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Hyperthyroid (Free T4 high, Total T3 normal, confused)

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Thyroid Disorders
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Posted 12/20/2014 2:00 AM (GMT 0)
I'm new here. Just wondering if anyone has any insight.
I'm confused as to what's wrong with my thyroid & what I should do about it.
I've been taking 20 MG's of Methimazole for almost 7 weeks.

I got new labs today.
My Free T4 is still high, but my Total T3 is back in range.
I haven't really read about this situation anywhere.
Also my doc said to lower my dose to 10 MG of Methimazole starting today because
my liver enzymes are too high.

Any ideas on what is wrong with me & what I should do?
*************************************************************************************
Problem: Hyperthyroid
Diagnosis: Unknown
Diagnosis Date: October 7th, 2014

All I know is that I have a slightly inflamed thyroid. No nodules.
Tested negative for Grave's Disease. The best guess is that it has
something to do with iodine & selenium supplements that I was taking.

October 30th:
TSH: <0.01 (0.44 - 4.75 mIU/L)
Free T4: 3.1 (0.6 - 1.2 ng/dl)
T3,Total 218 (87 - 178 ng/dl)
TSH Receptor AB <0.90 (<=1.75 IU/L)
TSI: Tested negative for Grave's (don't have the numbers from my dr)

December 5th:
Free T4: 2.5 (0.6 - 1.2 ng/dl)
ALT: 130 (12-60 U/L)
AST: 32 (15-41 U/L)
Bilirubin: 1.5 (0.3-1.2 mg/dl)
This is day 33 of 20 MG's of Methimazole.

December 19th:
Free T4: 2.2 (0.6-1.2 ng/dl)
Total T3: 178 (87-178 ng/dl)
ALT: 190 (12-60 U/L)
AST: 56 (15-41 U/L)
Bilirubin: 2.1 (0.3-1.2 mg/dl)
This is day 47 of 20 MG's of Methimazole.
Posted 12/20/2014 7:25 AM (GMT 0)
Hello and welcome to the forum,
Liver enzymes are elevated when Hyper not Hypo, and your TSH from 30/Oct is very low indicating that you are still hyperthyroid,this means that you need to increase your dose of Methimazole and not lowering it, regarding Total T3, it is considered obsolete test and of little use, next time test for Free T3 and not Total T3 !

Best ,
Posted 12/20/2014 10:06 AM (GMT 0)
And by the way, your Total T3 in Oct 30th is very high !
Posted 12/20/2014 4:07 PM (GMT 0)
My new labs are from December 19th. Total T3 is back in range (even though it's obsolete I'd think that Free T3 must be back in range also. Free T4 is still out of range, so I'm sure I'm still hyper.

My liver enzymes were all fine before starting the methimazole, so the meth is likely the culprit. It's a known problem that it affects some people's livers in an adverse way.

I'm just confused because I haven't come across a case where T3 goes back in range before Free T4. What does that mean? Does it give any clues as to what exact condition I have?
Posted 12/20/2014 4:10 PM (GMT 0)
Even though your TT3 in 19 / 12 is normal it is at 100% of the range so that is still high.
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