Hyperthyreose, høyt stoffskifte kan komme av en autoimmun tilstand,
graves sykdom eller andre årsaker, slik som autonome knuter som sender
Graves er en autoimmun tilstand som egentlig skal brenne ut av seg
selv etter en stund.
Her i landet behandles den gjerne med medisiner som setter ned
stoffskiftet, som Neo-mercazole eller propylthiaruzil. Noen er
overfølsomme for den ene og tåler bedre den andre. En viktig mulig
bivirkning man må være obs på er agranulocytose. Da blir det
plutselig for få leukozytter (hvite blodlegemer) og man må straks
Andre steder bruker man radioaktivt jod som standard.
Jeg limer inn her utklipp fra et hyper-forum som gir noen
interessante opplysninger om hva som trigger hyper-antistoffene.
Gluten er en kjent trigger for slike antistoffer, samt jod, røyk,
stress, MSG, aspartame og mange andre ting .
You might also want to consider any environmental triggers that might be preventing your TSI from
falling as fast as you'd like it to. These include excess dietary iodines in fast/processed foods,
aspartame in Nutrasweet, stress, cigarette smoke, low selenium levels, etc.
A 300 mg PTU starting dose is fine although recent studies show that a lower dose, usually 200 mg
is usually adequate for a starting dose. After about 6-8 weeks on your starting dose, your FT4
should fall into the normal range. At this time you're considered euthyroid and your dose is
lowered. And yes, PTU will lower your thyroid hormone levels regardless of the cause. Best, Elaine
Using 1.25 mg every other day and watching for a return to hyper symptoms sounds like a good idea.
One common reason for not responding as well to ATDs as one would like that I forgot to mention
is environmental or food allergies. Hayfever or allergies to pollen, wheat, and soy are
particularly problematic if they're not in control.
There are several studies showing the efficacy of long-term ATD use. One is Very-Long-Term
Methimazole Therapy is Effective and Safe in Patients with Hyperthyroidism Caused by Graves'
Disease by F Azizi, L Ataie, M Hedyati, Y Mehrabi, and E Sheikholeslami in European Journal
of Endocrinology 2005;152:695-701. Best, Elaine
Thyroid hormone is not an immune system stimulant. However, the immune system can react to the
foreign proteins found in glandular extracts. That is why some people develop TED or notice
problems when they start animal-based extracts. Using synthetic T3 doesn't cause this
If you're deficient in either T4 or T3 then the cells in your thyroid gland, including immune
system cells, work to try fixing the problem. The increased activity includes increased thyroid
antibody production. This is why hypothyroidism should be avoided when using any treatment for
T3 is more potent than T4. So you're more likely to notice some temporary hyper effects when you
first begin using it. This happens as your cells try to store adequate hormone, but the effects
generally diminish within a week or two unless your FT3 levels rise too high. It sounds like
you're taking 0.625 mg Cytomel twice daily for a total of 1.25 mg. This is a very low dose. If
FT3 is too low you can have symptoms of arthritis and fibromyalgia, like rib pressure points
under your arms. You want to look at your FT3 blood level to see if you're on an adequate dose
of replacement hormone. Best, Elaine
One more thing Elaine......the reason I thought Cytomel was a stimulant to the immune system is
that Diana Schwarzbein who wrote "The schwarzbein Principle" says if your Insulin Resistant you
should stay away from Cytomel and well as allergy meds, coffee, smoking, anything that "acts"
as a stimulant. She stresses in both of her boths againist the use of Cytomel.
I was wondering if you have ever read her books and what you think of this?
5 of 6 Posted Mar-12 7:49 PM Msg 4377.5 reply to 4377.4
I'm not familiar with that author. I suppose her logic would be that foreign proteins could
stimulate the immune system but this wouldn't hold true for everyone since we have specific
genes that determine what substances our immune system reacts to and how strong the reaction
will be. In fact, glandular substances are used in oral tolerance therapy, which is undergoing
clinical trials for diabetes.
Insulin resistance is not usually autoimmune. It's considered part of the metabolic syndrome
and a lot of new information on this subject has come out within the last year.
But since some people can react to glandular extracts Cytomel is a good alternative for you.
Your FT3 level would be the best guide as to whether your dose is adequate or needs to be
slowly increased. Best, Elaine
What do you know about Astragalus and Graves' DIseae? Can I take it? I had RAI in 1999-
and Radiation and steroids for the eye orbits a couple years later. Been "disease free"
(sort of- are we really ever free?) for about 5 years now.
I have had a cold/sore throat/stuff nose and chest, etc., for 2 weeks now----don't feel as
if I need antibiotics, but I am weary- have not taken ANY over the counter antihistamines,
etc. My eyes are so dry that I would not be able to handle that.
Any suggestions? And- what about Astragalus as an immune system protector?
Thank you- Susan
2 of 4 Posted Mar-15 1:28 AM Msg 4380.2 reply to 4380.1
Astragalus would be good since it's an immune enhancer rather than an immune stimulant.
In GD, especially after RAI, you want to strengthen but not stimulate your immune system.
Immunomodulators like astragalus and plant sterols/sterolins are helpful as is a
nutrient-rich diet, particularly avoiding saturated fats and sugars. Vitamin C, stinging
nettle and quercetin help with cold-like symptoms and allergies. Flaxseed oil supplements
and antioxidant vitamins also help with TED and immune system healing. Some of the newer
antihistamines like claritin don't cross the blood-brain barrier so they don't cause the
nervousness and dryness of the older compounds. Best, Elaine
Visit my new suite 101 topic on autoimmune diseases at http://autoimmunedisease.suie101.com
Author of Graves' Disease, A Practical Guide; Autoimmune Diseases and Their Environmental
Triggers; Thyroid Eye Disease, Understanding Graves' Ophthalmopathy
Could you let me know WHAT type/kind of Astragalus is the best for GD ---extract, root,
how many milligrams? etc! Thank you!
You also mentioned Plant Sterols- what type? Is there a brand name that you prefer or
I appreciate your fast response. You are always so helpful!
4 of 4 Posted Mar-16 6:08 PM Msg 4380.4 reply to 4380.3
To: Susanmaria unread
You can take astragalus as a tea, capsule, or tincture. For use as an immodulaor, using
3 "00" capsules three times daily seems to work best. As a 1:5 tincture in 60 percent
alcohol you can use 30 drops up to 4 times daily.
