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New, scared. Elevated FTI.. What does this mean??

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Old 01-06-2006, 11:44 AM   #1
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cherilyn30 HB User
New, scared. Elevated FTI.. What does this mean??

I first want to say how grateful I am for these boards. I have lurked everywhere here, but when I came to this board, lightbulbs went off! This is my first post. I am a 35 yr old female.

For the last few months, I have had increasing chest pains, with tight strangled feeling neck, eventually taking me to the E.R. about a month ago with what I thought was a heart attack. All heart tests came back normal, even a nuclear stress test. My regular doc has referred me to a cardiologist (appt. Tues.) for a possible heart cath test to be sure, as I now have high cholesterol (LDL 179) and just started Pravachol to lower it. The thought of that cath test scares me.

In the meantime, while following up with my regular doc, I began noticing high resting heart rates, spiking blood pressure, rapid weight loss (I am already THIN), along with many other thyroid symptoms, so I asked about thyroid tests, and had the blood test yesterday. Well the Dr office called today to tell me my FTI was elevated, suggesting "possible early hyperthyroidism" and is referring me to a endocronologist (as well as the cardiologist). I almost cried...FINALLY a possible REAL reason for my endless symptoms. Looking back, I can now see it has possibly manifested for years.

Anyway, I am not sure wich blood tests were run, and the ONLY information I have is that my FTI was 14.46. The nurse who called said it should be between 4.4 - 11.4. What does this mean?

I am wondering about Hashis since I also have a few hypo symptoms. Also wondering about Graves? What are the symptoms of those diseases? Also, what are the proper tests for Hashis or Graves? I want to go to the endocronologist as informed as possible.

Again, thank you for this board and all of you. I am grateful, grateful!

Thank you so much.

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Old 01-07-2006, 06:31 AM   #2
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Re: New, scared. Elevated FTI.. What does this mean??

Hi Cherilyn... Welcome to the board. I know exactly what you mean about feeling relief at a diagnosis! It doesn't make sense to be happy that there's something wrong, but it's true, isn't it?
There are fewer hyperT regulars on the board, and I'm not an expert on it. I'm hypoT myself. But here's what I do know about your situation.

FTI is not the best test for you. FTI is an estimate of the "free" portion of the most abundant thyroid hormone, thyroxine (T4). The better test would be a direct measurement of free thyroxine. You also should have a free T3 test, because it's possible that that hormone is too high as well.

You should have a test for Graves' antibodies, called TSI antibodies. A positive result will give you the reason for the hormone elevation(s).

It's possible that the endo will know these tests are the better ones for diagnosing hyperT, but if he doesn't mention them, it wouldn't hurt to ask for them.

It's likely there is nothing directly wrong with your heart, and that all of those cardiac symptoms are the direct result of your thyroid working too hard. A prescription for a beta blocker will probably help calm the heart symtoms until you get the thyroid under control.

If you turn out to be hyperT, I urge you not to take radiation treatment for it until you learn all of the cons and pros of the procedure. (I reversed the two words in that common phrase because I believe that RAI treatment has more cons than pros.) You may be offered no alternative to RAI, but you should NOT accept this radical approach when hyperT drugs can offer you a chance at remission without destroying your thyroid gland.

Look at our "Information Archive" sticky thread at the top of the thread title page. It has symptoms lists and treatment options, reading recommendations, and a lot more.

I could be wrong, but I think it's extremely unlikely that you have Hashi's. Graves' disease is the more likely possibility.

If you have more questions, please ask. And don't forget to check back with us after you see the endo to let us know how it goes.

Old 01-07-2006, 07:45 AM   #3
Join Date: Mar 2005
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merrillin HB User
Re: New, scared. Elevated FTI.. What does this mean??

Welcome to the board. It is so helpful.

I second everything Mid suggested. Get those TSI antibodies tested. I am a little worried from the start when I see a dr only ordered an FTI test ( free thyroxine index) which basically is a useless test. if you read alot of the posts you will see that many of us have run the gammit on dr's trying to find one who truly understands thyroid issues, especially when they are autoimmune in nater.

You need a whole host of tests............

Free t4
Free t3
TSI antibodies for Graves
TPO antibodies for hashi's
anti-thyroglobulin antibodies for hashi's.

Even though it is more likely to be graves, get them all tested to make sure you are not dealing with both overlapping on you.

You can have all the hyper or hypo symptoms with either, it isn't a black and white disease, ya know? I had hashi's and had mostly hyper symptoms even with totally normal labs. The key to my diagnosis was getting those antibodies tested and that is what finally showed what was going on.

Let us know how you make out,

Old 01-07-2006, 12:03 PM   #4
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cherilyn30 HB User
Re: New, scared. Elevated FTI.. What does this mean??

Midwest and Karen, thanks so much for your replies. You told me exactly what I wanted to know! I am going to list those tests on a sheet of paper, just as Karen has them listed, and take with me to the endo. I will not have any RAI, either. That is overkill as a first choice.

I am becoming very concerned about my heart rate, I have heard of 'thyroid storms'....scary. It is now ALWAYS too high, sometimes over 100 at rest. I'm afraid to do anything, as this raises it even more. I guess I want to know how dangerous this is, as I am still waiting for my regular Dr. just to make the endo appt. (endo "wasn't in" yesterday - typical).

