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Update & Endo #2

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Saw Endo #2 last week. He pretty much agrees with what I'm wanting

treatment-wise, but with a couple of exceptions.

#1 - He thinks every 3 months is plenty to test FT4 & TSH (no FT3) He also

wants to watch my white count, which is fine.

#2 - He recommends I take all 30mg of Tapazole in the morning rather than

splitting into 2 or 3 doses throughout the day.

<sigh> Can't have everything. And I can work around issue #1 - he says if I'm

not feeling right he'll order labs in between. He's certainly a far cry better

than endo #1.

Couple of questions:

1) At what point should one be weaned from beta blockers?

2) How concerned should I be about hives that only seem to occur when it's warm

out? On cool days, like today, I'm fine. But there have been rashes on warmer

days, like yesterday. I've taken Benadryl at bedtime and that pretty much

holds me for 24 hours, but I do fear the Texas summers in my future. Is PTU

easier on the allergies? (okay, so that was a 2-fer-1 question.)

LABS to date

9/4 -- TSH .004 (norm .35 - 5.5) Cholesterol 135 <G>

10/14 -- FT4 3.62 (norm 0.61 - 1.76), TSH .005 (norm .35- 5.5), TPO Ab 431

(norm 0 - 34)

Started Tapazole 10 mg BID on 10/18

Started Toprol XL 50mg (What a godsend!) on 10/28

11/03 -- FT4 2.12 (norm 0.61 - 1.76), TSH .004 (norm .35 - 5.5),

11/8 Tapazole increased to 20mg BID. After 2 days I lowered it to 15mg BID

11/14 TSI & Liver profile drawn - no results yet

Many thanks!

Carol

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At 08:05 PM 11/18/2003, you wrote:

>Saw Endo #2 last week. He pretty much agrees with what I'm wanting

>treatment-wise, but with a couple of exceptions.

>

>#1 - He thinks every 3 months is plenty to test FT4 & TSH (no FT3) He

>also wants to watch my white count, which is fine.

Only if you are stabilized. Personally, I wouldn't go more than 4 weeks if

my levels weren't stable, and no more than 2 months if they were stable

while on medication. (Of course, would test beforehand, if having symptoms.)

>#2 - He recommends I take all 30mg of Tapazole in the morning rather than

>splitting into 2 or 3 doses throughout the day.

Wrong-O!

><sigh> Can't have everything. And I can work around issue #1 - he says

>if I'm not feeling right he'll order labs in between. He's certainly a

>far cry better than endo #1.

>

>Couple of questions:

>1) At what point should one be weaned from beta blockers?

When FT's come into range.

>2) How concerned should I be about hives that only seem to occur when

>it's warm out? On cool days, like today, I'm fine. But there have been

>rashes on warmer days, like yesterday. I've taken Benadryl at bedtime

>and that pretty much holds me for 24 hours, but I do fear the Texas

>summers in my future.

I think that if it is minor, you are doing OK. I would guess that you will

have less hives if you stabilize at a lower dose, which you should.

> Is PTU easier on the allergies? (okay, so that was a 2-fer-1 question.)

Not necessarily. It is unpredictable which one will be better for you.

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Carol,

I can only speak from experience. I KNOW that when I split my doses the tap

had a greater effect. It was like....a smooth as opposed to a bumpy road,

let's say. No ups and downs during a given day. And, my levels came closer

to normal faster. The package insert says take it 3 x a day. If you're

taking 30 mg., do it in 3 x 10 mg. doses and don't tell him, till

after--when you've responded well.

Which brings me to the next point. The hives should be eliminated as soon as

you are euthyroid on a maintenance dose. Which will happen fast. You won't

need to be on 30 mg. very long at all, and you will be asking him for labs

inbetween the 3 months, cause you'll start to feel like you are going hypo.

I can almost guarantee it, if your experience is anything like mine. You

will need to drop your dose down, slowly works best--you don't ever need to

swing into hypo numbers if you're careful.

Finally, the Ft4 and TSH are fine as long as your FT3 level has been checked

and is in line with the FT4. My endo checks it a couple times a year,

knowing that it's never been a problem. But, if the endo refuses to check it

at all, that could be a problem. Mine wants to check it periodically, to

make sure I don't end up with T3 toxicosis. Which you'll have to ask a

brighter bulb than me to explain. Never have been good with the medical

terminology, but over the last 10 years, I've learned what I need to know to

keep healthy, at least!

Terry

>

> Reply-To: graves_support

> Date: Tue, 18 Nov 2003 19:05:06 -0600

> To: <graves_support >

> Subject: Update & Endo #2

>

> Saw Endo #2 last week. He pretty much agrees with what I'm wanting

> treatment-wise, but with a couple of exceptions.

>

> #1 - He thinks every 3 months is plenty to test FT4 & TSH (no FT3) He also

> wants to watch my white count, which is fine.

> #2 - He recommends I take all 30mg of Tapazole in the morning rather than

> splitting into 2 or 3 doses throughout the day.

>

> <sigh> Can't have everything. And I can work around issue #1 - he says if

> I'm not feeling right he'll order labs in between. He's certainly a far cry

> better than endo #1.

