The Wellness Q&A with Elaine Moore

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Lab numbers don’t make sense
Last Post 07 Aug 2023 11:24 PM by Elaine Moore. 1 Replies.
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KaraUser is Offline New Member New Member Posts:
04 Aug 2023 02:34 PM
    My latest lab numbers don’t make sense. I’m not sure if I am hyper or hypo but I am having a LOT of symptoms including an awful all day anxiety and flat affect and mood swings. I did have a nasty stomach virus 6/18 and before that I had a respiratory virus. It’s been almost 6 weeks now though and I’m not feeling any better. Symptoms include: hair loss, insomnia, no appetite, weight loss, feeling nervous/on edge, panic attacks, unable to tolerate caffeine, sad/cry a lot, knee pain, heat intolerance. Occasional high heart rate while up (120-130) but normal/low blood pressure (105/65) and RHR 72.


    TSH: 3.4 (0.4-4.2)
    FT4: 1.7 (0.9-1.7)

    Was on 2.5mg methimazole. Dr increased to 5mg/2.5mg every other day.

    TSH: 4.65
    FT4: 1.8

    Dr. asked if I felt more hyper or hypo, I said I thought hyper so we increased to 5mg a day and will repeat blood next week.

    I’ve never had hyper and hypo numbers at the same time. Is that possible/normal? What could be going on to cause this? Am I hyper or hypo and do I need more or less medicine or do I have to just wait to see which way it will finally swing?

    I have Graves’ disease but my mom has both Graves’ disease and hashimoto’s antibodies. She went hypo around 45. I just turned 40. Should I be tested to see if I do too? Could that be causing this?

    Thank you!

    Elaine MooreUser is Online Veteran Member Veteran Member Posts:4032
    07 Aug 2023 11:24 PM
    TSH lags behind thyroid hormone levels by about 6 weeks. So your result suggests you were on a higher dose of MMI and a lower FT4 a month or so before you had labs.Your TSH could also be related to a low FT3 so that should be checked. Whatever the cause, dosing should be based on the FT4 level.
    There aren't any specific antibodies for Hashimotp's since both TPO and thyroglobulin antibodies occur in both Hashis and Graves' although in the former they occur at much higher levels. At one tie we (in the lab) thought that these 2 antibodies were only seen in Hashis but now they occur in both disorders and they can be present in lower titers in people without a thyroid disorder.
    You could also have rare TSH antibodies (different from TSH receptor antibodies) that falsely elevate the TSH result. Heterophile antibodies can also falsely raise the TSH result. Best, elaine
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