hashitoxicosis

[fran0813]

About 4 years ago I had the right lobe of my thyroid removed due to Hasimoto's disease. I am on 75mg of synthroid. I have been feeling great for the past 4 years. A week ago I began to get very anxious and had 3 times of feeling lightheaded. It is usually worse in the morning when I wake up. I go between anxiety and slight depression. I just don't feel myself. Could my thyroid be cycling between hypo and hyper? Isn't this hard to diagnose? What is the treatment for this. I did not take my Synthroid today to see what I would feel like. I feel better but don't really know if this is why? Please help!!! I have never been anxious or depressed. I am 56 years old. Thank you for any help you can give me!

[goolarra]

I have learned that nothing is impossible when it comes to thyroid!  I'm glad to hear you're feeling better today. I think you should get your test results and make sure your meds really are adjusted properly.  So many symptoms can "cross over" and be symtomatic of both hypo and hyper.  A slight change in dose could have you feeling fine again.

You might want to have an ultrasound to see what the remaining thyroid is up to.

[fran0813]

Since my operation 4 years ago I have just gotten blood work every year and that is it. I have not been back to the surgeon who operated because I have been fine. I am going to make an appointment with him. Today I feel much better, still not 100%, but the anxiety is not there. Is it possible that I am going back to Hypo?

[goolarra]

I'd ask your doctor for exact numbers on your bloodwork and the reference ranges for FT3 and FT4.  We so often hear doctors saying everything is "normal" only to find that testing was inadequate or reference ranges obsolete.

You may not have any more nodules.  However, since Hashi's gives you a tendency toward nodules, even if you had none on the left when the right was removed, you could have developed more since.

It's really hard to adjust the dose when we're on the rollercoaster.  A lot of people find that TSH has to be suppressed fairly far down in the range to alleviate symptoms.  There's no way to track the frequent ups and downs and adjust meds to accomodate since it takes weeks for meds changes to have total effect and sometimes just hours for the Hashi swings.

Ask your doctor for the results of your labs and post them if you'd like so members can comment.  Is he the same doctor who has been managing your hypothyroidism right along?

[fran0813]

Thank you for your response. I had my blood work done by my primary physician and he said it was fine. Because I had the right lobe removed I didn't think I had any more nodules on my thyroid. If I am going from hypo to hyper, do they change the dosage of synthoid to accommodate for the change? Will they change it since my blood work came out OK, which is very frustrating!!!

[goolarra]

When was the last time you had labs?  If it was not very recently, I think that would be a good place to start.  Be sure to have free T3, free T4 and TSH tested.  FT3 and FT4 are the actual thyroid hormones and much more important than TSH in determining thyroid status.

Yes, with Hashi's, your thyroid can go from hypo to hyper.  This is because the nodules often associated with Hashi's can "leak" rather than secrete hormones into the bloodstream.  This leaking is pretty uncontrolled, so levels get disturbed  It's usually diagnosed by the patient...we can feel things going back and forth.  Unfortunately, there is no treatment for it.  We just have to stick it out until our thyroids are completely destroyed by the Hashi's and we're on 100% hormone replacement.  In the meantime, we have to stay on top of bloodwork and symptoms to know when a meds change is in order.

Skipping your dose a few hours ago is unlikely to change how you are feeling today.  It takes a while for your FT3 and FT4 levels to change after a meds adjustment (a few days to several weeks depending on sensitivity).