>

> Couple of questions:

> 1) At what point should one be weaned from beta blockers?

> 2) How concerned should I be about hives that only seem to occur when it's

> warm out? On cool days, like today, I'm fine. But there have been rashes on

> warmer days, like yesterday. I've taken Benadryl at bedtime and that pretty

> much holds me for 24 hours, but I do fear the Texas summers in my future. Is

> PTU easier on the allergies? (okay, so that was a 2-fer-1 question.)

>

> LABS to date

> 9/4 -- TSH .004 (norm .35 - 5.5) Cholesterol 135 <G>

> 10/14 -- FT4 3.62 (norm 0.61 - 1.76), TSH .005 (norm .35- 5.5), TPO Ab 431

> (norm 0 - 34)

> Started Tapazole 10 mg BID on 10/18

> Started Toprol XL 50mg (What a godsend!) on 10/28

> 11/03 -- FT4 2.12 (norm 0.61 - 1.76), TSH .004 (norm .35 - 5.5),

> 11/8 Tapazole increased to 20mg BID. After 2 days I lowered it to 15mg BID

> 11/14 TSI & Liver profile drawn - no results yet

>

> Many thanks!

>

> Carol

>

>

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In a message dated 11/18/2003 10:10:28 PM Eastern Standard Time,

carol@... writes:

> #1 - He thinks every 3 months is plenty to test FT4 & TSH (no FT3) He also

> wants to watch my white count, which is fine.

> #2 - He recommends I take all 30mg of Tapazole in the morning rather than

> splitting into 2 or 3 doses throughout the day.

>

Carol, endo #2 is wrong on all 3 statements....including the no FT3.

God bless,

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Great, ! Thanks!

Carol

Re: Update & Endo #2

At 08:05 PM 11/18/2003, you wrote:

>Saw Endo #2 last week. He pretty much agrees with what I'm wanting

>treatment-wise, but with a couple of exceptions.

>

>#1 - He thinks every 3 months is plenty to test FT4 & TSH (no FT3) He

>also wants to watch my white count, which is fine.

Only if you are stabilized. Personally, I wouldn't go more than 4 weeks if

my levels weren't stable, and no more than 2 months if they were stable

while on medication. (Of course, would test beforehand, if having symptoms.)

>#2 - He recommends I take all 30mg of Tapazole in the morning rather than

>splitting into 2 or 3 doses throughout the day.

Wrong-O!

><sigh> Can't have everything. And I can work around issue #1 - he says

>if I'm not feeling right he'll order labs in between. He's certainly a

>far cry better than endo #1.

>

>Couple of questions:

>1) At what point should one be weaned from beta blockers?

When FT's come into range.

>2) How concerned should I be about hives that only seem to occur when

>it's warm out? On cool days, like today, I'm fine. But there have been

>rashes on warmer days, like yesterday. I've taken Benadryl at bedtime

>and that pretty much holds me for 24 hours, but I do fear the Texas

>summers in my future.

I think that if it is minor, you are doing OK. I would guess that you will

have less hives if you stabilize at a lower dose, which you should.

> Is PTU easier on the allergies? (okay, so that was a 2-fer-1 question.)

Not necessarily. It is unpredictable which one will be better for you.

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Thanks, Terry! So good to know the hives may improve with a lowered dose. And

I definitely agree that my labs need to be done sooner. Heck, the way I've

responded to the Tap so far, I wouldn't be surprised if I'm euthyroid already.

I'll know in a few weeks.

When you talk about ups and downs, you're meaning after being off beta blockers,

right? I can't tell a whole lot about how I feel because I feel just great on

the Toprol XL. I have noticed feeling a bit sleepy for the past couple of

days, however. Reckon I should ask for labs early next week if it continues?

I have no idea how I'm going to convince him to do the FT3. Any and all

suggestions are welcome.

Thanks!

Carol

Re: Update & Endo #2

Carol,

I can only speak from experience. I KNOW that when I split my doses the tap

had a greater effect. It was like....a smooth as opposed to a bumpy road,

let's say. No ups and downs during a given day. And, my levels came closer

to normal faster. The package insert says take it 3 x a day. If you're

taking 30 mg., do it in 3 x 10 mg. doses and don't tell him, till

after--when you've responded well.

Which brings me to the next point. The hives should be eliminated as soon as

you are euthyroid on a maintenance dose. Which will happen fast. You won't

need to be on 30 mg. very long at all, and you will be asking him for labs

inbetween the 3 months, cause you'll start to feel like you are going hypo.

I can almost guarantee it, if your experience is anything like mine. You

will need to drop your dose down, slowly works best--you don't ever need to

swing into hypo numbers if you're careful.

Finally, the Ft4 and TSH are fine as long as your FT3 level has been checked

and is in line with the FT4. My endo checks it a couple times a year,

knowing that it's never been a problem. But, if the endo refuses to check it

at all, that could be a problem. Mine wants to check it periodically, to

make sure I don't end up with T3 toxicosis. Which you'll have to ask a

brighter bulb than me to explain. Never have been good with the medical

terminology, but over the last 10 years, I've learned what I need to know to

keep healthy, at least!

Terry

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