It took me six full months to go hypo, and I think it came on gradually more in symptoms than in bloodwork. I had labs drawn every two weeks because my case was a little more severe than most, and they always showed hyper, hyper, hyper, dropping very slowly but never enough. I had RAI in February 2011 and by May I started to pack on the pounds, get very heavy periods, and feel very tired all the time. In mid-July 2011, my eyes flared up one morning to the point that I called out of work because I looked like a freak. One was swollen shut, the other was red and protruded. After a few different appointments, I was finally diagnosed with TED and started a heavy round of prednisone. The same week I was diagnosed, my bloodwork showed I was hypo. I started Synthroid right away, first at 125mcg. I got hyper, dropped to 100mcg. Still slightly hyper, dropped to 75mcg. By now it's Christmas, I finally finished six months of prednisone and my eyes are in the cold phase but still drastically different than pre-TED. Still slightly hyper in February 2012 when I moved from FL to MA, so my endo had me alternative 50/75mcg every other day. I didn't get labs again until May when my new insurance kicked in. What do you know, I'm hypo again. So new endo upped my dose to 75mcg. As of last Friday, still hypo (TSH 14) so we upped it to 88mcg which I picked up this morning and will start tomorrow. He confirmed there is no thyroid tissue left 18 months post-RAI, yet we can't get me settled on the right dose. Oy!
I also feel the cross between symptoms, and unfortunately, new endo told me it's not thyroid-related. He said to schedule an appointment with a cardiologist to discuss the palpitations. I have been on the beta blocker since February 2010 and it's messing with my cholesterol and just not something I want to be on forever. There is no endocrine reason for me to still need it, yet if I skip a dose, I'm laying on the floor in a heap of sweat with a pounding heart. I also have no heat tolerance whatsoever, and I think that might be related to the heart rate.
As for weight gain, I'm sure the prednisone didn't help but I finished that in October and I still have not lost an ounce despite a clean diet (very little processed foods), minimal alcohol intake (I drink a glass of wine maybe three nights a week), and lots of exercise - both cardio and strength - and yoga and meditation. I'm at wits end, and yes I'm still hypo, but I haven't always been, yet my weight has never come down since about four months after RAI. When diagnosed, I had dropped from my normal 140 to 128. Now I am at 160 and it is NOT muscle (again, despite exercise). My next step is to see a nutritionist because something isn't adding up.
Kimberly has mentioned that our metabolisms can reset with Graves and that sucks because I was always petite but as a gymnast, also muscular with so much strength and endurance. Now I struggle to lift my own weight in a crunch and run for more than a few minutes. I am also going to ask my endo about T4, but I think first, we need to get me euthyroid and see if that helps at all.
It's a long journey, but hopefully in a few months you will feel better physically and about your body. Has your endo mentioned the possible need for another dose of RAI? Mine did for weeks until, thank goodness, the first dose finally kicked in.
Also, I don't think anyone goes hypo a week after RAI…? I think Bobbi or another facilitator has mentioned the half-life or something else about how long it takes to flush out the I-131 as well as the thyroid hormone.