The immunomodulators were first described in the last two decades. The brand name
Sterinol has probably been around the longest as far as patent medicines go. It can
be taken up to three times daily. Other plant sterols are found in Noni, Nonu, Nono,
and other immunomodulators include reishi mushroom extract, German chamomile, and flower
pollen extract (as long as you don't have pollen allergies). Many companies have also
introduced combination immunomodulators and I try to comparison shop, usually finding
products for sale at Puritan's Pride or the Vitamin Shoppe. Best, Elaine
Elaine, Is the treatment for GD the same as for Hyper? I read somewhere that only
20-30% of people with gd respond to the anti-thyroid drugs. What is the difference.
I am hyper,now the doctor says I'm GD. I'm confused.
6 of 8 Posted Feb-18 2:43 AM Msg 4341.6 reply to 4341.5
Hyperthyroidism is the condition of having elevated thyroid hormone levels, and Graves'
disease is the most common cause of hyperthryoidism. All types of hyperthyroidism can
be treated with anti-thyroid drugs. ATDs both lower thyroid hormone levels and help the
immune system heal. In GD, a defect in the immune system causes GD and this is a
self-limiting condition, meaning that it eventually resolves. Newer studies show a
much higher remission rate with ATDs, and Harvard researchers state that most everyone
will respond to ATDs when they're used properly, that is, until remission occurs. A
recent Japanese study showed a remission rate of 81%. Rates higher than 60% are commonly
seen in Europe where ATDs are used in nearly all cases. Best, Elaine
Author of Graves' Disease, A Practical Guide; Autoimmune Diseases and Their Environmental
Triggers; Encyclopedia of Sexually Transmitted Diseases; Encyclopedia of Alzheimer's
Disease; and an upcoming book on hepatitis.
7 of 8 Posted Feb-18 3:00 PM Msg 4341.7 reply to 4341.6
Thank you Elaine, so as long as I take my meds I should be o.k weather it's hyper or GD?
Also, I just came out of the hospital and the doctor put me on 300mgs of PTU a day, isn't
this a very high dosage? Should I be concerned?
8 of 8 Posted Mar-16 5:50 PM Msg 4341.8 reply to 4341.7
To: Linda34810 unread
Sorry I just found this message. A 300 mg PTU starting dose is fine although recent studies
show that a lower dose, usually 200 mg is usually adequate for a starting dose. After about
6-8 weeks on your starting dose, your FT4 should fall into the normal range. At this time
you're considered euthyroid and your dose is lowered. And yes, PTU will lower your thyroid
hormone levels regardless of the cause. Best, Elaine
I can't get this into my poor Gravish brain. When I get a blood test is the TSH number what
it was 6 weeks ago since the TSH lags behind 6 weeks. So if I am adjusting a dose, I am
actually adjusting to a dose to help what my TSH was 6 weeks ago? This is confusing to me.
Here are my labs. I started on 5 mg of tap after the nov bloodwork. felt great for 6 weeks
and then slowly got very sluggish and cold. So they cut it in half after the Feb bloodwork
and I feel a little better.
Is the FT4 a little low? And if so how can I fix that. the endo doesn't do block and replace.
Why do they even test the TSH if it doesn't mean much. In my case I felt awful when the
TSH started going up...even though it didn't go up that much.
Thanks for any input. It's greatly appreciated.
July 2005 ------ felt just ok TED worsening
Ft3 3.5 (2.3-4.2)
Ft4 0.77 (0.58-1.64)
thyroidgobulin ab Less thn 1.0 (0-2.3)
Oct 2005 ------ nervous wreck and tired
TSH .13 (.34-5.6)
FT4 .95 (.58 1.64)
TSI 3.1 (0 1.3)
Nov 2005 skinny, sweaty, tired, napping
TSH 0.08 (.34-5.6) different lab
FT3 3.9 (2.1-4.2) ------- Started Tap 5 mg
FT4 1.3 (0.9-1.1)
------ Felt wonderful at this point
FT4 0.9 (0.58-1.64)
TSH 1.81 (.34-5.6)
------ Started to feel like a slug,freezing!
Feb 26, 2006 ------ Was a slug
TSH 7.06 (.34-5.6)
FT4 0.9 (.58-1.64
2 of 2 Posted Mar-16 1:39 AM Msg 4381.2 reply to 4381.1
To: Robomomdonna unread
Don't worry about the 6-week lag. TSH is also affected by your TSH receptor antibodies.
They falsely lower it. TSH has very little value in monitoring ATD therapy except that
it will rise if you move into overt hypothyroidism, and it will show up in this case
before thyroid hormone levels become abnormally low. As soon as FT4 becomes too low for
your body's needs the TSH level can rise. So while the result shouldn't be used to
monitor your thyroid status it helps in showing a move into overt hypoT.
In your case, reducing your dose to 2.5 mg or 1.25 mg daily would be the easiest
solution to raising your FT4. It's important to avoid hypoT because your gland speeds
up activity trying to correct the problem. This causes increased antibody production
and can worsen TED. Best, Elaine
Here are my lab results from 3 weeks ago:
TSH: .08 (up from less than .01)
T4: 8.7 (4.50-12.5)
T3 Total: 160 (?-181)
I am on 50 mg of PTU down from 100 mg PTU about 4 weeks ago. Last week I started
really having trouble with my eyes again. I was fine when I went off Prednisone
and to PTU at 150mg/day. About 2 weeks after moving to 50mg/day I began having
lots of swelling in the right lid, lots of pain with movement in the right eye
and dryness.pain to the touch in the left eye. I am having my labs drawn again
next week, but cannot for the life of me figure out why I'm having TED trouble.
Usually when my levels improve, the TED improves. The only thing is that I got a
cold about 4 weeks ago and my psoriasis flared. I stuck on my PTU at the same levels
and mad my labs drawn 2 weeks post cold and my levels improving.
Why would my TED be getting bad again? Am I on too little PTU? I didn't want
to take more than 50mg since my T4 seemed to be getting lower more quickly than my
T3 or TSH. I am not having any Hyper symptoms. My eyes are very sensitive to
level changes. I can usually tell right away when my levels are off because my
right eye gets puffy. Now its really swollen again, like before I was on
Prednisone the last time.
Could my T4 be too low and its causing the pain/dryness/swelling? Or, could
I have to increase my meds to get this to even out? I am also making an appt
to see my opthamalogist again, maybe he'll put me back on Prednisone. Ugh.
I know my endo will suggest removing my thyroid - not an option for me.
