Hi Cara,

That episode with "too high of a methimazole dose" that you had caused agranulocytosis. This means, you not only had a low white blood cell (WBC) count, you had a decreased number of segmented neutrophils (granulocytes). Since we measure 100 WBCs and you're still running low on neutrophils until you catch up, you're going to have a proportionately higher level of lymphocytes. Normally, we mostly have neutrophils, followed by lymphocytes.

If you truly had an elevation of lymphocytes, you'd have an elevated absolute lymphocyte count. That is, it'd be higher than 5.0. This is a measure of how many lymphocytes you have and not just their percentage.

TPO antibodies are markers of thyroid inflammation. Your level is fairly common for Graves' disease and it may have rose due to the methimazole episode. Your immune system cells in your thyroid gland likely were working harder at these antibodies persist for several months before they start to fall.

Your FT3 is a bit elevated but your dose of PTU should be based on your FT4 level. Also, I know your doctor started you on a low dose to make sure you didn't develop agranulocytosis again. Unless your FT4 level is also high, your dose is likely ok. It takes FT3 longer to fall than FT4. Then again, if your doctor sees your WBC count isn't affected by the PTU he may slightly up your dose. I'd go by what he says, especially since you're having weekly labs.

I hope you do well on PTU. Best, Elaine