Swinging from hypo to hyper thyroidism

[AnnieCS]

Hello-

I am slated to see an endrocrinologist as my internist is baffled about my condition, I will not be able to see the endrocrinologist for 2 weeks.  I have been hypothyroid for 25 yrs and have been on synthroid. About 3 yrs ago my dosage started fluctuating based on blood tests (every 3 months).  From .150mcg to .125mcg back and forth.  I started on .137mcg in April and now I am suddenly hyperthyroid with last test at .14.  The interist repeated the test to rule out lab error for the .14 result. I have been on .1mcg for two weeks and still having severe hyperthyroid symptoms, sensitivity to heat, dizzy in am, insomina and waking up after sleeping.  Of course I have a lot of energy but the symptoms are not worth the increased energy.  My question is how can I be hypothyroid for so many years and now hyperthyroid?  I have not ever experienced the hyperthyroid state so I feel very weird.  Also in the past when my meds are lowered I notice that my menstrual cycle is suppressed (skip a period) otherwise I am a regular 28 day cycle and have been charting this for 2yrs.  I am trying to concieve (which may complicate things) and my gynocologist has proven via ultrasound that I ovulate.  I also track my ovulation each month and it happens around day 15.  I am 40yrs old.  It seems my throid is now working????  I am very confused, any comments or observations would be very appreciated

[casie878]

A related discussion, I have been hypo for 3 years now having signs of hyper again? was started.

[kippers]

A related discussion, fasting blood test or not was started.

[bevmar]

A related discussion, thyroid problems? was started.

[ancientmariner]

Sounds to me as if maybe the methimazole has suppressed your thyroid TOO much, because your symptoms sure sound hypO now. Good for you, not wanting to have the RAI. I sure wish I hadn't done it....

[MamaBon4]

I too have been diagnosed with Graves and Hosimotos which I don't understand!  How can we basically have hyper and hypo at the same time? The doctor has me on Methimazole which has totally slowed me down!! I am gaining weight, depressed, tired all the time even with 8 hours of sleep, my hair is awful!!  I feel terrible.  The Dr. wants to do the radio iodine thing but frankly I don't want to have that stuff in my body. At this point I'm ready to just stop the meds but I know that that would not be good for my heart. sigh... any thoughts?

[ancientmariner]

Have you been tested for Hashimoto's antibodies? That could explain your swings from hypo to hyper....

[mama3043]

I also am going back and forth. Been hypo for years, now hyper and hate the symptoms. I would rather be hypo. Joint pain is soooo horrible. One thing I found that alleviates it is that I cut back on my caffiene. Maybe you should try it if you are a coffee drinker.

[ancientmariner]

Have you investigated adrenal issues? I have read that low cortisol can give you hyper symptoms. That's because your body can't use the thyroid hormone without sufficient cortisol, so the thyroid hormone just sits in your bloodstream and gives you hyper symptoms. Your doc can order a 4 times a day saliva collection to test your cortisol at different points during the day. The 24 hour urine collection mixes everything to gether, so you can't see where you stand at different times, so in my opinion, the saliva test is better.

[ancientmariner]

Were you having hyper symptoms when they reduced the synthroid the first time? What were they? If your doctor is going by TSH alone, there are many studies that show that TSH can varie during the day, and also that when you're on meds, it can be suppressed (low). TSH doesn't measure thyroid function, it measures a PITUITARY hormone. The pituitary hormone tells the thyroid whether to work harder or take it easy, but when you're throwing thyroid hormone into your system, the pituitary senses it and tells the thyroid not to work so hard (i.e. low TSH).

What are your symptoms now? Are they hyper, or are they hypo? Many can be either. I'll bet you're hypO from the dosage decrease....not hyper!

[SandyKK]

I feel hyper. I feel like I am racing but I am exhausted. I am losing weight-- not a big appetite. I talk a mile a minute and I know I make everyone feel overloaded. I have trouble getting things done because I have to repeat them a lot. The other day, I am a college professor, i went into class I was brain dead. I just had to tell kids I was sick and went home. I have headaches, very thirsty. I read my writing, I am a reseracher, and nothing makes sense. Hands are sweaty. Worse when I am stressed. Can't sleep-- I am now on sleeping pills for the last two months.

[SandyKK]

I have had a swing as well. I had Graves disease and surgery when I was 14. Most of my thyroid was removed and I became Hypo for over 40 years. About a year ago, I think, I was told to reduce my Synthroid which was fine. For the last 6 months, I have been having problems with concentration and other things. Recently they decided to check my thyroid and it tested abnormal again .175. They have reduced it again but it has been two weeks and I am feeling awful-- same feeling I had when I was a kid. Anyone had surgery and years later had it come back? I have asked my Doctor why after all these years does it seem to be requiring so much less? Anyone experienced this? I can't imagine it can grow back?

[Ussie]

Yes I agree on the T4 not being that accurate. I was given a T4 test while on estrogen replacement. Then found out that estrogen will interfere with this test, showing it higher.

