Thyroid replacement and Graves Disease
I have Graves Disease. I was diagnosed in May of 2001. My thyroid was ablated in aug 2001 and I began taking thyroid replacement in Dec. of that year. I tried several T4 preparations and had severe side effects. Insomnia, shortness of breath, rash all over my body, severe muscle spasms in my legs, arms, and neck, my body feels hot all the time and I wake up in the night with severe charlie horses. I have so much confusion I have had to limit my driving. I finally started to feel alittle better after I started taking cytomel alone. My heart rate is anywhere from 70 to 105. I'm now on oxygen 24 hours of day because my oxygen drops into the eightys, I also use a c-pap. My blood pressure stays fairly normal. Everytime I take my thyroid wether it is small doses during the day or twice aday my body goes through the same symptoms. My right eye swells, redens and bulges. my muscles harden in my legs and arms and I have tremors in my neck and hands. I have a red rash all over my body. I have been to seven endocrinologists, including Mayo Clinic and they have no answers. I have my tsh free t3 checked often it fluctuates considerably even at the same dose which is around 37.5 mcg. It can be anywhere from 1.50 to 12. I am 56 years old. I have tried some different types of estrogen but I have a chronic yeast infection which doesm a little better when I don't use anything. Do you have any suggestions I could sure use some help.
Thanks
Sheila Marshall
Thyroid Replacement
Thyroid replacement is usually done with L-thyroxine (T4) alone. This is an only weakly active thyroid hormone. T 4 when taken by pill or secrete by the thyroid gland has a long half life, needing conversion to the active for (T3) largely by the liver. T3 is an active thyroid hormone which has a short half life. When T3 is taken as a pill for replacement of thyroid hormones as in your case, blood levels rise quickly and disappear relatively quickly too, needing doses at multiple times daily.
I have never had a patient who has developed an allergic rash to L-thyroxine personally.
Patients who have Graves' disease are at increased risk of Addison's disease or failure of the adrenal gland, albeit the actual risk is small. Addison's disease can lead to loss of salt (and water) from the body causing weakness and muscle cramps. An increase in skin pigmentation is typically seen also. Addison's disease in this context can be screened by a blood test for 21-hydroxylase (to detect the disease process) and by afternoon blood levels of the pituitary hormone ACTH, as well as the kidney hormone renin as the body makes its' efforts to stimulate the failing adrenal gland back into better functioning. Could you explain what the doctors think in the lung problem that requires you to take oxygen?
Kind regards,
Noel Maclaren MD