Hashitoxicosis??

[Mavs3982]

Hello-
On 11/29, I noticed that I was tired and went to the dr. My TSH was 13 so he told me to raise my dosage of Armour. I did and I got this AWFUL headache.  My dr told me to stop taking the medicine on 12/17. Since 12/17 my TSH has fallen from 13>11>6>3.6> 2.8- NO MEDS!

The other thing is my FT3 and FT4 keep increasing slowly with no meds! FT4 RANGE: .7-1.4 and mine are .66 > .72 >.89 >.89. FT3 Range: 1.7-3.6 and mine have gone from 2.6> 2.7 > 2.9 >3.5.
TPO is in range but, my Thyroglobulin Antibodies are 417> 458> 596 w/ the range being <20 . TSI is 87 w/ range >130. Normal people dont have ANY TSI, though.

The doc said that this is Hashitoxicosis.

I had an ultrasound done and that came out perfectly normal.  
I feel like I will constatnly fluctuating all the time. I am 24 yrs old. I want to have a family some day. I don't want to be sick all the time. I am off work (medical leave) because I am so sick right now. I want to have surgery but I don't feel like the doctors will do this. How should I go about getting docs to think about surgery?  I dont really want to wait a bunch of years for my thyroid to burn out. My Dads side of the family has Graves Disease and my Grandma has Hashimoto's. My greate grandma also had her thyroid removed, although no one remembers which disease she had.

[Mark Lupo, M.D.]

This may be hashitoxicosis -- would have expected a higher TSI -- could also check TBII to see.  In either case, the approach should be to monitor the thyroid function -- the current levels are normal -- if the TSH gets to <0.1 then an I-123 scan could help sort it out and you may be a candidate for I-131 treatment.  I do not see a compelling argument for surgery if there was no nodule on ultrasound and you don't have a large goiter.

[Mavs3982]

I am not interested in doing RAI if I go hyper because my family members have Thyroid Eye Disease that was exacerbated by the RAI. I also do not want to try Anti-Thyroid meds as I already have a compromised immune system. I work with children and get sick all the time and this is just not a good option for me. I just want to have a thyroidectomy to eliminate the swings from hypo to hypEr and I don't know if anyone will do that.

[Mavs3982]

I had TBII checked. It came back .3 and the range was 0-1.0.

I am not sure what this means. I was under the assumption the TBII was a test that checks for blocking and stimulating antibodies.