Hyperthyroid advice needed

March 24, 2012

Hi

My husband just had some blood test results yesterday as follows:

TSH <0.01 (ref 0.35-3.5)

Free T4 35 (ref range 8-21)

Free T3 19.2 (ref range 3.8-6.0)

Clearly this indicates hyperthyroidism but I have a few concerns. He was

diagnosed with 's last year and in Dr Peatfield's book he says that

adrenal insufficiency " makes a nonsense " of thyroid test results, but is this

just when it's untreated? He also had high sodium and chloride in the past,

which is supposed to be low in s, and normal potassium. Sodium and

potaassium were normal last week but chloride was still high, but only just

outside range.

Last June his TSH was 0.59 (ref 0.4-4.0), Free T4 was 15.8 (ref 10-22) and Free

T3 was 4.05 (ref 2.8-6.5) so besides the TSH being lowish, the rest was okay.

In Oct 09 his TSH was 1.21.

Also, the endo didn't test for antibodies but when we tested privately last June

his Peroxidase were at 99. At that time I thought he might have Hashi's as he

had low temps. His temps are still low and he doesn't feel `hyper', more

exhaustion and `hypo' but does have a high pulse, weight loss and muscle

weakness/loss. Is it possible he's on the `hyper' swing of Hashi's?

Other finding were low testosterone last June. I am wondering about pituitary

disease/tumour since cortisol, TSH and testosterone are all very low? I've

asked the GP to test FSH and LH, Peroxidase, Prolactin and DHEA to rule this out

which will be done on Monday.

Other test results were high Urea at 7.4 (ref 1.7-7.1), low Total Protein at 57

(ref 63-82), low Albumin at 31 (ref 35-50), normal Globulin although it's always

been low in past tests, Ferritin, B12 and Folate all normal. Only other

abnormal results were high Monocytes at 1.5 (ref 0.20-0.80) and high Eosinophils

at 0.47 (ref 0.04 – 0.4) – he is very allergic and eosinophils are often raised.

Short synacthen test (second one done) confirmed extremely low cortisol levels.

If anyone has any other insight into these test results I would appreciate it.

Otherwise my question is – should he start on Carbimazole right away as he feels

awful, or should he wait for the other blood tests to confirm whether or not

it's a pituitary disease or DHEA deficiency? The GP didn't have any idea and

he's not due to see the Endo for another two weeks. Is it dangerous not to

treat it right away? If he starts taking it now can he just stop or does it

need to be tapered?

Thanks for any advice

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