoms to what you eat?
Dx Graves 4/99, tx w/Tapazole & Atenolol - Remission 7/03; Relapse 1/06, back on Tapazole, remission & off meds again 11/06.

Old 08-23-2004, 05:43 PM   #5
Join Date: Oct 2003
Location: Clearwater, FL, US
Posts: 312
hypodude HB User
Re: K9Mom, others - a few Graves questions....

My food intake for the last 3 months has been VERY regulated and very simple due to these problems. I use no additional salt, never eat anything processed, etc. My typical day consists of a bowl of old-fashioned oatmeal with a chopped banana, a plain hamburger for lunch with a touch of ketchup and no bun and a simple dinner, say a fish fillet with mixed veggies....a few cups of milk in between and about 2 or 3 gallons of water each day. I lost almost 40 pounds in the last 3 months doing things this way. Sometimes I think Im taking in too few calories at 292 pounds.

Old 08-29-2004, 01:10 PM   #6
Junior Member
Join Date: Jul 2001
Posts: 22
Re: K9Mom, others - a few Graves questions....

Do you really drink 2 or 3 gallons of water a day? I drink a little over a gallon and was informed that was too much and would throw my electrolites completely out of balance. You may want to cut back on your water intake.

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