Autoimmune Thyroid Disorder

[hopeful2006]

THat is the latest diagnosis I have received frm my endocrin.  I am scratching my head at this.  First I was told I have hashimotos, then told I have graves too...then told I have the antibodies to both, but that doesn't mean I do.  Now he said, I don't want to label it, so it is autoimmune disease.  WHAT????? My last tests were TSH 0.073 Range 0.4-5.5 Free T4 1.2 Range 0.7-1.8 and Free T3 2.7 Range 1.8- 4.6 The previous month my TSH was 0.01 Free T4 was 1.7 and Free T3 was 3.9.  So you can see that TSH was going towards normal and  Free T4 and T3 was going toward high normal.  Now in 4 weeks if the trend continues he wants to put me on Synthroid......now I was just given Tapazole 4 weeks ago, but refused to go on it because I only talked to his physicians assistant's assistant...He though I had gone on it because it improved.  But now we are going with the opposite, synthroid.  Anyone have this issue--he said and I quote "you are not by the book"

[Barb135]

I've never been in your situation and do not have both Graves and Hashimoto's antibodies, though I know it's possible.  The one thing I would like to comment on is your very last sentence: you quoted your endo ans saying "you are not by the book" - be thankful that he recognizes that and is NOT trying to categorize you or "normal"..  

Too many doctors don't recognize the fact that we are all different and that we need individualized treatment........

[goolarra]

I can see his point...your first labs looked pretty hyper (thus the Tapazole), but your FT3 and FT4 seem to be falling fast.  Those are both pretty big jumps in just four weeks.  Lots of times, in the initial stages of Hashi's, we go through a "hyper" phase.  Sometimes the hyper-alternating-with-hypo continues for some time.  My guess is that you have Hashi's (although I understand why he doesn't want to commit).  Also, some people actually do have both Grave's and Hashi's.  Since you tested positive for the antibodies (do you know which ones specifically?), you definitely have an autoimmune disease.  

I think his idea of retesting in four weeks is a good one.  See if the current downward trend in the FT3 and FT4 continues.  What are your symptoms?

OMG, the very idea of a physician's assistant's assistant is chilling!

[hopeful2006]

Hi,
Thanks for your response...sounds bad but I am looking forward to seeing what my labs are so we can get me on something.  This has been going on for a year now.  My TSH for the year has been:  0.006, 0.01, 0.16, 0.08, 0.03, 0.01, 0.73.  With the range of 0.4-5.5 as normal.  My TSI antibodies were 799 with < 150 range normal.  My Microsomal antibodies were 107 (I think that is right--def above 100) with < 5 as normal.  I wish this was a trend but you can see that my TSH goes up and down.  Also my Free T3 and T4 did the same thing.  

[hopeful2006]

Hi,
You asked about my symptoms: heart palps, cold, thinning hair, hard to lose weight, (but I can on Weight Watchers), sweating, hands trembling, tired, blank stare, loss of memory.  I was staring(of course:) at a chart in the dr office and saw I had equal symptoms for both hyper and hypo.  --and yes the assistant to the assistant was worrisome in that I pointed out that I left his office with a "understanding hashi's" paper and was now being treated for Graves.  She said yes you have graves.  I said but what about Hashis but she said OH?  That is when I went to dr with a long list of questions (some I got from wonderful people here) and asked.  It was still hard for me to comprehend what I have because I have perplexed him, but we are keeping on it...at his assurance and will figure it out! Anything else you think I should ask?

[Smilerdeb]

You have Graves Disease and your thyroid is burning out.
With Graves...the thyroid will 'dump so you will be on a see-saw from hyper to hypo.
Be careful the synthroid doesnt make you med induced hyper.
Ask your Doctor if it is possible to do B & R (block and replace).
This entails you taking a small amount of T4 med (synthroid) usually 25mcg and ALSO taking 5mg od an anti-thyroid med.
Obviuosly you have to be monitored closely as it possible to go HYPO from the anti-thyroid meds within 2-3 weeks but that is where the synthroid comes in and stops this...sometimes needing the dosage adjusted.
Hope that helps.

[hopeful2006]

Thank you soooo much you have all been so helpful and I really appreciate all the information I get.  I am going to ask him and will keep you posted as to my labs in 4 weeks.