The Wellness Q&A with Elaine Moore

Welcome to the Wellness Q&A, where members can ask Elaine Moore health-related questions. Elaine Moore is a medical writer and retired clinical laboratory scientist with over 30 years experience in immunology. Because this is a question-and-answer forum, each post will receive one reply. For additional inquiries, a new thread will need to be started.

Last Post 15 May 2017 09:03 PM by Elaine Moore. 1 Replies.
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QueendyUser is Offline New Member New Member Posts:
15 May 2017 02:48 PM
    Hi Elaine,
    Thank you so much!!! Your site has been extremely helpful!!!
    I was diagnosed with Graves’ Graves’ eye disease a few weeks ago after having sleeping problems for about 1.5 years.

    I was wondering if it is better to take Methimazole 5 mg twice daily instead of 10 mg once daily?
    Since my WBC is low, is it OK just to test T3 free & T4 free each month for my thyroid to adjust medicine and supplements?

    I am a 54 year old female, 5.0 feet tall, I lost more weight lately to 95 lb.

    Oct 1 2015 Lab Results:
    TSH 1.810 (0.450-4.4500 uIU/ml). WBC 3.0 (4.5-11.0 x10 3 /uL), remain low till today.

    Dec 2015: Difficulty sleeping and insomnia.

    Mar 31 2016: TSH<0.01 first time detected abnormal, remain <0.01 till now. (All previous TSH tested normal on Oct 1 2015 and before.) Had minor symptoms mostly difficulty sleeping and insomnia, T3 free and T4 free in the high range.

    Mar 2017: Severe symptoms, also eyes become swelling and vision problems.

    Apr 26 2017 Lab Results:
    T3 free 8.5 (2.4-4.2 pg/ml)
    T4 free 4.0 (0.9-1.7 ng/ml)
    TSH<0.01 (0.27-4.20 uIU/ml) TSI 227 (<=122%); TPO antibody 32.8 (0.0 - 9.0 IU/mL).

    Apr 28 2017: my doctor started me on Methimazole 10 mg once daily; on May 8th, I changed it to 5 mg twice daily (6am, 6pm) on my own because of some mild brief side effects like joint pain and itching rash.

    Apr 28 2017: Vitamin D3 1000 IU once daily. Tested low Vitamin D level 29.0(30-100 ng/ml) since Jan 2010.
    May 3 2017: Selenium 200 mcg once daily. Hope it can help my eyes.
    May 12 2017: Acetyl-L-Carnitine 500 mg once daily.

    May 12 2017 Lab Results:
    T4 free 3.0(0.9-1.7); TSH<0.01. T3 free & TSI pending.
    I do blood test every month.

    Thank you so much!!!
    Elaine MooreUser is Offline Veteran Member Veteran Member Posts:2291
    15 May 2017 09:03 PM
    Hi Queendy,
    It is better to take your MMI in divided doses, 5 mg every 12 hours. Your FT4 has fallen nicely, about what you'd expect after 2 weeks. It takes a good 6-8 weeks for your FT4 to fall into range and even on your low dose it should make it into range by then, at which time your dose will be lowered. Having FT4 and FT3 levels monthly is a good plan although since you're new to meds you should have a repeat WBC level with your next labs to make sure it's not falling. Some people do run lower WBC counts than the range and some researchers think that this is a good sign, indicating low levels of inflammation. Of course, you wouldn't the level to fall critically low below 1.0 so it's a good idea to check your level 6-8 weeks after starting meds. TSI doesn't change quickly and there's no need to have this test more often than every 6 months. best, elaine
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