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Author: ipes2

GRAVE'S DISEASE (penyebab hyperthyroidism)

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Post time 9-1-2023 10:57 PM From the mobile phone | Show all posts
ipes2 replied at 9-1-2023 02:15 AM
waalaikumussalam

bila kita ada overactive thyroid, kita akan lose weight (tengok Kuiz Q288 tuh, d ...

Alhamdulillah doc..im getting better.
Tq for the explanation.

Mmg btol pun dr,factor keje yg bnyk , traveling pi balik keje yg jauh dan rushing every morning
tu lagi bertmbh penat.
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 Author| Post time 10-1-2023 03:57 PM | Show all posts
sue_0684 replied at 9-1-2023 10:57 PM
Alhamdulillah doc..im getting better.
Tq for the explanation.

ye dan haha awak akan tahu berat awak yg sebenar bila TFT awak is in normal range nanti
dan pada masa itu, boleh lah awak fight it out


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Post time 10-1-2023 04:31 PM From the mobile phone | Show all posts
ipes2 replied at 10-1-2023 03:57 PM
ye dan haha awak akan tahu berat awak yg sebenar bila TFT awak is in normal range nanti
dan pad ...

hahaaha.
tak per yg penting sihat ,ayat sedap kan hati
umo dah tua mcm ni metabolism pun slow melow,nk turun berat kena betul strict diet. diet iodine for 2 weeks bfore rai pun sy dah x tahan.

btw, sy still mengah lagi la doc tp x lah  seteruk mcm 1st rai tu.lama jgk ni almost 4 weeks dah.
kalau jalan laju sikit mengah.
tp resting pulse ok je 70++  - 80 ++bpm.
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 Author| Post time 11-1-2023 05:47 AM | Show all posts
sue_0684 replied at 10-1-2023 04:31 PM
hahaaha.
tak per yg penting sihat ,ayat sedap kan hati
umo dah tua mcm ni metabolism pun slow m ...

ok je tuh
letih kejap je
nanti tgk lah TFT macam mana
bila dah hypthy nnt, docs bagilah Eltroxine tu
u will be fine
a great majority of Grave's are, after their RAI
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Post time 19-7-2023 01:50 PM From the mobile phone | Show all posts
Edited by sue_0684 at 19-7-2023 05:43 PM

hi doc @ipes2 ,
lama x updates my grave's condition.
unfortunately, my endo told me i might need 2nd dose of RAI.
RAI last dec 22, after 2 months my thyroid level dah back to normal..tp since april 23 relapse balik sbb rasa dah tak selesa. may23 my lab result turned out T4:46.6...then mula balik carbimazole 3 tablets for 4 weeks.

jun 23 my lab result T4:18.9 +-, then adjusted again dose carbimazole.2 weeks for 2 tablets and 1 week for 1 tablets.July 23
turned out the T4:29.9. relapse lagi .

so currently my endo adjusted the dose starting july 23..4 weeks for 3 tablets and another 4 weeks 2 tablets.sept 23 the next appointment. actually, the endo told me i can go for 2nd rai anytime.tapi i delayed sikit la doc.tgok 2 bln lagi result.
and when i opt for surgery, my endo fully disagreed.dia kata high risk. i dah la baru diagnosed pre diabetic.ada hypertension lagi.penat la doc. dah control makan,sngkut jgk penyakit.doctor suruh i excercise semula.dah lama I stopped sebab selalu mengah.
check cholesterol :total chol :5.7, triglyceride:0.9,HDL:1.95,LDL:3.34.
my HbA1c :5.7..borderline. im exhausted just looking at the numbers..

org lain kemain tgok mkn manis2,dgn kalori tinggi lagi, x ada plak merungut kena diabetes la ,apa la.i mcm2 penyakit dah sangkut.
so doc,ada possiblity tak  or it has ever happened 2nd rai is failed? ni i tak  q n a lagi my endo.nnti dulu lah.sbb i x decides lagi.
degil btol my thyroid ni..
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 Author| Post time 21-7-2023 06:23 AM | Show all posts
sue_0684 replied at 19-7-2023 01:50 PM
hi doc @ipes2 ,
lama x updates my grave's condition.
unfortunately, my endo told me i might need  ...

