Hypo or Hyper?? Please help!
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Hi, I am trying to find advice and opinions for my sister whom I believe is currently hypo. We both were diagnosed with graves disease and had the radiation treatment to destroy our thyroid gland, therefore becoming hypo. She takes Synthroid and received her lab results. Her tsh is 0.22 and her free t4 is at 1.9.... Is she hypo or hyper? her doctor honestly seems confused himself too! Any advice is apprecited.
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MtViewCatherine Minicupcake88
Posted
Hi Mini, depending on how long its been since the radiation treatment, the thyroid gland could be still adjusting. Looks like your sister us hypo, but the pituitary hasn’t quite adjusted yet. It takes s full three months for the body to adjust to thyroid medication.
Looks like her TSH is low. But, her T4 is also low. Normally, when the thyroxin levels are low, the TSH spikes because the pituitary pumps out massive amounts of TSH to try snd increase the thyroid gland’s production of thyroxin.
With the low T4, you would expect high TSH. So this is why your tesults are confusing.
However, there are about a million other factors in thyroid function. When thyroid cells die off, they can release a lot of thyroxin, resulting in a temporary spike in levels. If she started her thyroid meds immediately, the meds would further suppress pituitaty production of TSH. Often when you first start meds or increase the dose, you get a drop in TSH until things level out. There’s about a three month lag time for the blood work to show what the meds are really doing.
It might be interesting to see her antibody levels.
I assume that prior to the radiation her TSH was extremely high?
There are a lot of factors involved in thyroid disease and treatment that we just don't understand. The labs don’t always give a full picture of what’s happening and aren’t fully reliable. So use the labs as a guideline, but really, the doc should be doing a clinical exam and asking questions about how your sister is feeling to get a better sense if where she is, in combination with the labs.