Silent thyroiditis without hypo phase?

[Donpodiochi]

I am a male 20 years old.
I have silent thyroiditis started 26 september 2011 with all the classic symptoms high HR (193 bpm when I first went to a doctor),anxiety,appetite and so on.
the hyper phase lasted until december 23 2011 but I still felt mildly hyper until around the beginning of march and now I am slowly feeling more normal everyday.
My question is can a person have silent thyroiditis without going hypo? or with very mild hypo?
The doctor says my results are normal and thinks I should have recovered by now but I don't feel quite normal yet.
my labs are as follows.
.Dec 12 2011.First TFT was normal
TFT
TSH    1.63   mui/l    ref range - 0.35 - 5.0
T4       16.6h  pmol/L ref range - 11.5 - 22.5

.January 4 2012.
Radio tracer uptake is diffusely decreased in both lobes of the thyroid glands and no hot or cold spots are demonstrated,left lobe enlarged.
thyroid uptake is 0.1 normal 0.75 to 4.00
.Ultrasound.
shows increased vascularity and left lobe slightly enlarged and says features suggestive of early thyroiditis.

TFT
TSH    0.01   mui/l    ref range - 0.35 - 5.0
T4      23.9h  pmol/L ref range - 11.5 - 22.0
.January 12 2012.
TSH    0.01   mui/l    ref range - 0.35 - 5.0
T4      24.0h  pmol/L ref range - 11.5 - 22.5
T3      8.5H   pmol/L ref range -  3.5  - 6.5
February 18 2012 (latest lab results)
TSH    2.89   mui/l    ref range - 0.35 - 5.0
T4      13.5h  pmol/L ref range - 11.5 - 22.5
T3      3.1H   pmol/L ref range -  3.5  - 6.5

All are free t3 and thyroxine free t4.

By the way the doctors gave me carbimazole for one month from january 12 to febuary 18 and then said it was the wrong medicine and i haven't had it since and the diagnoses was thyroiditis quite vague in my opinion,I figured It must be silent thyroiditis

Any insight on my condition will be much appreciated but my main question is,can it be possible that I wont have a hypo phase?

Thankyou

[Donpodiochi]

Hi, just thought i should say that I am feeling much better now,almost perfect but not quite there yet.I will probably be perfectly healthy by the end of the year.

"Generally, silent thyroiditis will go away on its own within 1 year. The acute phase will end within 3 months"

My (LT/SRH) started in september 2011 and I have had the hyper phase and the hypo phase.
The only phase left is the euthyroid phase which i am just emerging into and hopefully i will stay euthyroid!!

Anyway i would just like to post this so anybody else who has silent or subacute thyroiditis and is searching forums for help will see that you do recover from it and it doesn't last forever. you do ... eventually get better.
first you will have one good day then a little more good days and after that an odd bad day and before you know it there will be only good days :)

There is nothing better then a healthy thyroid :)

[Donpodiochi]

I see the doc every month or so,and they print the result out while I am there.
I feel in-between mild hypo and mild hyper I think.
This test is quite important,I dont expect anything to high or to low judging by how I am feeling though.
Thank you for concerning,I'll post the TFT on this thread as soon as I get the result.

[goolarra]

Well, as you pointed out, silent is really just a variant of Hashi's.  An antibody count would be interesting.  Too bad you haven't been having them right along so you (or "I") could see the progression...very interesting.

Is anyone looking at your results before 4/11?  I'm only concerned because your last labs you were still on carbimazole.  So, the labs you had drawn 3/12 are the first unmedicated and really important.  

[Donpodiochi]

sorry spam,.......Lag.......

[Donpodiochi]

Yes I have already done the TFT on 12 march but will get the result on the 11th of april while doing another TFT.
I have had no pain and thyroid is normal size,its only enlarged on the ultrasound and isotope scan.
It has to be silent or hashi's.
I'll ask them to do a antibody test for interest sake,apparently silent has fewer antibodies than hashi's.Maybe my antibodies are subsiding as should happen in silent thyroiditis.

[Donpodiochi]

Yes I have already done the TFT on 12 march but will get the result on the 11th of april while doing another TFT.
I have had no pain and thyroid is normal size,its only enlarged on the ultrasound and isotope scan.
It has to be silent or hashi's.
I'll ask them to do a antibody test for interest sake,apparently silent has fewer antibodies than hashi's.Maybe my antibodies are subsiding as should happen in silent thyroiditis.

[goolarra]

The fact that you had the flu just prior to going hyper makes me think of DeQuervain's thyroiditis, but your RAIU wouldn't indicate that.  Did you have any pain associated with your hyper phase?

Do you have FT3, FT4 and TSH scheduled again soon?

[Donpodiochi]

Thanks for advice did a little research and found that silent thyroiditis has the exact same antibodies as hashimoto's, so antibody testing wont help much.
silent thyroiditis is called lymphocytic thyroiditis and hashi's is called Chronic lymphocytic thyroiditis,they are very similar.
silent thyroiditis antibodies are antithyroid peroxidase (TPO) and anti-thyroglobulin (Tg) antibodies.
they say that some people with silent thyroiditis develop hashi's=lymphocytic thyroiditis that doesn't go away (i.e.Chronic lymphocytic thyroiditis)
I Hope I don't have hashi's,silent type is much better only time will tell at this point.
I did get hyper directly after contracting a flu if that means anything and had no prior symptoms of thyroid problems.
I will just hope for the best and continue getting TFTs to see whats happening.

[goolarra]

As I said, it's hard to say because your last labs were medicated.  You could be normalizing, and you could be on your way through the normal range going into the hypo phase.  You do have to go through normal temporarily to get there.  

If I were you, I'd insist on antibody testing.  Hashi's can be characterized by an initial hyper phase or swings from hypo to hyper, and Graves' is, of course, hyper.  It would be nice to know what you're dealing with so you  know what to anticipate for the future.

TPOab (thyroid peroxidase antibodies) and TGab (thyroglobulin antibodies) are the tests for Hashi's.  Many doctors only run TPOab, but if that's negative, Hashi's still can't be ruled out until TGab is run also.  TSI (thyroid stimulating immunoglobulin) is the definitive test for Graves'.  

Silent is considered a "temporary" thyroiditis, but it can still last a couple of years.

I think antibody testing would remove a lot of the uncertainty for you, and you'd have a much better idea what to expect.

[Donpodiochi]

My diagnosis by general practitioner's is that I have thyroiditis,I figured it has to be silent thyroiditis,no pain,low uptake with high T4 and low TSH,no swelling and seems to be getting better.
I have had no antibody test done.
The doctors I'm seeing don't no much about thyroid problems, they had to phone an endocrine because they were confused by the low uptake RAIU + hyperthyroid,He said your TFT looks hyperthyroid but you radiotracer scan looks hypothyroid.So clearly they have never seen a case of silent thyroiditis.
any way,
I seem to be getting better slowly,i'll just have to see what happens.
I will have to see what the next TFT result is to see if my TSH is going up.
One thing they do say is that it should get better on its own,actually they think I should be better already but without a hypo phase?

[goolarra]

Have you had antibody tests?

It's hard to say what's going on because you were still on carbimazole right up to your latest labs on 2/18.  

I notice your T3 from those labs was "3.1H".  Is the "H" a typo, because the result is clearly low...below range?  I will assume  the FT3 is correct at 3.1.

You were clearly hypo on the 18th, but, once again, that was a medicated hypo.  

You've never been diagnosed with silent?

[Donpodiochi]

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