Thanks for the help,
2 of 2 Posted Mar-8 4:44 AM Msg 4375.2 reply to 4375.1
To: samlab25 unread
I'm sorry to hear that your eye symptoms are worse? If your thyroid hormone
levels were too low before, this may have increased thyroid antibody production,
which would cause effects for up to 2-3 months. Your labs look fine although T4
and T3 are both usually falsely elevated in women. It would help to have the FT4
and FT3 levels to make sure that your levels aren't too low for your body's needs.
It could also be that your cold stimulated your immune system, which is the usual
reaction. This, or any immune reaction to allergens, could have stimulated your
immune system and increased thyroid antibody production. Studies show a link
between low selenium levels and thyroid autoantibody production. Selenium and
other antioxidants are now being used along with methimazole in Graves' disease
with good results. Vitamin E, vitamin C, Zinc, beta carotene and selenium are the
ones most often used. And you probably already know about the benefits of
flaxseed oil. Flaxseed oil has been shown in numerous studies to improve eye
dryness and help the immune system heal. Best, Elaine
I was diagnosed with Graves about a year ago. I've been on Methimazole and
I'm now at 2.5mg a day. After about 4 months on methimazole, I developed
tingling numbness in my hands and feet. I also get cramping in my hands and
forearms to the point where I can't type or hold a book. I have a pretty wild
tremor in my right hand when I hold it out flat. I occasionally can feel tremors
in my chest and head. All of this gets worse when stressed. In the last month,
I've developed a burning sensation in my shoulders. I also get a needle prick
sensation in my spine and legs. I also get so exhausted in the afternoon most
days. I'm just miserable. I couldn't type and email this morning and started
crying at my desk. On the bright side - I sleep great and I have no eye problems.
I felt better before I was diagnosed.
I've been sent to a neuro-muscular center about 4 hours away. I live in a
pretty rural community and my general practice doc and the neurologist here
don't think they can help me. I haven't been to an endo.
My gp told me I could go off of the methimazole - but, I'm going to taper it
off slowly. He cut my dose in 1/2 once and I ended up in the ER thinking I was
having a heart attack. So, I'm scared.
Do these symptoms sound like a reaction to the medication? Should I wait and
see if I feel better off the meds or, should I continue with the neuro-muscular
center. 8 hours of driving and missing a day of work for a 1 hr consultation
just seems ridiculous.
2 of 6 Posted Feb-23 7:56 PM Msg 4367.2 reply to 4367.1
To: sharlac (sharlac2) unread
I'd skip the neuro-muscular disorder consultant since it's not certain that
it's needed. Peripheral neuropathy and some of the tinging symptoms you mention
frequently occur in hypothyroidism. You don't need an endocrinologist
necessarily, but you want to make sure that your doctor is running FT4 and FT3
levels. You wouldn't need an FT3 with every set of labs but you should have one
now if you haven't in a while.
Doctors with little experience using ATDS often over-medicate patients,
especially if they rely on the TSH test. TSH will stay low for a long time
and in general TSH won't even rise until you're near remission or have become
hypothyroid from too high of an ATD dose. You want to make sure that FT4,
especially, is near the high end of the range or it may be too low for your
body's needs. With FT3 you want to make sure it's at least at mid-range.
If your ATD dose is too high, you can reduce it to 1.25 mg or you can ask
to try block and replace. In this protocol you leave the ATD dose alone and
add a little bit of thyroid replacement hormone. And you probably want to make
sure your doctor has run some immunological tests like an ANA to rule out other
autoimmune disorders. Tremor can occur in hyperthyroidism and rarely neuropathy
can occur. So you want to look very closely at FT4 and FT3, watching for both
hyperthyroidism and hypothyroidism. Some people will have an FT4 that's within
range but have a very high FT3. Most tremor is essential and without a specific
cause, but when it occurs in someone with a known thyroid disorder, thyroid
imbalance can be the cause. Once you get copies of your labs it'll be easier
to tell what's going on. Best, Elaine
Author of Graves' Disease, A Practical Guide; Autoimmune Diseases and Their
Environmental Triggers; Encyclopedia of Sexually Transmitted Diseases;
Encyclopedia of Alzheimer's Disease; and an upcoming book on hepatitis.
3 of 6 Posted Mar-1 8:12 AM Msg 4367.3 reply to 4367.1
To: sharlac (sharlac2)
You might try taking calcium to combat the tingling numbing sensation.
When your thyroid is being being repressed it can throw your parathyroid
off which controls calcium levels in your body. I had a total thyroidectomy
a year and a half ago after dealing wth Graves for over ten years. After
surgery my doc told me to be aware of that tingling sensation because it
can indicate a lack of calcium. I recomend calcium aspertate... it's a very
concentrated form of calcium that disolves instantly in your mouth thus
entering your blood stream more quickly. I'm sorry I don't remember the
brand name but if you do a search I'm sure you can find it.
4 of 6 Posted Mar-3 4:54 AM Msg 4367.4 reply to 4367.3
From sharlac (sharlac2)
Thanks for tip, I really appreciate it. My doc did check my parathyroid
and calcium and they were normal. Because tests are just one moment in
time, I will work on getting enough calcium like you suggested. About
2 weeks ago, I cut my anti-thyoid in half and I've been feeling a lot
better in the last few days. My TSH has been 2.7 - but, maybe that is
hypo for my body. I'll keep working on it.
5 of 6 Posted Mar-3 6:12 AM Msg 4367.5 reply to 4367.4
To: sharlac (sharlac2) unread
I know how frustrating dealing with thyroid disease is.
Good luck to you
6 of 6 Posted Mar-6 7:42 PM Msg 4367.6 reply to 4367.1
From sammawamma (sammawamm1)
To: sharlac (sharlac2) unread
Thank you so much for posting this; I'm so happy I could hug you through
the computer. I've been dealing with the exact same thing on and off for
MONTHS now! Tingling and numbness, hands and feet - mine also comes with
some swelling, too. And it definitely gets worse with stress!!! My
shoulders and chest have bothered me practically since I started ATDs.
I too felt WAY better before I was diagnosed...oh, how that statement
I have found that ibuprofen helps with the swelling/numbness - but never
for long enough. I have been to the endo and my GP multiple times about
this, each doctor just points me back at the other one. They do test my
levels when I ask them to, but only look at TSH. Grrr! I've since fired
my endo and may have to do the same for the GP, LOL! I have tried
adjusting ATD doses but I feel like my levels are contantly changing,
so it's hard to keep up. No, it's impossible. I'm beginning to think
there's some pattern to my cycle and my thyroid symptoms. But just when
I had given up and figured I just had to ride it out, I see this post.