[AnnieCS]

Thank you for all of your comments!  I appreciate the feedback.  I really  am having hyperthyroid symptoms that are not leveling off with a drop in dosage after 2 weeks on a lower dose.  Apparantly according to my MD ( have been making calls to the office) this is supposed to take longer than 2 weeks to adjust to lower synthroid.

I agree that a t4 test is the only one I have had and this is inadequate.  It is tough to get regular MD to address thyroid in depth, they seem to trivialize the situation.
I am so happy to be informed on the tests from everyones comments that I will ask for specific tests when I see a specialist.  I am also very glad that "acientmariner" is having a good response to armour.  I did post a personal family story with armour usage under 10/27/05 thread "new diagnosed with Hasimoto-sythroid side effects".  My new endo is Eastern Indian and I will ask about alternative medicine that is native to his country as well as traditional western medicine (therapy) for thyroid probelms.

[Ussie]

I believe the Ft4 and Ft3 is much more accurate tests, then the TSH.

[ancientmariner]

How do you know you are hyperthyroid? Do you have hyperthyroid symptoms, or is your doctor telling you you are because of your low TSH? The reason I ask is that I had RAI for Graves in 2002 and went very hypothyroid. After 2 years my GP reduced my Rx based on my low TSH. He told me I was hyperthyroid, even though I knew what that felt like and had NONE of the symptoms. I went along with him, and became so hypo that I could barely get out of bed, let alone go to work. I did some research on my own, read some books and medical studies. I may not be a medical professional, but I felt I was intelligent enough to draw conclusions from my reading, and certainly intelligent enough to take an active role in my thyroid treatment. Anyway, after my GP had played around with Synthroid doses for the better part of a year, and I still didn't feel well (never had on Synthroid), I asked him to prescribe Armour thyroid. He knew nothing about it, so I handed him the prescribing info from their website. And I started to feel better! I now see a DO (yes, a non-MD, and not an endo) who has slowly increased my Armour to where I am feeling almost normal again. And my TSH is .004! So TSH is NOT always the best indicator if thyroid function. How can it be when it measures a hormone from your pituitary gland?

[AnnieCS]

I have not been tested for a specific thyroid disease.  I do not have joint pain or RLS.  The blm you describe is the same for me.  I started using psyllium husk to even things out.  Since I have been hypo it has been tough for me to lose weight I am 20lb over weight however the weight is coming off.  I have lost 8 pounds in 6 weeks, while eating MORE food.  I decided not to eat so much food at meals and really make sure that it is healthy fruits vegetables rather than pounding down candy bars to curb my appetite.  Love the weight loss but would rather excerise to lose weight.  When I excercise now I get even more hyped up and overheated.  Yes I am tired for days on end because the sleep is so interupted, I wake up every two hours 1am 3am 5am on the dot.  Sometimes I fall back asleep very fast and other times I wait an hour to sleep.  I do get rem sleep inbetween. Also I get over heated and have to sleep with window  wide open (and it is 40 degrees outside)and no blankets. When I wake up I am so thirsty that I am drinking 1/2 liter of water at night. I wear summer clothes and it is fall where I am at.  Any temp over 60degrees and I am in that desert you describe.  I feel parched all the time, my mouth is always dry.  I started using a juice drink called recharge that has potassium and sea salt (made by knudsen) to keep hydrated and I am eating bananas  and drinking V8 for the potassium.  this curbs the dizzy spells at work.  I am professional with a demanding job,  I notice I over heat when I have to concentrate on doing math or technical work, when I use my brain it happens,weird thing is that I am becoming leass productive and getting brain fog.  I am in a circle trying to break out and I am very frustrated.

[supercalif]

I have tested positive for both Hashimotos and Graves Disease as well as TED. I have aslo been swinging back and forth and it is so frustrating. I get joint pain so bad that one dr thinks it's become rheumatoid, i get shaky, my heart races, i have hypertension, RLS (restless leg syndrome), eye pain (MRI showed orbital swelling), loose bm one day and constipated the next. I have no problem keeping my weight down as I am on synthroid. I am tired for days and days sometimes and then can't sleep night after night sometimes. I feel as if somebody dropeed me in the middle of the desert and left me to find my way. Do you go through any of this?

[Mark Lupo, M.D.]

You most likely still have hypothyroidism but have decreased synthroid requirements -- ie, the usual synthroid dose that had worked in the past is now rendering your over-treated (the most common cause of hyperthyroidism in the US).

Reasons this may happen: change in estrogen status (pregnancy, birth control pills, etc), change in supplements (stopping calcium, iron or high fiber for example), change in meds effecting absorption/metabolism of thyroid hormone (certain anti-depressants or cholesterol meds for example).  Substitution of a generic medication for synthroid.

Less likely there is a true gain in the function of the thyroid.  If you need to keep decreasing the dose -- an I-123 uptake study may be helpful.