Re: really necessary to stop PTU before uptake scan?

[Guest guest]

Hi Lucy,

You don't need the uptake test. If they're doing this to diagnose Graves'

disease, it is unnecessary and not all that accurate.

A blood test for TSI, the antibodies that cause GD (also known as stimulating

TSH receptor antibodies) is a better diagnostic tool. The uptake can only

suggest Graves' disease and show if you have nodules or not.

It is not good medical practice to take a patient from 400 mg PTU to nothing.

This can cause thyroid storm.

Your dose of 400 mg is also too high. After 6-8 weeks on PTU, your dose

should be reduced. After 6-8 weeks, all the thyroid hormone in your gland has

been

released. So you just need enough PTU to reduce the production of new thyroid

hormone. ATDs' should always be reduced slowly.

The usual starting dose, by the way, is 300 mg.

Doctors who keep patients on inappropriately high doses of PTU often don't

realize that TSH can't be used to monitor ATD therapy. TSH can take many months

to rise and should not be used to monitor therapy. Only FT4 and FT3 will show

what your actual levels of thyroid hormone are.

Anyway after 6-8 weeks, the FT4 and FT3 are generally normal or low, and the

dose is reduced slowly. Everyone should after a few reductions be able to be

maintained on a dose of 100-150 mg PTU daily.

I'm not sure I'd stay with a doctor who doesn't understand how to manage

anti-thyroid drugs and wants to put you at risk for thyroid storm just to have a

diagnostic procedure that you don't need.

You don't need to be managed by an Endo. Many of the younger Family Practice

docs are more up on the management of Graves' disease. Take care, Elaine

[Guest guest]

Dear Lucy,

If you want to try meds first, why are letting endo #2 stop your meds?

Sounds like he is preparing you for RAI. If he wants to check out your

thyroid, I think he can do an ultrasound. (I am a newbie, so others should

be able to give you more specific advice.) Methinks you need to find an

endo #3.

At 08:32 AM 6/28/2003 +0000, you wrote:

>Hi, I've been reading this board for awhile and I am currently

>reading Elaine's book. I still have so many questions and I am not

>even sure where to start... it's a long story. Most recently, went

>to endo #2 who stopped my PTU completely so that he can do an uptake

>scan. It's the usual story, I'm trying to find an endo who will

>support my decision to try meds first. (Endo #2 is also angry that I

>will not have RAI.) I had been taking 400mg PTU daily since April

>7th, when I stopped last week per his instructions, it was 10.5 weeks

>on 400mg/day. I was susposed to stop for 10 days and then start

>again at 100mg/day. I was nervous about stopping so suddenly so i

>took one PTU on days 1 and 2 of my " stop " days. Then, my

>palpitations were so bad this week that I took another one on the

>26th because i could not get in touch with endo #2. Now, I have been

>told that I must completely stop the PTU for 10 consecutive days

>before I can have the uptake scan and that even one pill will

>interefere. I'm not sure how to get my question into the right

>words... is this doctor trying to kill me? LOL - no, that's not the

>real question. I am concerned about thyroid storm and I would like

>to know how long is it safe to be off of the PTU? If I have to wait

>for another 10 days from the 27th, that will be 18 days w/o PTU. I

>don't feel too good.

>

>I am normally very " in-tune " with my body but I can no longer " feel "

>what I am as I could before. I knew when I was hypo, besides the

>sudden weight gain, I felt differently. Now, I feel really different

>but I cannot figure out which.

>

>I am so confused.

>

>Thanks for your understanding and for any help.

>

>Sincerely,

>Lucy

[Guest guest]

Hi Lucy:

Doctors usually want to do a thyroid uptake scan in order to diagnose

Graves. They usually prescribe beta blockers to help until the scan

is done, then prescribe ATDS.

If your doctor is trying to determine ifyou have Graves, seems a bit

late. Do you already have antibody tests? If the doctor suspects

something else, an ultrasound test can be effective. You should

understand exactly why they want to do the uptake scan.

Have you done labs lately? In your shoes, I'd probably want labs

again right away, including antibody test especially if you haven't

already had one.

Good luck,

--- In graves_support , " silvermountainmist2001 "

I had been taking 400mg PTU daily since April

> 7th, when I stopped last week per his instructions, it was 10.5

weeks

> on 400mg/day. I was susposed to stop for 10 days and then start

> again at 100mg/day. I was nervous about stopping so suddenly so i

> took one PTU on days 1 and 2 of my " stop " days. Then, my

> palpitations were so bad this week that I took another one on the

> 26th because i could not get in touch with endo #2. Now, I have

been

> told that I must completely stop the PTU for 10 consecutive days

> before I can have the uptake scan and that even one pill will

> interefere.