I will look into calcium and get yet another test done. I'm just so
happy to know this is "normal" - as normal as we're gonna get! LOL Thanks
I had RAI done on Oct 4th. I was put on 100 MCG of synthroid the end of
November when my TSH was 70. 6 weeks later my TSH reduced to 43 and my
synthroid was increased to 150. Here is the labs that I just had done:
TSH .71 (.4-5.)
FT3 270 (230-420)
FT4 1.6 (.8-1.8)
All of my labs are in the normal ranges, however, is there a ratio
between FT3 & FT4 that I should be concerned with? Does it matter where
they fall with in the normal range?
Thanks for your help,
2 of 4 Posted Feb-25 6:19 PM Msg 4370.2 reply to 4370.1
To: wickfam (wickfam2)
Glad to hear you're doing well. As for the ratio of FT3 and FT4, there
haven't been any studies showing what an ideal ratio would be. And
that's probably because good assays for FT3 have only been widely
available for the last few years.
The reference or normal range is a good guideline, that is, you wouldn't
want levels outside the range. But for deciding what type of replacement
hormone is optimal for you, symptoms play a larger role. For instance,
many people would have symptoms of hypothyroidism with an FT3 level like
yours. For some people, adding 100-200 mcg selenium daily to help conversion
of T4 into T3, might be enough to help them feel better. Other people might
need to be on T3 as well as T4 (Synthroid) replacement hormone. There are
studies showing that people benefit from the addition of T3 and other studies
saying that there is no improvement. It seems, though, that people with
severe hypothyroidism (people after RAI or thyroidectomy) often need T3
replacement hormone, whereas people with mild hypothyroidism from other
causes may not.
You might want to review the symptoms of hypothyroidism although I suspect y
ou're pretty familiar with most of them after having an elevated TSH. Subtle
symptoms include depression, joint pain, digestive disturbances, and hearing
loss. If you think you might benefit from the addition of T3, ask your doctor
about adding it. Best, Elaine
3 of 4 Posted Mar-1 9:35 PM Msg 4370.3 reply to 4370.2
From wickfam (wickfam2)
Thanks Elaine for your reply!
Can you tell me how long it would take after starting to take Selenium
before I would feel if it is helping?
4 of 4 Posted Mar-2 5:50 PM Msg 4370.4 reply to 4370.3
To: wickfam (wickfam2)
It usually takes 3-4 weeks to notice the effects of selenium replacement
if your levels have been quite low. If they're just mildly decreased you
could notice improvement sooner. Those of us with thyroid disorders have a
number of nutrient deficiencies. Some people notice an overall improvement
within a week of starting a good multi-vitamin. Best, Elaine
I first wrote you in November under the subject "Cyst and antibodies,
what's going on?" (and your replies were very thorough and helpful!).
I have a hot nodule and slightly low TSH, but my FT4/TT3 have been in the
low/normal range lately. You theorized that I am primarily hypOthyroid
and the hot nodule was sort of a last ditch effort from my thyroid to
try to produce enough hormone (paraphrase for "compensatory hyperplasia"
I think was the term). Since then I have got a hold of my old medical
records, and the labs and uptake/scan done in 2000 seem to back up that
explanation. Although I was diagnosed with GD after the 3/00 uptake/scan,
the fact that I had a "heterogeneous" goiter would seem to point towards
a hot nodule (although without the films I can't be totally sure).
That particular endo later changed the Dx to "thyroiditis."
I have another question for you about the nodule, and a question about
all those labs. First, could my nodule be a hemorrhagic adenoma (would
this be consistent with compensatory hyperplasia?) And if so, could it
be a follicular adenoma based on the details from the ultrasound report?
It is an autonomously functioning, complex nodule with "thick, irregular
internal septations". And if the nodule was caused by compensatory
hyperplasia, would the normal lobe of my thyroid show any kind of problems
on the ultrasound (it doesn't). My first endo said that since the
nodule is getting bigger, I will go hypER and I need to have surgery,
but when I got a second opinion that endo said the nodule is dying off,
so I don't need to do anything and I wont' go hypER.
Second, do my labs show any sort of pattern? I know they are incomplete
but I was wondering if anything jumped out at you. I am trying to figure
out whether my depression may be related to whatever is going on with my
thyroid, and I have an appointment with a psychiatrist to discuss going off
the Zoloft that I've been taking since 2004. (I read that
Zoloft/sertraline can cause hypOthyroidism, and it also does not seem to
be working as well as it used to).
Thank you very much for any input you could give me. It's frustrating
trying to sort all this out and you (and your book and articles) have
been such a big help to me.
TSH 17.3 (0.4-4.0) HIGH
TT4 5.4 (4.5-12.5)
TT3 1.4 (0.8-1.8)
FT4 Index 5.2 (4-11)
T3 Uptake 0.97 (0.77-1.17)
on birth conrol pills
3/21/00 Uptake and Scan
2 hr uptake 18% (2.5-7.5%) HIGH
24 hr uptake 47% (10-30%) HIGH
Diffuse heterogeneous goiter
Visible pyramidal lobe
Dx Grave's Disease
TSH 6.2 (0.4-4.0) HIGH
TT4 6.7 (4.5-12.5)
FT4 Index 6.4 (4-11)
T3 Uptake 0.96 (0.77-1.17)
birth control pills
TSH 1.8 (0.4-4.0)
TSH 1.57 (0.4-4.0)
TT4 5.9 (4.5-12.5)
TT3 1.2 (0.8-1.8)
FT4 Index 7.4 (4-11)
T3 Uptake 1.26 (0.77-1.17) HIGH
birth control pills
TT4 8.0 (4.5-12.5)
View Full Message
Edited Feb-20 by capuchin0monkee (capuchin0mon)
2 of 4 Posted Feb-23 7:34 PM Msg 4365.2 reply to 4365.1
To: capuchin0monkee (capuchin0mon)
Your first set of labs with the 17 TSH show that you were hypothyroid.
your subsequent labs where TSH fell do not necessarily mean that you
were hyperthyroid. Also, while your uptake was slightly increased, it's
not as high as the levels seen with overt Graves' disease.
Your high elevated thyroglobulin and TPO antibody titers are the type of
levels seen in Hashimoto's thyroiditis (autoimmune hypothyroidism). You
also have TSI, which are the antibodies that occur in Graves' disease.
You probably also have blocking TSH receptor antibodies. Both blocking
and stimulating (TSI) TSH receptor antibodies falsely suppress TSH and
make this result unreliable.
