Hi guys! I haven't checked in for a while. I found that I was obsessing about the disease and my symptoms and reading the boards made it worse for me so I checked out for a while and tried not to think about it much. I was just thinking last week how lucky I was that all seemed to be going so well and strange that it was so easy - DX 2/21; RAI 2/24; Synthroid 150 on 4/20 and all tests since seem to be “in range”. Until just a week or so ago…

So here is my question. Is it possible that having been stable on my first dose of Synthroid for 4 months that I could suddenly be hyperthyroid again? Minor symptoms I noticed the last week or so like less hair coming out in the shower than normal, nails seem exceptionally strong again - both great things I don't want to complain about! But my stomach has been rumbling a lot and well “processing” all food fairly quickly and my main concern is either I am having anxiety attacks (which is very possible due to intense work stress right now) or my pulse is racing due to hyperthyroidism. When I say racing, it isn't as bad as some here have, but it is abnormally high for me - between 85 and 105 and a little short of breath like I am having a panic attack. Before I call my dr for anxiety meds (who frankly is tired of hearing from me so often this last 12 months), I was just curious if it would make sense that my thyroid could be messed up. My last lab was July 18 and TSH was 1.855 / F T3 2.1 (still slightly low - lab range is 2.3-4.2) / F T4 1.27 (range .73 - 1.95). That's only 6 weeks ago and dr prefers I wait at least 8 weeks (or more) to retest.

I know you aren't drs and can't say for sure. Just wondered if this was a normal occurrence I just hadn't heard of or been warned about yet. As always your wisdom and experience is much appreciated!

Hi, and welcome back. I'm glad things have been going well for you.

Keep in mind that replacement hormone IS thyroid hormone. It is also a type of drug that has to be very carefully calibrated to the specific individual. So, if you are on slightly too high a dose of it, you can become hyperthyroid again. That has happened a couple of times to me over the past fifteen years. We change the dose, slightly, and things are fine again. In my experience, this type of situation was never as horrid as full-blown hyper (with undetectable TSH), and it was quickly “fixed.”

Another, less likely possibility is that “some” thyroid tissue remains and has flared. But given the tendency of today's doctors to totally ablate the thyroid, that is much less likely. Back when I had my RAI, doctors were just starting to totally ablate, but many people were given lower doses to try to keep “some” thyroid tissue. They sometimes had to have a second dose of RAI. I don't hear of that happening as much in recent years.

Hello,

Well definitely I am not a doctor yet I can only go by what my current endocrinologist told me now post RAI 4 months.

I started at what I think a very low dosage of 75 mcg of Synthroid; he is very conservative as he is very concerned of me developing a afib situation starting me out too high for me being in my early 50s yet I have no heart issues (thank God) and no history of it in my immediate family.

I know of doctor on the other hand who start patients at a higher dosage as I know people who had less millicuries of the (I-131) than I and weigh much less than me who started post RAI at 125 mcg and 150 mcg. Some doctors work down.

What I was told by my endocrinologist's nurse that it can take really a whole 3 months before changes are felt; endo told me 2 months. Although you are further along. There must be some explanation as from what Bobbi has also shared here.

Also my endocrinologist said do not expect to be stable for almost a year on the right amount of Synthroid; he also said true some get stabilized sooner than others. He is breaking me into this oh so slowly with my extreme sensitivities to medications, supplements, herbs, treatments, surgeries and testing me once a month instead of every 2 months like most of his patients.

Plus like Bobbi said how much I-131 the person receives; I had 15 millicuries; I find some with less had an easier time than I have getting dosage right quickly; then I know some who had 29 millicuries to make sure it gets destroyed; like another endo I know just wants it killed and try to get patients on the right amount of Synthroid right away if possible. I find these endocrinologists are all doing something different. My endo told me I'd probably end up with 125 mcg of Synthroid eventually; yet I read somewhere which it is not an “approved” source that a lot of post RAI people end up on 150 mcg - 200 mcg of Synthroid which I know two people by me who actually had in time. Yet again we are all so different some stories I read of it as an up and down thing for some people the first year.

Well I only share by what my endocrinologist(s) said as I ask tons of questions of them.

It sounds like you are on the right path though and working with a good doctor you will get to where you need very soon! Best of luck to you!….beach