was hypo now hyperthyroid

[nanettesw]

I am new here but was hoping you all had some ideas.

I was diagnosed 6 months ago as hypothyroid with a high tsh but a normal t4. I had many of the classic symptoms of hypo. I was put on levothyroxine and was tested every 4-6 weeks to see if meds needed adjusted. They kept reducing my meds and I was finally taken off of them altogether because I was hyperthyroid.

I was just tested again a week ago and my tsh came back very low .005 with .5 being the low end of the "normal" range. I feel fine right now other than I am a little shaky at times and I am tired often. I got my t4 results back today and they are normal. I also got a t3 test done but do not have the results yet and I have a thyroid uptake scan scheduled for next week.

Why do you suppose it is doing this, and should I be concerned even though I feel just fine?

[nanettesw]

Well I went to the Dr today to review my lab results and my TSI came back elevated(not sure of the #), my uptake was high (26%) at 6 hours and upper normal (33%) at 24 hours with no nodules and no heterogeneous areas. My FT3 was normal (again not sure of the number). I should have asked for copies, I thought I could remember them all. my tsh was .005 ref .5 - 4.7 and FT4 was 1.5 ref range .7 - 1.8

Anyway My doctor said "it looks like it could be graves" but did not actually come out and say it. and he said that it is "supressed" because everything other than tsh, uptake and tsi were normal and I feel good. And he just wants to monitor my levels again in 3 months.

So do I have Graves or not and if I do why was I hypo 6 months ago and since I feel good now should I even be worrying about this right now or should I be pushing for more tests.

[Barb135]

Have you had a thyroid ultra sound done?  Can't help wondering if you might have nodules "leaking" hormones independently of your thyoid. This can swing you back and forth between hypo and hyper.  Also wondering if you have had antibody tests done?  Oops, I almost missed the TSI; if positive, that would confirm Graves Disease.  

You also need to get Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab); either or both of these, along with a goiter (swollen thyroid) and nodules would confirm Hashimoto's Thyroiditis.  There are people who have both Graves and Hashi's.

Both Graves and Hashi's are autoimmune diseases, in which your body produces antibodies that attack and eventually the destroy the thyroid gland

High TSH would indicate hypo, and the symptoms you described go with that.  

Keep in mind that fatigue goes with either hyper or hypo........ whichever you may be at a given time, you will most likely be tired........

6 months ago, you were hypo, which means you didn't have enough hormones; now, they say you are hyper, and while your FT4 is high in it's range, that doesn't mean you are hyper, if you are feeling better.

My latest TSH was 0.01, which was actually up from my normal level of < 0.01; my FT4 was the same as yours (1.5, high in the range) and my FT3 was about 75% of it's range....... I feel better than I've felt in years......

I think too much emphasis is being put on your TSH and not enough on your actual thyroid hormone levels or antibody levels.  BUT, you should also ask for tests to make sure your pituitary gland is working properly.  In addition, I'd suggest that you ask for Vitamin B12 and Vitamin D tests.  While thyroid issues can/will certainly affect your periods, have you had other "female" hormones (estrogen, progesterone, etc) tested?  The entire endocrine system must work together in order for you to feel well.

We will be very interested in seeing the T3 test

[nanettesw]

OK so here are my results
I Had 2 tsh tests done in the same week

the first one .013  the second one .005 ref range .5 - 4.7

It was never that low when I was on medication.

my free t4 was 1.5 ref range .7 - 1.8

I have not taken any meds for 2 1/2 months now and my tsh still seems to be going down.

When I had a high tsh I was so tired all the time, neck hurt, itchy skin, 6 week long heavy periods, cold all the time and I suffered from depression and anxiety.

Now I am still tired a lot but that may be due to having 6 kids (19 month twins). My periods have stopped altogether. I am sometime chilled to the bone and sometimes so hot I have to go outside for a while to cool down. And I am a bit shaky most of the time.

I would take how I feel right now any day over how I felt 6 months ago. I forgot to mention that I also got a TSI done but do not have the results to that either.

[Barb135]

Are you really hyperthyroid, as in having hyper symptoms, or are they basing the decision strictly on your low TSH levels?  

What is the exact level of your T4, and is it "free" or "total"?  Total is considered pretty much obsolete and of limited value.  Just because you are in the so called "normal" range, doesn't make that normal for you...... please let us know if the T4 test was free or total and post the exact result, along with the reference range, as these ranges vary from lab to lab, so must come from your own report.  

In addition, when you get the T3 test back, also let us know whether that's "free" or "total" - same applies to that as to T4.  Post the result and reference range.

You are only considered hyper if your symptoms (most important) and labs for Free T3 and Free T4, indicate that you are hyper.

I went through a similar experience -- as soon as I got on thyroid med for being hypo, my TSH hit rock bottom and my doctor started backing off on my med, in spite of the fact that my FT4 was actually below range; he refused to run FT3...... he had me down to almost no med, in an effort to bring my TSH up, and in so doing, he kept me sick for almost an entire year because he wouldn't believe that I really wasn't hyper.  My TSH regularly runs < 0.01, but we don't even look at it so long as my frees are right for me.

Did you feel fine before you were taken off med?  If so, there's a good chance you were never hyper and will go hypo again rather quickly.

Please post the FT levels, so members can comment more fully.