It looks like you have Hashitoxicosis which is a condition of primarily
hypothyroidism along with TSI antibodies. The TSI antibodies, rather than
causing Graves' disease, in this case cause your thyroid hormone levels,
FT4 and FT3, from falling too low and they can cause transient hyper
symptoms. Hashitoxicosis can be an intermediate stage before people move
into Graves' disease or it can be a chronic condition causing symptoms of
hypoT that aren't properly diagnosed.
Depression is one of the earliest symptoms of hypothyroidism and is thought
to be present in some degree in all hypothyroid people.
I don't know enough about the histology of the various nodules except that
various kinds can be septate. Your best bet would be to have a thyroid biopsy.
This can confirm Hashitoxicosis and it can identify the type of tissue that
your nodule is composed of. According to the College of American Pathologists,
much nodules are benign and most will shrink by 50% in about one year of
being on a low-iodine diet.
3 of 4 Posted Mar-1 12:44 AM Msg 4365.3 reply to 4365.2
From capuchin0monkee (capuchin0mon)
Thank you very much for your reply. I saw the endo again and she agrees
that I have Hashitoxicosis along with the nodule. She ordered TBII,
Blocking TR Abs and a.m. cortisol, I'm sure the other Abs will confirm
the dx of Hashitoxicosis.
I have a couple more questions for you. First of all, my TSH rose to
0.85 (TT3 96, FT4 1.0). On the day of the draw I felt really good, normal,
no "brain fog". Could this have something to do with the TSH?
Also, could the TSH be rising due to the fact that I was on a low iodine diet?
(I stopped at the end of January, but I heard that TSH can lag behind for
6 weeks). If so, should I resume the diet?
Finally, what treatments are there for Hashitoxicosis other than surgery?
Block and replace? My endo said that if my TSH does not drop again at my
next labs, she will consider starting me on replacement hormone. Could I
monitor body temperature and use that to predict when I'm having upswings
4 of 4 Posted Mar-1 1:01 AM Msg 4365.4 reply to 4365.3
To: capuchin0monkee (capuchin0mon)
Yes, a low iodine diet will lower your thyroid hormone levels and this will
cause TSH to rise. You're correct in that there is usually at least a 6
week lag before TSH reflects new stable thyroid hormone levels, but it'll
start to rise before then.
Hashitoxicosis can be treated with block and replace because the ultimate
goal is to slow down your immune system and reduced thyroid antibody
production. Surgery may be needed if your gland has scar tissue from
long-term hypothyroidism and inflammation or if your nodule was suspicious
for malignancy. Most people, though, don't need surgery.
Body temperature does reflect thyroid status for most people. You'd
especially want to avoid becoming hypothyroid because your thyroid
speeds up its activity trying to correct the hypothyroidism. This
increased activity encourages thyroid antibody production.
What's important to consider, too, is that your TSH will be falsely
decreased by both blocking and stimulating TSH receptor antibodies.
As these levels increase, your pituitary recognizes them as if they
were TSH molecules. Thinking you have adequate TSH in your blood
circulation, the pitutiary slows down on or stops secreting TSH. Brokken
has written articles describing this. And for this reason it's important
to evaluate your thyroid status with FT4 and FT3 levels and realize that
TSH levels can be misleading. Best, Elaine
I am a 40 yr old male who has had a partial thyroidectemy 3 years ago.
Left lobe and isthmus removed because of nodule. Once removed a minimally
invasive follicular carcinoma was found.
My endo and GP advised taking thyroxine for life to kill off the rest of
the thyroid and prevent regrowth of nodules.
However my surgeon post surgery stated that doing nothing post surgery was
also an option and that the thyroid gland may cope on its own.
It was really only the fear of the nodule returning that i took the thyroxine
Well two years later i am as ill as i was when i first presentd to my GP.
Of course my labs are within the normal range and all the doctors now
pronounce me euthyroid. So they are treating me now for anxiety and depression.
Well the depression has gone but nothing can touch the persistent anxiety.
I am of the opinion that i am still hyperthyroid and would like to ask your
opinion on this.
I am currently taking 175mg thyroxine built up in 25mg steps over two years.
If i am hyper would this just be making me more hyper ?
Would it still be an option to stop thyroxine all together and let my gland
do the job or are the risks too high or maybe i have killed the gland?
2 of 2 Posted Mar-1 12:52 AM Msg 4372.2 reply to 4372.1
To: alan65 (alan6511) unread
Usually, with a partial thyroidectomy, you gain thyroid function over
time. Taking thyroid hormone doesn't destroy your gland, but it slows down
cellular growth if your pituitary stops producing TSH. The idea here is
that since TSH causes thyroid cells to grow and produce hormone, without
TSH any malignant cells will not continue to grow.
But, usually thyroid function still improves. People on replacement hormone
after partial thyroidectomy are usually able to cut their dose of
replacement hormone about 6 months to a year after the procedure. It could
just be that your dose of thyroxine is now too high for you. It's important
that you have both FT4 and FT3 levels when you're monitored. If either of
these levels are too high for your body's needs you can have symptoms of
hyperthyroidism. I'd ask for a copy of your lab results and see if your
dose of replacement hormone may be too high for you. Best, Elaine
Hi Again Elaine-
After a year I was informed that my TSH is now 4.0 and FT4 is normal,
so my Endo took me off of my Tapazole that was at 5 mg/day. What do
I wait for now? Should I expect Thyroid Storm or Tachacardia if my
Hyper/GD kicks in again? I'm nervous about this b/c of my PAC Arrythmias.
2 of 4 Posted Feb-20 6:48 PM Msg 4363.2 reply to 4363.1
It's always a good idea to wean off meds slowly. This helps your immune
system adjust to the change from being suppressed or slowed down, and
it helps gauge if you're truly in remission or if your dose is just too
high for you. The usual protocol is to move to 2.5 mg for a week or
two, and if you don't notice hyper symptoms you move down to 1.25 mg daily.
Then after a week or two you can cut down to 1.25 mg every other day and
continue on this dose or whatever low dose you decide to stick with for at
least 6 weeks. At this time you'd want to repeat labs and see what your
labs look like at a minimal dose. If you're secreting TSH normally, then
remission is likely. You could also ask for a TSI level to help determine
if you're in remission, but you'd still want to stop meds slowly.
Because your TSH is high according to the new ranges, it wouldn't hurt
to stop your dose for a few days before resuming the lower ATD dose.
