The Wellness Q&A with Elaine Moore

Welcome to the Wellness Q&A where members can ask Elaine Moore any health-related question. Moore is a medical writer and retired clinical laboratory scientist with over 30 years experience in immunology. Get started by selecting Member Questions. This is a question-and-answer forum, and each thread represents a member question or set of questions. The question will only appear once it's answered. Thank you for joining.

Drooping eyelid surgery
Last Post 21 May 2023 04:07 PM by Elaine Moore. 1 Replies.
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MeganUser is Offline New Member New Member Posts:
09 May 2023 04:37 PM
    Hi Elaine,

    I've been on my way to remission for over two years now taking less than 1mg of Methimazole daily ( Graves since 2012, another relapse ( 5th?) after lots of stress and Covid in 2020).

    My last lab tests:

    February 2023 1.2mg ish daily

    TSH 4.07 (0.35-4.9) / FT3 2.7 (1.58-3.91) / FT4 0.84 (0.7-1.48)

    April 2023 1mg ish daily

    TSH 2.2 / FT3 2.57 / FT4 0.93

    May 2023 less than 1mg

    TSH 1.23 / FT3 2.47 / FT4 0.92. TRAB 3.73 H (0-1.99) previous test August 2022 12.97 so decreasing but still to high.

    My question is should I try to stop taking Methimazole if I still have elevated TRAB? Or better wait til they will be lower?

    Is there any way I could lower them? Added Berberine 2 months ago and borage oil which has anti-inflammatory benefits.

    Is it a good idea to do the surgery for drooping eyelid now? The surgeon told me I should be euthyroid for a year ( my FTs are in range but I feel hypo and anxious and put a lot of weight so not sure what euthyroid means.)

    Thank you Elaine, I look forward to hearing from you soon.

    Best regards,

    Elaine MooreUser is Online Veteran Member Veteran Member Posts:4079
    21 May 2023 04:07 PM
    Hi Megan,
    euthyroid means normal thyroid function and your labs suggest hypothyroidism based on your elevated TSH. Being hypothyroid can cause droopy eyes and trigger thyroid eye disease.
    You'd do better with block and replace, adding levothyroxine to your MMI.
    TRAB measures both stimulating and blocking TSH receptor antibodies. When you have equal amounts of both eye problems are common. When you mostly have blocking antibodies they cause hypothyroidism and both antibodies falsely lower your TSH result.
    I'd hold off on surgery until your thyroid levels are optimal. Although you mentioned your thyroid hormone levels (FT4 and FT3) being in range they're likely too low for your body's needs. This causes increased thyroid activity and raises your TRAb. You'd be better off with block and replace or levothyroxine alone which is used in cases like yours.
    Best. Elaine
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