HealthBoards

HealthBoards (http://www.healthboards.com/boards/)
-   Thyroid Disorders (http://www.healthboards.com/boards/thyroid-disorders/)
-   -   Does this mean I'm hypothyroid now? (http://www.healthboards.com/boards/thyroid-disorders/901152-does-mean-im-hypothyroid-now.html)

awondering1 05-16-2012 05:41 PM

Does this mean I'm hypothyroid now?
 
I was diagnosed with hyperthyroidism in February. My blood work showed the following at the end of February:
TSH was <0.015 L normal range 0.465 4.680 uIU/mL
T4, Free was 3.22 H normal range 0.79 2.35 ng/dL
T3, Total was 2.72 H normal range was 0.97 1.69 ng/mL

I was put on 10 mg Methimazole 2 times a day.

I had a follow up in March, where it was lowered to just once a day with the following blood work results:

TSH was <0.015 L normal range was 0.465 4.680 uIU/mL
T4, Free was 1.43 normal range 0.79 2.35 ng/dL
T3, Total was 1.27 normal range was 0.97 1.69 ng/mL

My April appointment was cancelled by the office because the doctor wasn't in the office. I just got the blood work results for my May appointment which show the following:

TSH was 3.539 normal range was 0.465 4.680 uIU/mL
T4, Free was 0.69 L normal range 0.79 2.35 ng/dL
T3, Total was 1.16 normal range was 0.97 1.69 ng/mL

Does that mean I'm hypothyroid now for sure because my T4,Free is low?

I was scared this would happen since my numbers fluctuated for so long and it took about six months to even be diagnosed, but last month the nurse from my endocrinologist's office assured me that the cancelled appointment wouldn't make a difference and that I didn't need to be squeezed in earlier.

My CBC also showed a slightly low WBC 3.8 when the normal range is 4.0-11.0 10^3/cumm and ABS Neutrophils 1.80 L when the normal was 2.00-7.50 10^3/cumm. I'm not sick, so what would account for that?

sammy64 05-17-2012 04:19 AM

Re: Does this mean I'm hypothyroid now?
 
Sorry to tell you this but, you were hypothyroid back in March.

Dosing for hyperthyroidism is always based upon the FreeT4 level with the goal of the patient taking the lowest possible dose that will maintain the FreeT4 level in the upper half of the range if not towards the high end of the range, regardless of TSH.

This means that, based upon your lab's ranges, your FreeT4 level should be maintained at least at 1.7 and probably closer to 2.1-2.2.

I suspect you have Graves' disease, the most common cause of hyperthyroidism - the Graves' antibodies skew TSH low and this isn't a concern. I also suspect that your doctor doesn't know this because he hasn't kept up with things (all-too-common with thyroid care).

This would explain why your dose wasn't lowered more back in March. Unfortunately, it seems your doctor also doesn't realize how effective anti-thyroid drugs are - otherwise he would have made sure to order labs for you in April to prevent you from dipping hypo.

Your slight blood count abnormalities are most likely due to your hypothyroid state (they're not really that much out-of-range).

awondering1 06-06-2012 01:47 PM

Re: Does this mean I'm hypothyroid now?
 
I'm more confused than ever. I fully thought I had become hypothyroid (and quite bummed about it), but then I saw my endocrinologist and he ordered a Thyroid Uptake and Scan. I had to stop the Methimazole before the test.

I had thyroid function blood work done a few days prior to the test, and the results from that blood work put me back in hyperthyroid level, so I'm just very confused.

The following results are from about 10 days after stopping Methimazole for the rest:
TSH was <0.015 L normal range was 0.465 4.680 uIU/mL
T4, Free was 2.69 H normal range 0.79 2.35 ng/dL
T3, Total was 2.97 H normal range was 0.97 1.69 ng/mL

My dose was lowered to 5 mg daily (for when I restarted after the test)... which I did a few days ago.

I'm wondering if you can also explain the results of the uptake and scan:

Findings:
Static images demonstrate bilaterally symmetric diffuse thyroid activity. There is no evidence of focal cold or hot nodule. There is increased uptake. 4 hour uptake level is 51% and 24 hour uptake level is 71%.

Impression:
Findings are consistent with hyperthyroidism most likely secondary to Graves' disease. Please correlate.

I don't have my next appointment until the end of the month.


All times are GMT -7. The time now is 03:47 PM.