Aa
Aa
A
A
A
Close
Avatar universal

Intermittent Subclinical Hyperthyroidism

I am a 25 year old female and have had sub clinical hyperthyroidism, with varying TSH levels for the last year and a half.  I was first diagnosed when I was in an intensive work environment and I had a panic attack (the first and only in my life). The next day I went to the doctor and I had a fever, I was hypertensive (150/95), and my heart was over 100 bpm at rest. This followed a period of a few months of diarrhea 5x a day and sleeping only a few hours every night. I attributed it to stress. The doctor did blood work and found that my TSH was .2. He put me on a low dose of propranolol and referred me to an endocrinologist. The ultrasound showed nodules. The thyroid uptake scan indicated inflammation. The endocrinologist has seen me every few months, and my TSH has been as high as .8 and the lowest is .3. I can recognize when I am hyperthyroid, and have managed with taking propranolol as needed.  I feel fine when my TSH returns to a higher level. More recently, I have moved and started an intense school program. I started having hyperthyroid symptoms and have had severe anxiety and only slept a few hours a night and had diarrhea up to 10x a day, and lost 10 lbs in a few weeks.  I felt so ill that I could not stay in school. I had my thyroid tested and the TSH was .3; however, my new endocrinologist told me that it was an anxiety disorder and that while all the tests (TSH, free T3 and T4) showed mild hyperthyroidism (I do not test positive for Grave’s), my results were inconclusive because I was on the pill.   My questions are: Is this all psychological or is there a possibility that a person can be this affected by mild hyperthyroidism?  Also, do you have any ideas as to why I might fluctuate in and out of normal every few months?  I knew that free T4 numbers can be artificially elevated with the pill, but can TSH show hyperthyroidism because of the oral contraceptives?  I am desperate to get to the bottom of this to prevent these episodes from happening again.
3 Responses
Sort by: Helpful Oldest Newest
Avatar universal
It would not be a bad idea to stop the OCPs (oral contraceptives) and use a non-hormonal method to see if your symptoms don't improve.  A good choice would be the Paraguard IUD (intra-uterine device) which is good for up to 10 yrs., but can easily be removed should you desire pregnancy.  Make certain you use a back-up method (i.e. condoms) if you stop the OCPs and are not using another method (or anytime the possibility of sexually transmitted infection is  a possibility....new partner, partner with new partner).  Some women do experience anxiety & mood swings with OCPs or the symptoms, if pre-existing, can worsen on OCPs.

Dianne
Cert. nurse-midwife
Helpful - 0
97953 tn?1440865392
MEDICAL PROFESSIONAL
You should ask about the nodules --- if multiple small nodules, then not likely a cause for hyperthyroidism - but it's possible that one or more of these is over-producing thyroid hormone and it did not show up on the I-123 scan (possibly due to dietary iodine or other misleading factor).  Would make sure you have had a TSI test for Graves' disease as this would be more common than over-functioning nodules.
Sometimes a trial of low dose methimazole (5-10mg per day) to keep TSH clearly normal is helpful to see if the symptoms are likely due to the thyroid.
OCP's ("the pill") do not lower TSH usually.
Helpful - 0
Avatar universal
You mentioned being on beta blockers but were you ever put on anti-thyroid meds? The flucuation could be from hot nodules pumping out to much hormones at varying times.

You need to have the graves AB tested, which is the TSI. The prescence of AB's is a graves marker. Also request that your TPO, and ATG(anti-thyroglubin) be tested. These are tests for automimmune thyroid disease.
Helpful - 0

You are reading content posted in the Thyroid Cancer / Nodules & Hyperthyroidism Forum

Popular Resources
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.