Hi Elaine,

I had labs again yesterday. I've been on 20 mg. methimazole since February 20.

April 24, 2023
TSH 0.145 L (0.47-4.68)
FT4 0.82 (0.78-2.44)
FT3 3.71(2.45-5.93)

previous labs:

March 29, 2023
TSH 0.153 L (0.47-4.68)
FT4 0.99 (0.78-2.44)
FT3 4.47 (2.45-5.93)
taking 20 mg. methimazole and he told me to stay on that dose.

February 20, 2023
TSH 0.754 (0.47-4.68)
FT4 0.56 L (0.78-2.44)
FT3 4.00 (2.45-5.93)
I was taking 30 mg. methimazole since the end of November 2022 and he had me lower to 20 but first had me skip one day of methimazole completely.

I asked your opinion at the end of March, and you thought he should lower my dose after those labs, but he didn't. I saw him on April 3 I and asked if low TSH by itself affects the heart and afib and he said no. I was surprised but pleased at that answer. He then said the next lab to go abnormal is FT3. I thought to myself then why does he never check it unless I request it! If he would have in September, would it have already been high? We will never know. (Last September when I had my regular 6 month appointment with him my TSH was low at 0.035. He offered methimazole again but I declined. At the time my FT4 was normal at 1.45. He rarely tests FT3, although he does now. My first ER visit last October they didn't check it either that time but the next week when I went to the ER for the second time they did check it and it was high, as was FT4.)

His comment on yesterday's labs was "good values" but no mention of lowering my dose. As I mentioned before I have had hundreds of episodes of afib since October 2022 when my thyroid went crazy. I had two episodes in January, none in February, one in March, and so far none in April. I don't want any more afib but I also don't want to go completely hypo. I see him July 3 and will request labs again before the appointment. Should I have them sooner than late June, especially if I stay on 20 mg. methimazole until then?

Thanks, Pam

Hi,
with your FT4 leaning toward the low end, I would ask to have labs sooner, like earlier in June or sooner if you notice any hypo symptoms. I'm glad you talked him into routinely checking FT3. Best, Elaine