apa khabar sue0684
oh relapse ye; di UK dan Ireland, ada sebahagian kecil RAI ini relapse
ada beberapa factros, termasuklah guna weaker RAI
berapa ratus Mbq hari tu depa bagi?

tgk pada TFT awak tu, yes still active
disini kami buat juga TRAB ie TSH Receptor Ab, utk tgk disease activity

Chol tu slightly up, begitu juga LDL, tentu kerana thyroid dysfunction lah tu
jika thyroid tak betul, cholesterol metabolism juga tidak betul
tapi HDL awak bagus
HbA1c tu not bad at all (5.7% ialah 39mmol/mol ie normal)

sy rasa lebih elok awak choose RAI over thyroid surgery
ini pendapat sebahagian besar American Endocrinologist dalam Grave's Disease

Conclusion:
no worries lah, you disease Grave's ni is really common dan ada definitive Tx nya eg RAI or Surgery
majority works well je
ALso rates of secondtime RAI failure is real small
HDL bagus, HbA1c bagus..
buatlah cheat days tentang food intake tu

InsyaAllah ok je


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Post time 21-7-2023 07:50 AM From the mobile phone | Show all posts
ipes2 replied at 21-7-2023 06:23 AM
apa khabar sue0684
oh relapse ye; di UK dan Ireland, ada sebahagian kecil RAI ini relapse
ada bebe ...

alhamdulillah doc..
masa 1st dose, doctor bagi 15 mci..maybe sikit.sbb tu masih aktif..

tq doc for opinion..
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 Author| Post time 21-7-2023 02:36 PM | Show all posts
sue_0684 replied at 21-7-2023 07:50 AM
alhamdulillah doc..
masa 1st dose, doctor bagi 15 mci..maybe sikit.sbb tu masih aktif..

alhamdulillah
15 Mci ni ialah 555 Mbq
kami sini guna 600 to 800 Mbq
dlm referral cards mainly sy tick 600 la
maybe sbb size badan pesakit berbeza di malaysia dan uk
apa2 pun, im sure 2nd round will eliminate it fully insyaAllah
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Post time 21-7-2023 08:55 PM From the mobile phone | Show all posts
ipes2 replied at 21-7-2023 02:36 PM
alhamdulillah
15 Mci ni ialah 555 Mbq
kami sini guna 600 to 800 Mbq

or maybe sbb i ada grave's + mng -multinodular goiter? sbb tu active lagi thyroid gland?
ada possiblity tak doc after 6++ months rai,saya baru jadi hypothyroid?
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 Author| Post time 22-7-2023 06:07 AM | Show all posts
sue_0684 replied at 21-7-2023 08:55 PM
or maybe sbb i ada grave's + mng -multinodular goiter? sbb tu active lagi thyroid gland?
ada possi ...

awak ada Grave's  kan?
ke, ada jugak MNG?

dua2 ye?

yes, sesiapa yg buat RAI boleh slowly become hypothyroid even after a  few years
sebab tu bila  org yg jadi euthyroid ie normal  selepas  RAI,   kita  perlu buat TFT up to 2  years or  more in some countries, utk  pastikan  dia remain euthyroid; sebahagian  besar org  yg buat RAI akan   jadi hypothyroid selepas beberapa bulan
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Post time 22-7-2023 07:12 AM From the mobile phone | Show all posts
Edited by sue_0684 at 22-7-2023 07:19 AM
ipes2 replied at 22-7-2023 06:07 AM
awak ada Grave's  kan?
ke, ada jugak MNG?



i ada dua2 doc..my endo ada informed last time nodules yg  ada (mostly kanan-ada 3 nodules lagi) sizenya remains.dari thn lepas uss May 22 smpai before RAI dec 22 ..

