Various TSH levels

[LisaGirl]

Hi!  About 6 yrs ago I was diagnosed w/ Graves/Hyperthyroidism by an Endo DR at Duke.  Went through all the tests and the gland was healthy so we used meds to slow things down.  After a year of treatment, things seems to return to normal and maintain so the DR took me off meds.  That lasted for about a year and a half and then my regular FP DR tested me due to HYPO symptoms.  Turns out I had gone the other way to HYPOthyroidism.  For the last couple of years I have been on Synthroid as high as 150 mcg/day.  Until about 12 mths ago at my physical when my TSH level came back LOW.  My DR has gradually (every 6-8 wks) been testing and stepping my meds down.  Most recently I have been on 75 mcg for 2 mths and my test came back this week (again) w/ TSH at .01 and FT3&4 regular.  So my DR has decided to take me completely off Synthroid for now and test again in 6 weeks.  No symptoms at all.  Just wondering what could be causing the swing back to HYPERthyroidism and has anyone else experienced this???  THANKS!

[Mark Lupo, M.D.]

This can happen - stopping the synthroid is the best way to sort it out and see if you have recurrent hyperthyroidism that needs anti-thyroid meds or I-131.

[Lake Lover]

If your doctor were to run both the TSI and TPO antibodies tests it would indicate what is happening.

There is a thyroid disease called hashitoxicosis which is both Graves and Hashimoto's happening at the same time. The symptoms that present with whatever antibody is dominent at the time.  It's very difficult to get a diagnosis for hashitoxicosis because many graves patients have both TSI and TPO antibodies present, you however, have had both hyper and hypo symptoms so it sounds likely to be your issue.

It can be difficult to treat because the patient is always going back and forth on symptoms.

Read up about it on the web so you can have questions prepared to ask your doctor.