Why don't you call your doctor and mention that you're concerned and
ask about weaning off meds slowly and then repeating labs. Best, Elaine
3 of 4 Posted Feb-20 8:54 PM Msg 4363.3 reply to 4363.2
Thanks for the advice, the Dr. said if I wasn't comfortable with ending
I could do 5 mg 3X a week, but your dosages sound better. However, is
the two conditions I mentioned a reality for me? How will I tell if
the Hyper-T is coming back? p.s. - My Dr. doesn't believe in "remission".
4 of 4 Posted Feb-28 5:10 AM Msg 4363.4 reply to 4363.3
To: jessegirl01 unread
Thyroid hormone levels rise slowly. Before you'd reach the point of
thyroid storm, you'd have noticeable symptoms of hyperthyroidism.
There are some conditions, though, that could make you more susceptible
to the effects of thyroid hormone. These include respiratory infections,
particularly pneumonia, but problems are more likely to occur in elderly
people who haven't been diagnosed or received treatment for hyperthyroidism.
In the elderly, symptoms of hyperthyroidism are often apathetic where
patients seem withdrawn and somnolent rather than nervous or anxious.
About 20% of people with GD will start producing blocking TSH receptor
antibodies rather than the stimulating variety that causes hypothyroidism.
Both blocking and stimulating antibodies can cause a drop in TSH. But
when thyroid hormone levels and TSH both start to fall, it's usually
blocking antibodies that are contributing to hypothyroidism and interfering
with TSH production. You could ask to have a test for blocking TSH receptor
antibodies or ask your doctor about thyroid replacement hormone if you have
any hypothyroid symptoms. Best, Elaine
Hi Elaine, it's me again.
I'm so confused. As I've said in previous posts, I have Subclinical Hyper
T w/nodular goiter. My numbers now - as they have been since Septemter -
are TSH <0.01; FT4 1.3 (range .8 - 1.8) TT3 1.91 (I forget the range, but
it seems to be mid-range) The only symptoms I have are slight palpitations
(never higher than 93 bpm) lots of anxiety & depression; sleep problems -
all of which could be menopausal, too. I had the Thyroid Scan & Uptake and
it was 30% after 24 hrs. My PCP prescribed Inderal 80 mgs, but I didn't
want to take that much. I saw an Endo who agreed that my symptoms were
primarily caused by menopause and that the thyroid problems should correct
themselves. She changed the Inderal to 10 mgs PRN and she said that we
should just do blood work every 6 weeks and meet again in 6 months.
Well, after my first round of blood work (with the results as listed above)
she now wants me to start Tapazole 10 mg and come back next month. Why
the change in treatment plan? Is she expecting the numbers to change faster?
Aren't the T4 & T3 in the normal range? I haven't taken any of the
beta-blocker because I just don't feel the palps are that bad and I'm
afraid to lower my blood pressure. And I'm not sure I want to start ATDs
mostly because I feel bad enough without putting on weight. Which also
reminds me: why do I have more symptoms of Hypo? Will Tapazole help w/the
I really want to do the right thing, but I just don't know what that is.
2 of 4 Posted Feb-23 7:20 PM Msg 4368.2 reply to 4368.1
To: Lola51 (Lola518)
The reference range for FT4 is usually 0.8-2.0 and for total T3 it's
0.9-1.8 pg/dl, and total thyroid hormone levels are usually elevated
in women. Because we have much more T4 relative to T3 it's standard
practice to use the FT4 for monitoring therapy. Because your FT4
isn't even on the high side, a Tap dose of 10 mg could easily move
you into hypothyroidism. Your doctor may not realize that T3 is often
falsely elevated and she may not know that TSH stays low or suppressed
for a long time. It's also possible that you had a FT3 rather than TT3
since the range for FT3 is 2.3-4.2 and in most labs T3 is measured in
ng/dl with the range being 80-180. You might want to clarify the range
on this test result and see if you had an FT3.
Hypothyroidism and hyperthyroidism cause some overlapping symptoms.
Palpitations and sleep disturbances show up in both disorders. However,
if your bpm of 93 is when you're at rest at least 10 minutes, this
would more likely be related to hyperthyroidism. If you're not at rest
when your heart rate rises, this wouldn't pertain. Have you tried a
low iodine diet? That's usually the first line approach for nodular
goiter and also subclinical disorders? Best, Elaine
3 of 4 Posted Feb-24 8:55 PM Msg 4368.3 reply to 4368.2
From Lola51 (Lola518)
I called the Endo today to ask about why she wants to start the
Tapazole and she said that my numbers have gotten so much higher.
I said that actually, they hadn't. She disagreed and said my TSH
was .02 when I came in Jan 24th, and now it's back to .01. Then
she said my FT4 was normal, but that my TT3 (yes, it really is the
Total T3) was 1.9 which was indicative of thyroid toxicosis (or
something like that) Then I quoted your post saying that I understood
that therapy was done by FT4 and she said I was absolutely wrong and
was I getting my information from the internet. When I said that I
was corresponding directly w/Elaine Moore, she said that she doubted
you had time to sit and answer questions, that this is exactly how a
"50 year old man corresponds with little girls" and tells them he's
someone else. I could just scream!! (You aren't a 50 year old man,
Normally I would just look for another doctor, but I've been fighting
my PCP over this, too, and quite frankly, I'm worn down. My heartrate
is normally 74 - 78 bpm - when it's running rapid it only gets to
about 85 - 95 bpm resting. I have the propranolol, but I've been
nervous about taking it because it doesn't seem like my heartrate
is all that fast and I don't want to slow it down to comatose. Is
Actually, the anxiety and depression and joint pain have gotten to
be the worst they have ever been, and I just want to feel better.
I just can't put on weight - I would love to try the low-iodine diet,
but I'm just too tired and worn down to do any kind of diet - and I
heard Tapazole will put on weight. I could just cry.
What's next? I appreciate your help,
4 of 4 Posted Feb-25 6:32 PM Msg 4368.4 reply to 4368.3
To: Lola51 (Lola518) unread
You're right. I'm not a 50 year old man. And treating hyperthyroidism
is primarily influenced by the FT4 level. If you reall had thyrotoxicosis
with an FT3 that was quite elevated, a low dose ATD (lower than 10 mg)
would make sense. And as far as test sensitivities go, a TSH result isn't
significantly different than a level of .01. We can repeat the test on
the same specimen and get results ranging from .01 to .03 and this wouldn't
be statistically significant. If your TSH had fallen from .02 to less than
(<) .01 that would be considered a drop in TSH but still not much of a drop.