so doc,ada chances la yer i akan jadi hypothyroid even dah almost 1 Year after RAI..
hopefully no need to go for 2nd dose
coz it's exhausted betul nk deal dgn mood changes.
dah bnyk kali dah ni turun naik i punyer TFT.i dah dapat recognize dah kalau thyroid hormone i naik,mesti ada changes to my body and mood.
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 Author| Post time 26-7-2023 07:11 AM | Show all posts
ye, mood can change dgn thyroid fluctuations, ini benar
ya, hypothyroidism can be delayed for quite a bit actually, so yes u can still be hypo after a while
tetapi, jika telah di follow up oleh Endodan mereka rasa sue perlu a second RAI, ikut lah nasihat mereka kerana mereka ada semua data pasal sue
jika ada nodules, ie MNG, kadang2 tricky sikit, tapi ok saja, kita biasa je handle kes2 begini

tanyalah pendapat docs awak, apa kata mereka.. sy rasa kadang2 mereka folo jap sebelum decide
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Post time 26-7-2023 07:31 PM From the mobile phone | Show all posts
Edited by sue_0684 at 26-7-2023 11:07 PM
ipes2 replied at 26-7-2023 07:11 AM
ye, mood can change dgn thyroid fluctuations, ini benar
ya, hypothyroidism can be delayed for quite  ...


tq doc for opinion.
i also thought i need for 2nd rai .baru discussed dgn endo during last appointment recently.17.7.23.
so he suggested 2nd rai.kena zass habis thyroid cell.
i postponed dlm 2 months sebab nak cari masa yang sesuai.around oct-nov ni i will go for 2nd rai .
cuma i nak tanya doc,why most of hyperthyroidism cases i found around, they went for surgery? bila tanya, doctor yg suggested.
i pernah jumpa 3 cases je including me yg go for rai therapy.
maybe diorang bukan kes grave's disease?
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 Author| Post time 27-7-2023 03:15 AM | Show all posts
sue_0684 replied at 26-7-2023 07:31 PM
tq doc for opinion.
i also thought i need for 2nd rai .baru discussed dgn endo during last appoint ...

so, Graves di USA first choice is RAI dan Ireland, many yg prefer RAI. Di UK, ramai yg prefer Carbimazole. Tetapi carbimazole kita stop after 18 months therapy. Surgery hanya bila goitre pada Graves ini really besar
untuk MNG, selalu jugak kena operate sebab carbimazole pun dapat control kejap je dan RAI tak berapa berkesan; juga jika dalam thyroid tu ada nodule yang toxic, maka kita operate lah buang separuh dari thyroid tu contohnya

so, awak ni ada dua2 ye ie Graves campur dgn MNG; so rasanya kena ikut saranan docs yg look after awak sbb dia ada semua data2nya; Graves selalu nye diffuse goitre ie goitre yg membesar smoothly secara keseluruhan; as opposed to MNG la yg berbebola. ikut la saranan doc awak jika dia kata sesuai utk 2nd RAI. jika tak jalan jugak sy rasa surgery je; ini pendapat tanpa ketahui data2 awak

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Post time 27-7-2023 04:44 PM From the mobile phone | Show all posts
Edited by sue_0684 at 27-7-2023 10:43 PM
ipes2 replied at 27-7-2023 03:15 AM
so, Graves di USA first choice is RAI dan Ireland, many yg prefer RAI. Di UK, ramai yg prefer Carb ...


tq doc for your explanation..
baru tahu kenapa ada yang perlu surgery,ada yang tak..
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 Author| Post time 28-7-2023 11:14 PM | Show all posts
sue_0684 replied at 27-7-2023 04:44 PM
tq doc for your explanation..
baru tahu kenapa ada yang perlu surgery,ada yang tak..

