Elaine and all...T's continue to fall...please help!!

[Guest guest]

Hi Elaine and all,

Most recent labs. (Graves' Disease dx late June 2003. Started on

200 mg PTU mid July 15. Slowly reduced every 3-4 weeks since. FT4

and FT3 within " normal " range in 5 weeks. Even with dose reductions

the T's continue to fall.)

PTU lowered to 1/3 of 50 mg 3X's a day on Oct 14.

Latest tests.

Oct 14 2003 Oct 28

TSH 3.0 (.5-5.5) TSH 3.52 (.35-5.0)

FT4 1.1 (.8-1.8) FT4 0.91 (.89-1.76)

FT3 3.11 (2.3-4.2)

Yesterday, I reduced PTU to 1/6 of 50 mg 3X a day due to Oct 28

blood results.

The T levels continue to drop. Will they ever level out or raise to

the top of the " normal " range?

Did I do the correct dosage change for now?

Should I quit eating goidrogens, no iodine, etc?

What will I do next? I'll have blood drawn in another 4 weeks.

I'm concerned the endo will want to " try " me off the PTU. I've

taken it just over 3 months. Do you agree that is a mistake?

What other options are there?

I don't have a doc to add synthroid.

Ever hopeful...but freezing cold!!!

I am grateful for all you do!

Alice

P.S. I've seen an acupuncturist during this entire time. Could I

possibly be near remission? I need to convince a doc to do TBII

test...is that the correct one?

[Guest guest]

Hi Alice,

Good thing you reduced your PTU dose. Your labs show you're moving into

hypothyroidism.

You would be better to have a TSI instead of a TBII. About 10-20% of people

with GD move into spontaneous hypothyroidism. This happens when they begin

producing more blocking than stimulating TSH receptor antibodies. The TBII test

measures your total levels of blocking and stimulating antibodies. So it could

be high even if you moved into autoimmune hypothyroidism. The TSI test

measures only stimulating TSH receptor antibodies. Having a low TSI would

confirm

remission.

Since your thyroid hormone levels are falling at your low dose, you may still

want to consider stopping the PTU after tapering down to taking it every

other day for a while and then every third day. If you can't get a TSI test and

block and replace (adding synthroid isn't an option) this would be your next

step. Some people achieve remission in as little as 6 weeks although for most

people it takes 12-18 months.

Also, if you never had a TSI early on, it could be that you had thyroiditis

rather than GD. The natural course here is 2-3 months of hyperthyroidism,

followed by 2-3 months of hypothyroidism. The hyperT can then return for a short

while or the hypoT can be permanent. Usually, though, in thyroiditis after one

cycle of hyperT followed by hypoT, the condition resolves. Best, elaine