FAQ

RESTING PULSE

85 beats/minute – normal

below 80 beats – under-active thyroid

above 90-100 – overactive thyroid

Please note that exhausted adrenals can lift the resting pulse.

My personal resting pulse was 140 when diagnosed with Graves’ disease

 

Even though the thyroid function can be unique for an individual, most people report feeling well when their FT4is in the middle of the reference range if not slightly higher and their FT3 is in the upper 1/3 of the reference range with TSH 1.5-2.0 mIU/L.

TSI (IgG antibodies) are diagnostic of Graves’ disease. 70-100% of Graves’ disease patients have these antibodies. Generally, if they are present and you are hyperthyroid, you have Graves’ because they make the thyroid produce excessive hormones and are specific to the thyroid stimulating hormone receptor. Sometimes TSI may also appear in Hashimoto’s thyroiditis but their level is low.

Other thyroid antibodies seen in Graves’ are TPO (Thyroid peroxidase antibodies) and TG- Thyroglobulin antibodies.

Generally a healthy person should not have thyroid antibodies (or at least in very low levels). A person with thyroid autoimmune disorder produces a high level of antibodies.

Diagnostic test results for Graves’ disease are: low TSH, elevated thyroid hormone levels, presence of TSI and elevated RAI-U test (radioactive iodine uptake).

 

No test can predict remission but there are some indicators. Looking at the level of antibodies can be helpful. TSI index determines patient’s immune system status. A decrease in TSI index and stable Thyroid stimulating hormone (TSH)  levels (normal for six months) may indicate possible remission. Usually TSI index should decrease with antithyroid drug therapy and high value of TSI index after the conclusion of drug therapy may predict a relapse. Unfortunately, a low TSI index does not necessarily predict a long term remission. Some doctors taper the antithyroid medication dose slowly over a few months and observe TSH levels. It is important to say that TSH levels may remain undetectable for a while even though a person might have normal thyroid hormonal levels due to the activity of antibodies.

New research developed Mc4 assay  to serve as a more sensitive index of remission or relapse of Graves’ disease.

Kamijo K. Murayama H, Uzu T, Togashi K, Kahalt G J. A novel bioreporter assay for thyrotropin receptor antibodies using a chimeric thyrotropin receptor (mc4) is a more useful in differentiation of Graves’ disease from painless thyroiditis than conventional thyrotropin-stimulating antibody assay using porcine thyroid cells. Thyroid. 2010 Aug:20(8):851-6.

Graves’ disease relates to the inheritance of predisposing genes and environmental triggers.  Genetic defines the predisposition to Graves’ disease but not the fate as environmental triggers needs to be present for Graves’ disease to develop. Female children are more predisposed to Graves’ disease. When Graves’ disease occurs in children it tends to be linked to father’s genetics, especially when a father has thyroid antibodies. Identical twins (same genetics) from affected parents have a maximum of 50% chance of both developing Graves’ disease. Non identical children from affected parents (half of identical genes) have about 13% chance of both having Graves’ disease. Therefore parent to child chance of developing Graves’ disease in also about 13%  (as a half genes is inherited from each parent). The chances of Graves’ disease increase with each additional family member with Graves’ disease.

1. Brix TH, Kyvik KO, Christensen K, Hegedus L. Evidence for a major role of heredity in Graves’ disease: a population based study of two Danish twin cohorts. J Clin Endocrinol Metab Feb 2001;86(2):930-4.

2. Gregory A. Brent G. Graves’ disease. New England Journal of Medicine 2008; 358:              2594–2605

3. Seqni M. Pani MA. Pasquino AM. Badenhoop K. Familial clustering of juvenile thyroid  autoimmunity: higher risk is conferred by human leukocyte antigen DR3-DQ2 and thyroid peroxidase antibody status in fathers. J. Clin. Endocrinol. Metab.2002 Aug: 87(8):3779-82.

Yes,  Bugleweed (Lycopus virginicus or Lycopus europaeus-gypsywort) has been approved by German Commission E for use in mild hyperthyroidism. It is used in Europe for a mildly overactive thyroid, usually in the early stages and often with combination of Melissa. A study involving 62 patients confirmed positive effects of Bugleweed (Lycopus europaeus) in mild forms of hyperthyroidism without adverse reactions (1). German Bugleweed europaeus preparation is called Thyreogutt mono tablets or drops. Scientific studies of this preparation showed statistically significant improvements for mild hyperthyroidism for over 300 patients without side effects (2).

1.Beer AM, Wiebelitz KR, Schmidt-Gayk H. Lycopus europaeus (Gypsywort): effects on the thyroidal parameters and symptoms associated with thyroid function. Phytomedicine 2008 Jan;15(1-2):16-22.

2.Eiling R, Wieland V, Niestroj M. Improvement of symptoms in mild hyperthyroidism with an extract of Lycopus europaeus (Thyreogutt® mono). [Article in German]. Wien Med Wochenschr. 2013 Feb;163(3-4):95-101.