Nausea, Brain Fog, diarrhea x3 weeks. Borderline hyperthyroid.

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Hi everyone. I am a 35 year old female. No health issues until now. I'm desperate for answers.

About 3 months ago, I remember telling my coworker that I couldn't shake my lightheadedness. I would get "hot flash" dizzy episodes followed by elevated resting heart rate (120s) and the immediate urge to defecate. These episodes started happening so frequently, with horrible diarrhea, nausea, horrible brain fog and lack of appetite. I lost 14 lbs in 2 weeks. I ended up in the ER 3 times and followed up with many doctors. Been unable to work. All labs are normal. My thyroid was initially "normal" .947. Then two weeks of getting worse my thyroid was .256. Free T4 1.65. I started methimazole. Then a week later my TSH was .176 FT4 1.64.

Graves antibodies negative. Hashimotos negative.

My doctors don't seem to think that my "borderline" hyperthyroid could cause this severity of symptoms.

My question to you all is how long does methimazole take to kick in and what would cause the rapid drop in TSH level?

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  • Posted

    Methimazole kicks in after being absorbed and works by reducing the output of thyroid hormones. It does not however affect the thyroid hormones already produced and stored. Those are gradually processed by your body and depending on your initial levels that my take some time (days to several weeks).

    TSH (Thyroid Stimulating Hormone) is like a thermostat for the thyroid. The higher the level the more it stimulates the output of thyroid hormone. 

    There could be several reasons why your TSH level is dropping besides Grave's or Hashimoto's for example: 'hot' nodules in your thyroid that produce too much thyroxine, thyroiditis, an infection of your thyroid, or even a problem with your pituitary (that secretes TSH).

    I can't comment on the lab values you posted since you did not mention the units or normal range.   

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    • Posted

      Hi Dan R... I just got a number from my doctor's nurse for my last labs a week ago and my TSH came in at >0.006

      I believe, based on what I was told, that normal range is 0.0450 to 0.450.

      Knowing that mine is less than 0.006 should I increase the Methimazole from 5mgs per day? I do not have an endo right now, she's out having a baby for 3 months. I'm on a waiting list for Nov. 2nd. I see a endo surgeon next week. Thank you. Sandi

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    • Posted

      The symptoms of hyperthyroidism are caused by a surplus of thyroid hormones (T3 and T4).

      Your TSH is low just because your body is trying to tell your thyroid to reduce the production of thyroid hormones. 

      If your T3 and/or T4 levels are elevated it is 'normal' for the TSH value to drop. At least is shows that the TSH control mechanism is working. 

      In that respect, a low TSH value in itself is nothing to worry about.

      As your thyroid levels normalise your TSH level should rise to its normal range as well.

      I would not advise you to change your dose of Methimazole without speaking to a doctor first. I think it is more important to establish first why your thyroid is running hyper. Maybe your endo surgeon can shed some light on that.  


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    • Posted

      Hi Dan R, thank you. I do as well. First off my endo had only been testing my TSH level. I asked the reception at the surgeons office if he treats hyperthyroidism/Graves disease and they said no. He does the surgery. I'm going to pick up my test results tomorrow. I'll post, if it's anything different than what was tad to me this AM... SO are you saying that maybe my T3 AND T4 levels may be normalised since the TSH is so low.

      I also have a small case of TED (Thyroid eye disease, for anyone who may not have heard of TED). I'm scared it may get worse and I'm hoping it will get better on its own. I have a faint stare in my right eye. It's notisable but not gross yet by any means.

      What tests can be done to find out why my thyroid is ruining hyper? Thank you so much. What is your experience with hyper or Graves? I'm also very emotional and have a hard time making decisions. And have made many bad ones. Thanks again.


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    • Posted

      Hi sandi36602, just to clarify, in patients with normal thyroid function low TSH values come along with high T3/T4 values and vice versa.

      A small percentage of people have TED (also known as Graves' Ophtalmopathy) but do not show signs of Graves' disease.   

      As far as thyroid tests are concerned possible options would be an ultrasound scan of your thyroid to check if it is enlarged, and an iodine uptake scan to check if there are 'hot' nodules (overactive areas within your thyroid).  

      The tests linda187 suggested concern the adrenal glands. 

      Btw, some people with TED benefit from increasing their selenium intake. Brazil nuts are high in selenium. 

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    • Posted

      Thank you. I bought 2 bags of Brazil nuts and eat one to two daily. I also read that somewhere, and hey I thought, it can't hurt. How do my doctor's know what's happening if they're ONLY testing TSH? There's NO mention of T3 or T4 anywhere in my results. Thanks again, Dan.

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  • Posted

    I was told I would start to feel better within a few days of taking the methimazole. It was about 4 days later that I did but it took several weeks before I was able to do every day chores around the house. 7 wks now and I still can't run my house in my own with out some kind of help. And driving is a hit and miss some days I'm good and can drive some days I'm too dizzy and can't drive.

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    • Posted

      My levels are all normal right now but I'm still having symptoms. The dr is testing more frequently right now because she is afraid she is putting me into hypo now.

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    • Posted

      It's very FRUSTRATING! I wish that Dr.s who study Endocrinology could understand it better. It seems they don"t really at all. My endo plays hit or miss with my levels and meds... she never tests anything else, never said what to do or not do, even told me I had the weirdest case she's ever come across. I wish they knew more about homeopathic treatment along with medical treatment. Testing minerals and vision deficiencies. They may have more luck getting this right. Just a thought. If I want to see a homeopathic Dr I must pay $300 my first visit out of pocket. .. plus plus for every other visit and I just can't afford it. No insurance covers that treatment and the tests. Sad really.

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