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Suggest Treatment For High T4 And Symptoms Of Hyperthyroidism
Question: I just took radioactive iodine (not for the scan and dose calibration which was two weeks ago) treatment yesterday for Graves Disease.
But I had blood drawn in the morning right before taking the iodine pills and my thyroid panel shows T4 and T4
were high. ( For example my T3 was 3.5.) I am having hyperthyroidism symptoms like my pulse is 100/minute. I feel like I am having a constant panic attack. Should I begin taking my methimizole pills again? Or should I wait 45 days for my scheduled follow up appointment with my endocrinologist?
But I had blood drawn in the morning right before taking the iodine pills and my thyroid panel shows T4 and T4
were high. ( For example my T3 was 3.5.) I am having hyperthyroidism symptoms like my pulse is 100/minute. I feel like I am having a constant panic attack. Should I begin taking my methimizole pills again? Or should I wait 45 days for my scheduled follow up appointment with my endocrinologist?
Brief Answer:
Thyroid
Detailed Answer:
Generally there is a systematic way to approach this. When I see someone like you in my practice I counsel them that radioactive iodine treatment takes several weeks to have its effect on the thyroid. I am sure you were told so too.
I further manage many of my patients with Graves disease with beta blocker medication after radiation treatment for a couple weeks and gradually wean it.
The reason for doing so is that within a few days to a week after radiation treatment. there is a temporary release of thyroid hormones in greater amounts owing to the effect of radiation induced intentional damage to the thyroid gland. This spurt of thyroid hormone release into the bloodstream tends to cause symptoms of hyperthyroidism. Beta blocker medications like atenolol and propranolol blunt this effect and provide temporary symptom relief. They can gradually be withdrawn over the course of a few weeks till the temporary hormone release settles down.
I suggest you call your endocrinologist and share with him or her how you are feeling at the moment. Perhaps (s)he will consider this treatment above.
There are other rare causes of a rapid pulse and panic attack like symptoms such as Pheochromocytoma. However this required in-person assessment by an endocrinologist to see if this is really worthwhile testing now, especially with the thyroid still not controlled.
Thyroid
Detailed Answer:
Generally there is a systematic way to approach this. When I see someone like you in my practice I counsel them that radioactive iodine treatment takes several weeks to have its effect on the thyroid. I am sure you were told so too.
I further manage many of my patients with Graves disease with beta blocker medication after radiation treatment for a couple weeks and gradually wean it.
The reason for doing so is that within a few days to a week after radiation treatment. there is a temporary release of thyroid hormones in greater amounts owing to the effect of radiation induced intentional damage to the thyroid gland. This spurt of thyroid hormone release into the bloodstream tends to cause symptoms of hyperthyroidism. Beta blocker medications like atenolol and propranolol blunt this effect and provide temporary symptom relief. They can gradually be withdrawn over the course of a few weeks till the temporary hormone release settles down.
I suggest you call your endocrinologist and share with him or her how you are feeling at the moment. Perhaps (s)he will consider this treatment above.
There are other rare causes of a rapid pulse and panic attack like symptoms such as Pheochromocytoma. However this required in-person assessment by an endocrinologist to see if this is really worthwhile testing now, especially with the thyroid still not controlled.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
The high level of tea three was already present when I took the radioactive iodine the lab test was before I took the pill I'm afraid that any further surge in my thyroid levels caused by the radioactive iodine treatment will make things even more difficult my question is should I wait for my follow-up visit in 45 days or should I call the doctor sooner?
Brief Answer:
Follow up
Detailed Answer:
You should call the doctor sooner to see if the beta blocker type of medication I mentioned above is worth considering for you, in addition to anything else that (s)he may have in mind to make you feel better.
Follow up
Detailed Answer:
You should call the doctor sooner to see if the beta blocker type of medication I mentioned above is worth considering for you, in addition to anything else that (s)he may have in mind to make you feel better.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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