hah memang gitu
malah, jika ada nodules yg besar2, radiologist akan classifi kan mereka
jika di UK, dia classify ikut U system eg diakata ''ini orang ada MNG, tapi 5 dari nodules itu besar dan semuanya U2 kecuali satu tu U3''
haaa U3 tu kena FNA lah
jika di US, radiologist akan reports nodule dalam classification system based on TIRADS
Di Korea lain, pulak, di Japan lain pulak

jika ada nodule yg kita risau, kita buat radionuclide uptake scan
jika nodule itu byk ambil radionuclide isotope itu, maka ianya ''hot'' nodule ie active dan membuat byk thyroid hormones (dan selalunya org itu overactive lah thyroid nya) dan kita lega lah

jika nodule itu kita risau tapi dia tak uptake pun radionuclide isotope itu, maka kita panggil dia ''cold'' nodule dan ini kita tidak suka kerana sebahagian besar cold nodule adalah cancer

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Post time 30-10-2023 12:17 AM From the mobile phone | Show all posts
salam doc @ipes2 ,
lama tak updates sini . on 16th October lepas saya dah amik 2nd dose of rai dah doc..so far so good alhamdulillah. short term effects post rai kali ni tak seteruk mcm 1st time .tak ada sakit di leher mcm dulu,x ada bengkak. cuma dlm seminggu dua ni susah tido sikit.boleh tido tp a lil bit late.

kali ni my endo suruh stop terus carbimazole dan saya pun rasa ok. kali ni amik propranolol je itu pun once a day sbb heart beat x ada la tinggi sgt.
cuma mudah letih sikit,so i consume q10  supplement.so rasa ok sikit.

tp doc,yg saya perasan dlm last week (2nd week post rai) ,sy rasa tekak rasa sakit sikit2 bila ada terbatuk atau telan air liur..bkn tiap masa rasa, cuma kdg2 je..rasa mcm sakit tekak nk demam tu. sampai sekarang pun ada rasa lagi . normal ke?mkn,minum ok.cuma klau minum sy x minum panas2,minum suam2 je.. next appointment on 14th nov ni.

p/s:thread ni mcm bnyk story sy plak doc.mcm thread sendiri.  ..or tak ramai yg kena grave's disease?
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 Author| Post time 31-10-2023 04:31 AM | Show all posts
sue_0684 replied at 30-10-2023 12:17 AM
salam doc @ipes2 ,
lama tak updates sini . on 16th October lepas saya dah amik 2nd dose of rai dah ...

waalaikumussalam

wahh second dose RAI.
Jaid hulk tak?
ha ha
Sorry cuba buat kelakar
Bersinar2 hijau tak malam2 leher awak

Itu yg rasa tak comfortable kat tekak tu, biasa je lah
akan settle insyaAllah

Ha pesakit sy yg Graves tapi tak turun2 T4 nye 80, T3 nya 30, dah pagi PTU 3 kali sehari dlama 5 minggu, dan beri dia lugols iodine 10 hari dan last week dah gone for operation dah.. tengok lah mcm mana

kurus kedengking.. nanti tentu gemok dia jap lagi

Eh ramailah Graves disease, esp dikalangan wanita; West or east sama je
Mujurlah awak tak ada issues dgn mata.
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Post time 31-10-2023 07:30 AM From the mobile phone | Show all posts
Edited by sue_0684 at 31-10-2023 12:35 PM
ipes2 replied at 31-10-2023 04:31 AM
waalaikumussalam

wahh second dose RAI.


hehe,naseb baik x jadi hulk

alhamdulillah,sy tak ada TED.mata yang cengkung sblm ni dah okay dalam bulan jun-july tahun ni.
cuma kena strictly jaga mkn doc.ni even dah jaga mkn pun, berat sy dah mula naik.sekarang around 60-62 kg.sy try control supaya x naik bnyk.ini pun dah overweight.
berat ni dah static dekat 2 bln dah.
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Post time 14-11-2023 02:19 PM From the mobile phone | Show all posts
Edited by sue_0684 at 14-11-2023 09:27 PM

salam doc @ipes2 ,
Baru lepas jumpa my endo today.so the result was t4:24.7, tsh <0.01.hyper sikit je..
tadi doctor nk cont carbimazole for 1 tablet  tp sy tak nak.
sbb i still can manage the symptoms.lgpon  im feeling better than 4 weeks ago ( post rai).so my endo ok jer,as long as sy mkn propranolol.
tidur pun dah getting better.
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