Re: new member -- Carolyn

[Guest guest]

Carolyn,

It is advisable to post the ranges for test results, so it is clear what

your lab considers to be within normal limits. I can say that your TSH

suggests hyperT right now. Not sure if that is a Total T4 or Free

T4...Perhaps you can post again with the details, and we can give you a

better idea.

Free T4 and Free T3 (not the other T3 and T4 tests, which are outdated and

inaccurate) are the tests to have, along with TSI and TPO antibodies. Also,

an ultrasound should be performed, to see if there are nodules. Unless you

have these done, your diagnosis is in question. And finally, before you

start meds, it is important to get a baseline for WBC and liver function tests.

If you are hyperT, and Graves' is confirmed, you will want PTU or Tapazole.

If you are having a lot of hyper symptoms, esp. palpitations and tremors,

you can get a beta blocker (as long as you don't have asthma) to give you

some relief until the ATD kicks in (can take a few weeks). But I'm really

not sure that you are hyper, as it depends on which T4 test you got, and

the range, and also the other tests I mentioned.

At 02:35 AM 8/18/2003, you wrote:

>-

>I'm the new one, Carolyn. I've just been diagnosed with GD and here are my

>test results:

>TSH = .002 T4 = 5.0

>I'm not on medication yet. Does anyone have a comment on these scores?

>What advice can you give me on treatment?

>Thx,

>Carolyn

[Guest guest]

Carolyn,

Good that you ordered the book.

I'm not sure what you are confused about. Maybe I'm missing something... It

makes sense to me that you start on PTU or Tap, and probably a beta blocker

for a short time, just until the ATD kicks in, and then you wean off the

beta blocker. Of course, you would follow your doctor's recommendations, as

to dosage, etc. DON'T exercise until your thyroid levels (FT3 and FT4) are

within range -- this can damage your overworked heart. And monitor the

thyroid levels at least every 4 weeks (FT3 and FT4, along with WBC). You

will want to have a liver panel at 4 weeks, 8 weeks, and then every 3

months. TSI and TPO-Ab testing should be done periodically (not more than

every 3 months), but certainly at the time when remission is suspected, and

before weaning off the ATD.

You want to stay on top of your labs, as you will likely need timely

reductions of your dose as you are on the ATD, until you stabilize at a

good level and then remain on a maintenance dose. It can take 8 weeks for

the ATD to have its full effect, as your stored thyroid hormone is used up

and new hormone production is blocked. A typical starting dose is 300mg PTU

or 30mg Tap. You will want to watch out for rashes, hives, and other side

effects (may simply mean your dose is too high), and there are more

serious, but very rare, side effects to be aware of, such as a rapid drop

in WBC (those on ATDs are advised to get a blood test immediately in the

event of sore throat, fever, or other sign of infection, in case there is a

drop in WBC). The package insert for the meds, as well as many other

sources, can go into more detail.

So please get the baseline labs I suggested previously, if at all possible

(I would push for them). Get a binder and keep copies of ALL lab work, so

that you are in a good position to participate in your care, and get

healthy sooner.

Best wishes,

At 12:12 PM 8/18/2003, you wrote:

>,

>The test was Free T4, and I'm hyper. I have lots of tremors and heart

>palpitations.