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Graves vs. Hashimotos
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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Graves vs. Hashimotos

I have been diagnosed with thyroid problems for 3 years now.  We are uncertain if they existed earlier, but we know that after I delivered my twins I became extremely hyperthyroid.  6 months after delivery I had my first thyroid test pulled.  I had lost 30 pounds from my pre-pregnancy weight, was fatigued, and experiencing a very slow, irregular heart beat.  My TSH at the time was .03.  My family Dr. did nothing about it.  I let it go for 1 1/2 years.  I went back for another TSH test because my symptoms were only getting worse.  I was now experiencing irritablity,  was unusually warm, and would soak my bed clothes at night with sweat.  This time my TSH was 2.5, but they checked my Anti-TPO antibodies as well.  They both were positive and very high.  I was referred to an endocrinologist, she retested my TSH and it was now 4.9 only 1 month later.  She did not want to do any treatment because she felt synthroid would send me into hyperthyroidism again.  She felt it was possible Grave's Disease but couldn't tell for sure unless I became hyperactive again.  I went for a second opinion.  The 2nd edocrinologist felt I had post-partum thyroidist and then Hashimoto's.  He treated me with synthroid.  After 6 months of synthroid I became hyperactive again.  6 weeks after stopping synthroid I am still hyperactive.  What should I do?  Is it possible that I do have Graves Disease and he is wrong?  Should other test be completed.  I am struggling to function day to day and need relief.
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97953_tn?1193367871
You have autoimmune thyroid disease -- in most cases the second endo impression would have fit best -- ie, postpartum (autoimmune) thyroiditis with subsequent hashi.  But in some cases there is either recurrent thyroiditis (hyper) or a fluctuation between a graves-like scenario (hyper) and hashi (hypo) -- these are tough cases that need close monitoring.  If still hyper off synthroid, then to further evaluate can do I-123 uptake/scan as well as TSI & TBII which are the Graves antibodies.
7 Comments
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710534_tn?1264356357
HI THEIR MY NAME IS CLAIRE AND HAVE GRAVES IT IS HORRIABLE I REALLY FEEL SO SORRY FOR YOU IS YOUR EYES GRITTY AND SORE DO THEY DRY UP VERY EADSY.
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Avatar_n_tn
Yes, my eys are sore and very dry.  I wear contacts and have trouble wearing them all day.  So far no eye bulging, but it isn't confirmed Graves.  I just want resoltion.  I am tired of not feeling well. 3 years of the hormonal ups and downs has left me feeling very drained.
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710534_tn?1264356357
Ah you poor darling i know what your going through but you must be strong life its self is very demanding and being sick dosent help it really dont sound like graves to me i really hope not feel so sad for you hugs claire............................
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245460_tn?1238008096
You really need the antibodies test for thyroid. TSI test is definite for Graves. Also A RAI uptake and scan to check for a goiter and/or nodules. I am so sorry you are going through this.

Hugs from another Graves patient,
Dee
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Avatar_n_tn
Just wanted to toss in more hugs from another Graves disease gal.

I was initially in thyroiditis for a year, then I was told I would end up hyPO and that I tested positive for Hashi's.  My tsh was a roller coaster for the past 6 years cycling closer and closer..finally 3 months ago I went full blown hyPER and my endo doc tested me for Graves and it came back positive.  Go figure.  I just started meds for hyper 4 weeks ago.  

What I don't understand is how one doc 6 years ago tells me that I tested positive for Hashi's and then now I tested positive for Graves.

Good luck on your journey!
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259041_tn?1206486447
You can have antibodies for both, I do but my Graves predominate over the others. You can have Hashi and then move to Graves, this is common. They are both auto immune diseases. It's whatever one is in control at the time I guess!
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97953_tn?1193367871
Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
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