The low iodine diet isn't complex. You don't have to read charts or study
labels. You just want to avoid fast and processed foods. When you do eat
them, you want to add foods known as goitrogens (raw broccoli, almonds,
peanuts, cabbage, etc) that help block iodine absorption. But if you can
focus on nutrient-rich foods with adequate, but not excess, protein,
like salads, stir-fry, grilled fish, chicken, etc and avoid saturated
fats and sugars, you'll most likely see improvement.
Beta blockers are helpful in reducing cardiac symptoms and symptoms of
anxiety if you need them. Using a low dose, you shouldn't notice side
effects. And propranol has the advantage of mildly lowering thyroid
hormone levels without causing hypothyroidism.
Graves' disease can cause weight gain when it increases our appetite
yet makes us too tired to perform light exercise. In this case, a low
dose of an ATD, like 2.5-5.0 mg, can actually help people lose weight.
If you're not feeling as good as you should, you may want to give a
low dose of the meds a try, especially the propranolol if that's what
you were prescribed. Best, Elaine
First bloods TSH 0.01 and T4 27 second bloods TSH 0.01 and T4 24.4
Have terrible symptoms all of them including runs and weight loss but
since second bloods palps have got slightly better but may be due to
high anxiety drugs. Just been put on Carb thingy 15 mg Is this OK
is this the right thing she has worried me because she says it can get
rid of my white cell count. How can I stay away from colds etc -
i have children! I wont be able to go out! This is really scary with
all the side effects. PLease reassure me that this is the best course.
My dad died of heart attack at 50 (I am 36) so I want to protect my
heart but Grandmother died at 38 of liver diesese. Does this matter?
Very confused and scared
2 of 5 Posted Feb-19 1:50 AM Msg 4360.2 reply to 4360.1
A dose of 15 mg carbimazole is a low starting dose. The problems you
mentioned, such as white blood cell decreases and liver problems, are
seen in less than 1% of people using anti-thyroid drugs. And these
effects are most likely to be seen in people on inappropriately high
doses of meds.
Heart conditions are often genetic, but fatal liver conditions aren't.
Liver disease is more likely to be caused by viral or toxic hepatitis
and progression to cirrhosis. Heart problems can occur in both
hyperthyroidism and hypothyroidism. The carbimazole takes a good 6-8
weeks for full effects and at this time the dose is usually lowered.
It's best to monitor your levels with free T4 levels (FT4 test). Total
T4 levels are often falsely elevated in women since these levels measure
inactive hormone and are influenced by estrogens. Until the carbimazole
kicks in, many doctors use beta blockers like propranolol to help reduce
any cardiac symptoms. Best, Elaine
Author of Graves' Disease, A Practical Guide; Autoimmune Diseases and
Their Environmental Triggers; Encyclopedia of Sexually Transmitted
Diseases; Encyclopedia of Alzheimer's Disease; and an upcoming book
3 of 5 Posted Feb-19 3:56 PM Msg 4360.3 reply to 4360.2
Thank you so much for your reply. I started on the Carbimazole this
weekend and hten had two nosebleeds and panicked and went to the
hospital! They sent me home saying it was very unlikely it was the
Carb and go to Dr on Monday. I can see this is going to be a recurrent
thing with me! I said this to my husband about rushing to the hospital
every week and he laughed and said he was thinking every day! He knows
me too well. Heart rate is still a little high probably between 80 and
95 so I am not on any beta blockers. Is this OK? Thanks again for
your reply it helps a lot to know there are friends out there. Should
I be taking any vitamins etc or any specfici foods to help with symptoms
until drug kicks in? Thanks again K
4 of 5 Posted Feb-20 4:52 PM Msg 4360.4 reply to 4360.3
To: kat3az unread
Hi Kat try not to panic weve all been there here on this board it is so
scary and the bes thing you can do is learn about the condition and try
and relax l know easier said than done but it really does help. As
Elaine says your on a low dose alot of us start of on higher does and
some like myself sty on a high dose.. my heart rate has got up as high
at 160 something but thats another story its mainly between 75 and 87
these days with meds good luck to you and take care Elaine is the best
x ps l was on beta blockers a short while they didnt agree with me.
(joint pain and triedness ) just try not to worry we are all here for you
5 of 5 Posted Feb-23 7:43 PM Msg 4360.5 reply to 4360.3
To: kat3az unread
I hope the nosebleeds haven't returned. I can't imagine them being from
the Carbimazole. We get a lot of people in the ER this time of year
because it's so dry here and the forced heat makes it even drier. A
good multiple vitamin free of iodine is a good way to correct some of
the nutrient deficiencies associated with hyperthyroidism. Until
the ATDs kick in, beta blockers are great for reducing any cardiac
symptoms especially if your heart rate is high. At a low dose, any
side effects are rare and usually mild. Best, Elaine
Hello:I've been feeling really sick for awhile, but just finally got
tested.I thought I might have hypothyroidism - but now I'm thinking
hyper orGrave's? My doctor said he'd never seen free T3 as high as
mine andall of my female hormones are out of whack too - registering
aspostmenopausal even though I am only 32 and still get my period.
I'mreally scared and would appreciate any input. Thanks!!TSH
1.35 .40-5.5Free T4 1.3 .8-1.8Free T3 1000 230-420IGF-1
363 126-291 (growth hormone)estraadiol <32 postmenopausal
progesterone 29.7LH 11.5FSH 32.8 postmenopausalDHEA 433
0-325cortisol 12.2 3-17insulin 39 <17All of these are out of
whack except the cortisol fell within thenormal range.
2 of 6 Posted Feb-18 3:35 AM Msg 4356.2 reply to 4356.1
Your FT3 is most likely falsely elevated. If it was truly this
high, you would have a low TSH. The most common cause is antibodies
to T3. However, because so many of your other assays seem to be
falsely elevated, you probably have heterophile antibodies that are
causing false positive results with the immunoassays that we use to
run these tests. Your doctor can call the lab and tell them he
thinks something is interfering with the test and request the tests
to be repeated at a reference lab after testing for heterophile
antibodies. You can do a google search on heterophile antibodies
for more info, but they're not harmful.....just annoying when they
skew lab results. Let us know how things turn out, Elaine
3 of 6 Posted Feb-18 3:47 AM Msg 4356.3 reply to 4356.2
Thanks for the response! But then what do you think is wrong with
me? I have many symptoms of hyper - the biggest of which it is
almost impossible for me to sleep on a daily basis. I also have
trouble breathing, tightness in chest, extreme anxiety, and nausea.
I've read online that a high free T3 level can be indicative of
Grave's even with normal TSH and T4 levels - do you think that's
possible? I originally thought I was hyperthyroid - the only reason
I didn't initally think so is because the first TSH test I took did
not indicate so, as you stated.
