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Old 06-12-2012, 10:24 AM   #1
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I have HKPP - in your opinion could it be caused by Graves?

I have hypokalemic periodic paralysis. I've been symptomatic since age 13. I'm now 30. I also have symptoms of hyperthyroidism like adrenaline rushes/anxiety, trembling, peeing often, racing/pounding heart and occasional arrhythmias, heat intolerance, sweating, muscle weakness, etc.

My symptoms tend to wax and wane to a degree. For example, three months ago I had oral surgery and I've been sick with this stuff ever since. Other times I can feel somewhat normal for awhile.

I am aware that Graves can cause both HKPP and hyperthyroidism. However, my thyroid levels don't seem to indicate Graves. I had a TSI of 90 when tested a few years ago (normal was <=125). My TSH is usually around .9 and when tested several years ago my T3 and T4 were firmly normal.

What do you more experienced folks think?

Last edited by Timber; 06-12-2012 at 10:31 AM.

 
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Old 06-12-2012, 10:40 AM   #2
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Re: I have HKPP - in your opinion could it be caused by Graves?

Sorry to hear of your struggles!

I will not deny that I'm curious to see just how "normal" your FreeT4 and FreeT3 levels are. I'd also be interested in knowing what "somewhat normal" means for you. Are you completely free from symptoms? If not, it would be helpful if you shared just what's going on when you're feeling "somewhat normal".

The fact that you have measurable TSI can mean something in regards to patient experience and possible disease.

Knowing the answers to my questions will help provide an inclination.
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Old 06-12-2012, 10:47 AM   #3
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Re: I have HKPP - in your opinion could it be caused by Graves?

Thanks!

My T3 and T4 haven't been tested in 4 years and to my knowledge that's the only time they were tested. I've had my TSH tested a number of times and it's never been abnormal that I've been told. Although the number is slowly creeping down as it was 1.3 a few years ago and is .9 now. I have an appointment with my GP next week and will request repeat TSI and T3/T4.

In any case, my levels in 2008 were: T4 1.0 (ref range 0.7 - 1.7) and T3 3.2 (ref range 2.6 - 4.4). So they were normal.

No, I am never completely free from symptoms and the older I get the more they linger. My life has been pretty awful the last few months because I've been so sick.

Last edited by Timber; 06-12-2012 at 10:48 AM.

 
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Old 06-12-2012, 11:12 AM   #4
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Re: I have HKPP - in your opinion could it be caused by Graves?

I'm glad you'll be getting tested soon.

I can tell by the ranges you posted that the T3 result from 2008 is actually the preferred FreeT3. And, sorry to tell you this but, that FreeT3 level would be considered hypo by a thyroid-savvy doctor.

Healthy people have FreeT4/T3 levels in the upper part of the range. Your level was below mid-range.

People with measurable TSI, hypo labs and the experiences you describe are dealing with a form of thyroid disease called "Hashitoxicosis".

A person with Hashitoxicosis will often have "normal" TSH because TSI can suppress TSH and keep it from rising as it normally would when a person is hypo.

Even though the patient is basically hypo, the TSI antibodies erratically stimulate the thyroid and cause it to produce excess hormone. At times such as these, the patient will suffer with hyper symptoms such as those you've described.

We'll be looking forward to seeing the results of your next labs.
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Last edited by sammy64; 06-12-2012 at 11:16 AM.

 
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Old 06-12-2012, 11:14 AM   #5
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Re: I have HKPP - in your opinion could it be caused by Graves?

Could you tell me exactly what tests to request next week?

 
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Old 06-12-2012, 11:25 AM   #6
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Re: I have HKPP - in your opinion could it be caused by Graves?

Even though labs sell all sorts of outdated thyroid tests, these are the only ones that are accurate:

FreeT4 (T4 or thyroxine, free, direct)
FreeT3 (tri-iodothyronine, free, serum)
TSH (thyroid stimulating hormone)

As I'm sure you figured out, getting accurate labs done doesn't necessarily mean they are accurately interpreted by a doctor.

In addition to a current TSI (thyroid stimulating immunoglobulin) test, getting tested for all types of thyroid antibodies could be helpful to give you some idea of your disease course:

TPOab (thyroid peroxidase antibody)
TGab (thyroglobulin antibody)
TBII (thyrotropin binding inhibiting immunoglobulin)

Now, my lab doesn't offer the last test and instead offers TRab (TSH receptor antibody). This test isn't as helpful since TRab is a measurement of all TSH receptor antibodies which include TSI and TBII. The TRab test is better than nothing if only to get some idea about your disease course.

I'll explain it all once you have results (unless you'd like to know sooner )
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Last edited by sammy64; 06-12-2012 at 11:30 AM.

 
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