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Old 09-04-2012, 05:28 PM   #1
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TSH low, T3 & T4, High then low - Graves?

Hi,
I went to the doc about headaches and sore eyes at night. He tested my TSH - and called with concerns. He repeated the tests, then sent me to and endocrinologist. Initial thought was Graves, but some hesitation bc it could be thyroiditis. Now I need to wait another 4 weeks for more bloodwork and another appt.

Symptoms: Dry eyes, waking me up at night. No menses since April - after years of regular cycles. Fingernails like paper, shaking in the morning, feeling weak and dizzy at times, fatigue, and waking up at night frequently. Sometimes I lose weight easily, but mostly I work my tail off and diet and stay the same. I am in very good shape, so people just assume I am hyper - but don't take into account my very intense workouts. Resting heartrate was 55. I'm 47 years old. First they were sure it was mild Graves, but want to hold off on a scan until they see bloodwork in a month. Thyroid ultrasound was clear.

What do you think? Thank you.

June, 2012:
T3, free 4.8 (range 2.3 - 4.2)
TSH was 0.02 - range 0.4 - 4.5
T4 was 1.7 - range 0.8 - 1.8

July, 2012:

TSH = 0.01 (range 0.4-4.5)
T4, Free = 1.5 (range 0 .8-1.8) (last time it was 1.7)
T3, Free 4.8 ( range 2.3-4.2)
TSI - 48

August, 2012:
TSH = 0.03 (0.4 - 4.5)
T4, Free 1.1 range 0.8-1.8
t3, Free 3.2 range 2.3 - 4.2

 
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Old 09-05-2012, 09:47 AM   #2
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Re: TSH low, T3 & T4, High then low - Graves?

Since you have measurable TSI antibodies, it's more likely to be Graves' than a transient thyroiditis you're dealing with. MDs try to say that TSI must be out of lab range to be positive, but in truth, any measurable TSI is positive for Graves'. You don't actually need an uptake scan to diagnose this. TSI is proof enough and doesn't expose you to the unnecessary radiation of a scan.

As of now, you aren't hyperthyroid, even though your TSH is low. The TSI antibodies are keeping your TSH suppressed, but your free Ts are not excessive. If anything, they're a bit on the hypOthyroid side. If your FTs are bouncing around from hyper- to hypoT as they seem, it would explain why you can easily lose weight sometimes but not others.

If they finally decide this isn't transient and is Graves', do NOT allow yourself to be rushed into radioiodine ablation of your thyroid gland. It's unnecessary and risky. Anti-thyroid drugs can control the excess hormones until remission is achieved. Do your research; MDs frequently don't know or won't tell you what is known about Graves' treatment and the truth about its remission rate without RAIA. If you can obtain a copy of Graves' Disease: A Practical Guide, it will help you sort through the maze of untruths and guide you toward the best treatment for this disease.

Good luck to you!
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Old 09-05-2012, 12:24 PM   #3
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Re: TSH low, T3 & T4, High then low - Graves?

Thank you so much for your help. I have been really confused. I'd like to treat the shakiness that I feel in the mornings after I eat. I am also wondering if there is anything to help me sleep better as I am suddenly waking up at 3 am. I used to be a great sleeper. I also have to go to the bathroom more than I used to. Just a lot of little changes over the last year, including my fingernails tearing, even as I type.

I will look for the book. I do want to know if it is Graves or not, and am wondering why it's not so easy to tell. Also, I am worried that treating it will make me gain weight. I have to work so hard to stay where I am, but they don't believe that, because I'm thin and athletic looking.

 
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Old 09-05-2012, 12:26 PM   #4
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Join Date: Sep 2012
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tgstock HB User
Re: TSH low, T3 & T4, High then low - Graves?

Thank you so much for your help. I have been really confused. I'd like to treat the shakiness that I feel in the mornings after I eat. I am also wondering if there is anything to help me sleep better as I am suddenly waking up at 3 am. I used to be a great sleeper. I also have to go to the bathroom more than I used to. Just a lot of little changes over the last year, including my fingernails tearing, even as I type.

I will look for the book. I do want to know if it is Graves or not, and am wondering why it's not so easy to tell. Also, I am worried that treating it will make me gain weight. I have to work so hard to stay where I am, but they don't believe that, because I'm thin and athletic looking.

 
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