My latest ER run was new years eve (before my thyroid was tested). I was given an ekg, then given one anxiety pill and sent right home with a resting heart rate of 96! I am sooo tired of the anxiety bit from doctors.

Although I think we're on the right track now, I don't want to die while waiting on the doctors. On another thread, someone mentioned using benadryl to slow the heart. Is that ok to try? I've got to do something. I'm not sure how much longer my heart will take this.

Also, is an endo generally the correct Dr. to see for thyroid problems?

Anyway, please forgive my endless questions, and thanks again for the valuable info you have given me. Any further input on this will also be appreciated. Hope you all have a good weekend!


Old 01-07-2006, 01:07 PM   #5
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Re: New, scared. Elevated FTI.. What does this mean??

No no... Don't take Benadryl. It may raise your heart rate. That's why such drugs carry warnings against thyroid patients using them.

Here's what I'd do: Call the doc and tell him your heart rate is alarming and that you want to try a beta blocker to slow it down until you can see an endo. BB's are relatively safe drugs, and he should have no objection to the suggestion. But if he does, get more vocal and insist you want that referral to the endo ASAP! Subtly hint that you have learned that hyperT and its characteristic high heart rate can be dangerous [You wouldn't be lying.] and that you want to be seen at the endo's first opportunity. Endos are notorious for scheduling appts months away. Obviously, that wouldn't be in your best interest.
If you are extremely worried about it, put in a weekend call to his answering service. He sort of deserves to be disturbed if he didn't think to Rx it on his own when you last saw him.
We thyroid patients often need to be the squeakiest of all wheels in order to get some grease. So squeak already!

Normally, I don't advise those with uncomplicated hypOthyroidism to see an endo. They're bad with hypo. But for hyper, I think it's a very good idea... probably the best speciality for that condition. Just don't let yourself be talked into that radiation. I have seen cases on the board where someone saw an endo on Friday and was scheduled for RAI the very next week. Terrible idea, as you can imagine. Anti-thyroid drugs should always be given a chance.

Last edited by Administrator; 06-26-2011 at 04:27 AM.

Old 01-07-2006, 07:08 PM   #6
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K9Mom HB User
Re: New, scared. Elevated FTI.. What does this mean??

Did I hear my name? *grin*

Hi Cherilyn, welcome to the first step in your thyroid education!
I agree that it does indeed sound more likely that you have hyperthyroidism, most likely caused by Graves disease. (Don't let the name scare you, it is only named Graves because of the doctor's name that discovered the disease)

First, I would recommend all of the tests mentioned above. With those results alone a definative diagnosis can be made. A thorough exam by a qualified professional should include:

* palpation of the thyroid gland to check for nodules and size of gland (this usually involves swallowing a sip of water while the doctor feels your thyroid)
* checking your reflexes
* checking your hands (or tongue) for tremors
* checking the skin on your shins for signs of pretibial myxedema
* measurement of your eyes with an exophthalmometer (sp?) which will check for any protrusion of your eyes

I agree that you should AVOID radioactive iodine ablation of the thyroid gland until you have educated yourself and fully understand the con's and pro's (thanks midwest - I totally agree with you on that!!) of each of the 3 treatments for hyperthyroidism (if indeed this is what you have).

Ask any and all questions you can think of....go into the Endocrinologist appointment informed and capable of understanding what they tell you. You will be way ahead of the game if you accomplish this!

When we are hyper it effects our thinking abilities, so I always urge newly diagnosed people to take ATD's (anti-thyroid drugs) to bring their thyroid levels down to normal (while they education themselves on the disease) Once the thyroid hormone levels are normal, then the thinking normalizes and we can make better decisions.

Best of luck to you. There is no "quick fix". It is a long road to feeling well again, but it can be done....I'm living proof!
Dx Graves 4/99, tx w/Tapazole & Atenolol - Remission 7/03; Relapse 1/06, back on Tapazole, remission & off meds again 11/06.

Last edited by Administrator; 06-26-2011 at 04:27 AM.

Old 01-08-2006, 06:23 AM   #7
Join Date: Mar 2005
Posts: 2,093
merrillin HB User
Re: New, scared. Elevated FTI.. What does this mean??

There is no such thing as too many questions so feel free to ask away. This is a process where lots of info is the only way you can get informed and take control. We have alll been there and don't mind in the least!

I am soooo glad K9 showed up That is your first place to start.

Keep us posted on what is going on............get really informed. It is very helpful when you go into a dr's appt armed with info because they usually see that you are well read on your disease and they are more interested in you. If they are offended by your interest in your own health then walk away, that shows an ego problem. I have run through many, many dr.s Listen getting in with an endo can take so much time. It took me 12 months to get into the one I wanted to see, well worth the wait, but a long one. You have to take charge in the meantime. Any dr can order those tests I mentioned in my previous post. Get those run, get a copy of the results for yourself and post them here and we can have a look at your bloodwork and then help you decide what is possible going on. That way when you get into your endo you will be armed with some info.

Rest assured you have come to the right place!


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