4 of 6 Posted Feb-20 6:37 PM Msg 4356.4 reply to 4356.3
Your FT3 is higher than what we usually see, which makes a false
elevation likely. Whether it's from T3 antibodies or heterophile
antibodies, you could have a similar false elevation with the TSH
result. Usually in falsely elevated TSH levels due to TSH
antibodies the results are much higher, but heterophile antibodies
and also antibodies to mouse, hamsters, goats or whatever the
source of the monoclonal antibody in the test is made from can
cause these interferences. These false elevations appear to be
affecting your FSH and other results. Estradiol may not be
affected since it's often run on a different type of assay---
levels are low though in people on oral contraceptives, in
ovarian failure and in some women during the early follicular
phase of the cycle.
See www.palpath.com/serohetero.htm for more info on heterophile
antibodies. There are also studies showing that there can be a
genetic component influencing production of these antibodies,
and there are studies showing the antibodies also influence the
immune response in a way that protects against type 1 diabetes.
More importantly for you, there are other testing methods available,
particularly methods that use a dialysis step to remove interfering
proteins. Quest performs a T3, Free, Tracer Dialysis Test and a Free
T4 by dialysis assay. These are more expensive and aren't run locally
but this is probably the fastest way of determining if you're truly
hyperthyroid. Dialysis methods aren't available for TSH or at least I
don't know of any. Same with the other tests you had. But if you
were tested for heterophile antibodies, you could have these tests
performed at a reference labs that uses a reagent that can remove
these proteins. Then you could have the other tests performed.
It's true that you can have a high FT3 with a normal TSH if you
have just started producing FT3 and the pituitary gland hasn't
yet reacted to the high level. But it would be odd for your level
to rise this high. If your doctor agrees that you may be
hyperthyroid based on symptoms he might use beta blockers to
reduce symptoms until he gets the other results and even start
a low dose of ATDs after your blood is drawn for the new tests.
5 of 6 Posted Feb-20 11:11 PM Msg 4356.5 reply to 4356.4
Thanks for your response! I saw an endo today and he wasn't very
much help - he said he'd never seen T3 so high and insisted it
was a lab error. Even though I insisted I had symptoms of
hyperthyroidism, he said he didn't see any symptoms. I asked
what he expected to see and he said velvety skin and racing pulse
(even though he did not even take my pulse). He said I "looked
like a smart girl who read too much." I have been feeling increasingly
sick for awhile and I'm concerned that I'm not going to be able to
find someone who knows how to treat me. Should I ask for a low-dose
of an ATU even though the endo insists I'm fine and it's not my
thyroid? When I suggested it might be my pituitary, that seemed
to be beyond the scope of his knowledge. I will share the testing
information you provided at my next appt. Thanks again!
6 of 6 Posted Feb-21 7:33 PM Msg 4356.6 reply to 4356.5
To: amyjoy21 unread
Your doctor is correct in that your FT3 result is likely a lab error,
and for this reason, it's important to get a correct result. Why don't
you call the office and tell them you realize that your FT3 was
probably falsely elevated, but to tell for certain you'd like the
dialysis assay tests done on FT4 and FT3.
Hyperthyroidism causes a constellation of different symptoms, and
most patients only have a few predominant symptoms. The symptoms
your doctor mentioned aren't seen in all patients with
hyperthyroidism. Some people may just feel anxious, irritable,
have an increased appetite or scanty menstrual periods.
It's not right that you or your insurance pay for a lab test that
your doctor suspects is in error. He could easily request that
the lab have the test repeated by another method, which involves
sending the sample elsewhere. Or he could order the tests I
mentioned. To just assume they're incorrect without pursuing this
isn't a good idea.
Another article in Laboratory medicine from April 2003 by Mildred
Fleetwood called Interference in Clinical Laboratory Tests by Human
Antibodies to Specific and Non-Specific Immunogens," describes the
problems labs have with interferences in hormone assays by both
heterophile sand specific anti-human animal antibodies (HAAA).
The article clearly states that "clinicians should contact the
laboratory staff with any result that is unexpected (too high or
too low)." Best, Elaine
Hi Mrs. G.
Usually, if you become hyperthyroid while on meds, you just need a
med adjustment. A dose of 100 mg levothyroxine may just be too high
for you. Rather than increase the PTU, you may just want to cut
down the levothyroxine. In most cases, over time the PTU can be
reduced but it could be that you're being exposed to environmental
triggers. Common ones include cigarette smoke, estrogens, stress,
aspartame in nutrasweet, and excess dietary iodine in fast/processed
Recent studies show that people with low selenium levels are also more
likely to elude euthyroidism. In several studies, selenium, beta
carotene, and vitamins C and E are being used along with ATDs. You
could try adding 100 mcg selenium if you're not taking a supplement
with selenium. The stress of caring for a sick child could also have
caused you to relapse somewhat. Now that your child has a proper
diagnosis and treatment, things may improve for you. Best to you, Elaine
Hi Mrs G,
I didn't use the nicotine patch, and I had smoked for around 15
years when I quit. I did buy some weird herbal cigarettes that I
told myself I could use if I got desperate. They were pretty
awful so I only smoked 1-2 of them. But knowing they were there
sort of helped.
I also told everyone I knew that I quit. And nearly everyone I
knew told me I shouldn't be saying this since I wouldn't be able
to do it. This was the first time I ever seriously quit and I was
offended by their negativity. One of my co-workers in toxicology
even said nicotine was more addictive than heroin. I'm stubborn
so this unexpected feedback made me determined to succeed. I
also told myself that if I ever decided to smoke again some day
when I was older and the kids grown that I could, but after 25
years of not smoking I don't expect I'll get the urge again.
When I quit, I did have an elevated blood pressure for a day or
two. After that I decided the worst was over and I didn't want
to go through it again. After 3-4 works I finally found myself
not thinking about cigarettes all the time. Probably different
things work for different people but this approach, with the
help of the vitamins and minerals, worked for me. Best to you,
am on 300mgs a day of PTU after leaving the hospital. I am now
suffering from itching and hives. Is there anything I can take or
use for some relief?Linda
2 of 2 Posted Feb-20 6:40 PM Msg 4362.2 reply to 4362.1
Many doctors prescribe diphenhydramine (Benadryl) for itching
and hives or they lower the PTU dose. Even though the usual
starting dose has traditionally been 300 mg daily, newer studies
report good results with starting doses of 100-200 mg. It would
be a good idea to call your doctor and let him or her know about
your symptoms. Best, Elaine