Blood work, possible Grave’s/Hyperthyroidism? 08-05-2019

Checkdis · Aug 5, 2019

Hey guys,

New labs from a rheumatologist suggest possible Hyperthyroidism. Strange thing was I recently had blood work on 05/31/2019 and my TSH and FT4 has optimal levels with no signs pointing towards Hyperthyroidism. Strangely enough my rheumatologist took blood and tested my thyroid again very early in the morning around 7:30am. This time my TSH came back low and T4 high indicating Hyperthyroidism. In the past my TPO antibodies have been elevated so I am assuming possible Grave’s with my symptoms. I have dry eyes, swollen eyes in the morning (not terrible). Anxiety, frequent urination, hair loss, sleep issues, and light headed.

This is my first abnormal readings for TSH and FT4. I am going to be retested in 2 weeks with my endocrinologist.

captain · Aug 5, 2019

Hemoglobin and Hematocrit may increase with hyper and yours is normal. They test Thyroid Stimulating Immunoglobulin for Graves Disease and I didn't see it in your labs.

Vince Carter · Aug 5, 2019

Thyroid labs are incomplete, TSH and T4 are plenty not enough, not testing the active Thryoid hormone Free T3 is pretty lame.

TSH
FT3
FT4
Reverse T3
Antibodies

...These are the 5 that we recommend.

Vince · Aug 5, 2019

If your Labs do show Graves disease. Find a good thyroid doctor that runs complete labs. My former wife had Graves disease and her doctor really messed her up. I think the worst thing he did was convince her to have radioactive iodine. Then he treated her with T4.

Checkdis · Aug 5, 2019

captain said:
Hemoglobin and Hematocrit may increase with hyper and yours is normal. They test Thyroid Stimulating Immunoglobulin for Graves Disease and I didn't see it in your labs.

Vince Carter said:
Thyroid labs are incomplete, TSH and T4 are plenty not enough, not testing the active Thryoid hormone Free T3 is pretty lame.

TSH
FT3
FT4
Reverse T3
Antibodies

...These are the 5 that we recommend.

Vince said:
If your Labs do show Graves disease. Find a good thyroid doctor that runs complete labs. My former wife had Graves disease and her doctor really messed her up. I think the worst thing he did was convince her to have radioactive iodine. Then he treated her with T4.

I agree with all the information. Yes the labs to test these were not taken but I believe that is for the Endocrinologist to write a script. I have had these panels tested in the past, which was normal results. Just TPO was 219...

But if I do not have Graves’ and this is just Hyperthyroidism... what should be the best steps and best treatment plan? I know I will need some further evaluation like an ultrasound of the thyroid...etc.

Vince Carter · Aug 5, 2019

"normal" quite often means "not good"

Checkdis · Aug 5, 2019

Vince Carter said:
"normal" quite often means "not good"

I will retest, and have the endocrinologist drive this since it is in their scope I believe.

I will take note of the blood work suggested and make sure they are tested as well. I think at this point I need scans rather than blood work. But with these abnormal levels this should qualify for insurance to cover all testing required.

Vince · Aug 5, 2019

Checkdis said:
I agree with all the information. Yes the labs to test these were not taken but I believe that is for the Endocrinologist to write a script. I have had these panels tested in the past, which was normal results. Just TPO was 219...

But if I do not have Graves’ and this is just Hyperthyroidism... what should be the best steps and best treatment plan? I know I will need some further evaluation like an ultrasound of the thyroid...etc.

I believe the best treatment for hyperthyroidism is
Antithyroid drugs. Which I know very little about.

Checkdis · Aug 5, 2019

Vince said:
I believe the best treatment for hyperthyroidism is
Antithyroid drugs. Which I know very little about.

Since i’m not on TRT right now... you think starting it up Testosterone will slow down the thyroid? Only reason why I ask is I used to be on TRT for low T but I was trying to see if I can restarting my HPTA... could low T for a long period of time cause hyperthyroidism?

Vince · Aug 6, 2019

Checkdis said:
Since i’m not on TRT right now... you think starting it up Testosterone will slow down the thyroid? Only reason why I ask is I used to be on TRT for low T but I was trying to see if I can restarting my HPTA... could low T for a long period of time cause hyperthyroidism?

Using testosterone won't cause hyperthyroidism, but hyperthyroidism can lower testosterone.

Checkdis · Aug 6, 2019

Vince said:
Using testosterone won't cause hyperthyroidism, but hyperthyroidism can lower testosterone.

I was doing a bit of research last night, and in fact I heard that Hypothyroidism causes low T, and Hyperthyroidism somehow causes higher levels.

How Thyroid Disease Affects Men - Dr. Izabella Wentz

Male hormones are thought to play a protective role in the development of Hashimoto’s, and men with low testosterone are more likely to be diagnosed with Hashimoto’s, while men with hyperthyroidism are more likely to have elevated levels of testosterone.

And another short case study:

Serum levels of free and bound testosterone in hyperthyroidism. - PubMed - NCBI

Maybe Hyperthyroidism won’t be so bad, I do need to lose some weight and if it truly is influencing my Testosterone levels, we will know next week when I see my Endocrinologist.

I have been feeling more energy lately and stronger...

Vince · Aug 6, 2019

Checkdis said:
I was doing a bit of research last night, and in fact I heard that Hypothyroidism causes low T, and Hyperthyroidism somehow causes higher levels.

How Thyroid Disease Affects Men - Dr. Izabella Wentz

And another short case study:

Serum levels of free and bound testosterone in hyperthyroidism. - PubMed - NCBI

Maybe Hyperthyroidism won’t be so bad, I do need to lose some weight and if it truly is influencing my Testosterone levels, we will know next week when I see my Endocrinologist.

I have been feeling more energy lately and stronger...