Ron - TSH suppression

[Guest guest]

This is from a post of about a year ago. (Thanks B. and Elaine.)

The point is that TSH can stay suppressed for a while.

If Iwere to find myself going hypo even on minimal doses of PTU (at 3

you're not quite there yet) but still wanting to stay on PTU because of

eye problems or elevated TSI, that's when I'd consider BRT (block and

replace therapy).

Take care, Fay

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I stopped by the library

(yes, I live there!) and within 10 minutes found the article which Elaine

references in her Suite 101 article on TSH levels and how they can

remained

suppressed for long periods of time. Man, I am so tempted to mail it to

my

doc! It very clearly states exactly why the TSH level is an inadequate

test

for patients with GD and why.

Here's just the abstract for anyone who cares:

From Journal of Clinical Endocrinology and Metabolism, Oct 2001, pg

86(10)

" Antithyroid treatment for Graves' hyperthyroidism restores euthyroidism

clinically within 1-2 months, but it is well known " (I love how it says

WELL

KNOWN here...obviously not well known to MY doc) " that TSH levels can

remain

suppressed for many months despite normal free T(4) and T(3) levels. This

has been attributed to a delayed recovery of the pituitary-thyroid axis.

However, we recently showed that the pituitary contains a TSH receptor

through which the TSH secretion may be down-regulated via a paracrine

feedback loop. In Graves' disease, TSH receptor autoantibodies may also

bind

this pituitary receptor, thus causing continued TSH suppression. This

hypothesis was tested in a rat model. " (Description of testing on rats

deleted for length here) " We conclude that TSH receptor autoantibodies

can

directly suppress TSH levels independently of circulating thyroid hormone

levels, suggesting a functioning pituitary TSH receptor. "

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