Please help my Tyroid(TSH) is too high

[good_faith]

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My blood test shows.

TSH (Thyroid) < 0.01
AST (liver) = 52
ALT (liver) = 69

My family doctor orders me to go get Thyroid Uptake test.
He thinks I may be hyperthyroid, and AST & ALT seems high.

I lost over 10 lbs for the last few months.
I feel so hungry and tired all the time.
What do you guys think?
Could you tell me if the numbers above are too high?

thanks

 

[ckent]

Yup, you have hyperthyroidism. A search on the web should reveal any further information you want to know about the condition. Weight loss, nervousness, and diarrhea are all symptoms of hyperthyroidism. I would just urge you to follow up with your doctor so that you can receive proper medical care. It usually can be managed either medically or surgically, but patients must listen to their doctors and follow through with therapies and tests. Grave's disease, which is the most common cause of hyperthyroidism, can be associated with slightly elevated liver enzymes (AST, ALT). Here is a link for some further patient information about hyperthyroidism:
http://my.webmd.com/content/healthwise/145/35997.htm?lastselectedguid={5FE84E90-BC77-4056-A91C-9531713CA348}

 

[sanfilippo]

agreed. it sounds like hyperthyroidism with that low of a TSH. hopefully your doc also drew a free T4, which should be concomitantly HIGH. if you have a diffuse goiter or lid lag, you should probably get antibody (esp. TSH receptor) testing for graves' disease. if you have an isolated nodule, maybe you should get a biopsy or a radionuclide scan, but i can't say i've seen the latter done any time recently. i used to work with an endocrinologist my M2 year and hyperthyroid patients were usually given PTU to start while the antibody tests were pending. some patients may opt for 131-I therapy; it may be preferred in graves' cases but, obviously, a pregnancy test should be done first. PTU is preferred over Tapazole if pregnant but both may induce hyopothyroidism in the newborn.

most labs now routinely test for free T4, thus obviating the need for the RT3 uptake test. back in the days of total T4/T3, you would need it since certain conditions may upregulate TBG (pregnancy, OCP's, liver disease) or downregulate (steroids).

correct me if i am wrong here...
-s.

 

[good_faith]

Thanks guys

I checked the web above, and found good information about the disease.
I made an appointment to take iodine Uptake test in Nuclear Medicine department. They told me the test will take two days. I will see my doctor next week after she receives the results.
What is your suggestion mean while I am waiting for result to get conform?
What is like to be living with hyperthyroidism?
What effect is going to have in my school/daily life? I am planning to attend med school in Fall 2005.
Any suggestion appreciated.

 

[sanfilippo]

you can take an oral medication like PTU for a few years to get you into remission. you can also opt for radioactive iodine treatment to get you back to normal but about 1/4 of patients will become HYPOthyroid and need to go on Synthroid. radioactive iodine is also relatively safe. again, i am assuming you don't have graves' or a nodule, which may carry a different prognosis, but in general hyperthyroidism is very manageable.

-s.

 

[lurkerboy]

Tapazole (methimazole) is actually a better medication to take because it has fewer side effects. While you wait for that to kick in, your doctor might also put you on a beta-blocker like metoprolol or propranolol to help manage the symptoms you are experiencing.

Long-term you might be interested in pursuing radioactive ablation because you'll only have take a small dose of thyroid-hormone replacement (synthroid) as mentioned earlier.

 

[jashanley]

At this point it sounds like hyperthyroidism, but like Sanfilippo says a free T4 or FTI should be drawn. Patients can have a low TSH with a normal free T4 and usually they have a concomitant illness, aka Sick Euthyroid. Be careful. I'm sure your Doctor knows to check all the tests and confirm the diagnosis be treatment is started. Treatment with medication is not a benign undertaking ever, as no medication is safe. I also recommend discussing it with your doctor instead of placing it on a forum such as this. The medical advice you receive on a forum such as this may be only partly true or with good intention but wrong in basis. So take it with a grain of salt and go right to the source: your PMD. Many of the people here are not yet doctors or are resident doctors. They have not fully spoken to you nor do they get the opportunity to examine you fully.

 

[BareFoot]

i had the same thing happen, actually I diagnosed myself with hyperTH in med school. Turns out I had mild graves (without the bulgy eyes etc). i did an endo rotation and worked with a thyroid expert (at a very reputable institution) who told me everyday i should get my thyroid zapped (radioactive). this would mean instead of tapazole, i would later have to take synthroid (more than 1/4 will have to take synthroid as posted earlier).

BUT keep in mind, this is the US way. In most other countries, Japan and most of Europe, they do not believe radioactive iodine should be the knee jerk reaction. in Japan where hyperTH is rampant, people will remain on tapazole forever. note that synthroid is the safer of the 2 drugs. if you take tapazole, they have to monitor your TSH more frequently and your WBC has to be checked if ever you develop a cold/fever etc for fear of agranulocytosis, an adverse side effect of tapazole. synthroid has been around for decades and decades and though synthetic is exactly like what your own body makes--is VERY safe, one of the most commonly prescribed drug (as long as it's not abused, i.e. diet users).

so in the end, i'm too lazy to get zapped but I will have to one day. it is much easier to deal with hypoTH then hyperTH, especially in pregnancy (it's more difficult to control TSH levels with Tapazole).

i've had it for a long time, of all the doctors I've spoken to (~8-all specialists) only 1 has ever recommended staying on Tapazole for more than 1 year (~25% will be disease free after being on Tapazole for ~6months--need to check that chart again though).

whatever you do, get treated. i had a resting HR of 125 and that's NOT a good thing even if I could eat whatever the hell I wanted and never exercise

feel free to PM me