High TSH, Antibodies present, normal T4 and Hives

[beacon800]

Hello,

I had hyperthryoid symptoms for a couple weeks, including racing pulse, flushed face, restless, increased bowl movements and persistent hives.  These symptoms improved except for the hives.  Recent blood test showed 7.5 TSH, TPO ab 381, Thyrodlobulin ab 51 and Free T4 is at 1.3, normal.  All other blood work, CBC, normal.

This looks like Hashimotos.  Can a person first have hyperthyroid symptoms and then go to Hashimotos?

I also have persistent hives.  Would I benefit from taking replacement thyroid even if my T4 is normal?  I would love to stop these hives.  Taking lots of benedryl right now.  No other thyroid symptoms.

My family practice doc says he can do nothing.  I am seeing an endocrinologist in a couple weeks.  Any advice deeply appreciated.  

MK

[Mark Lupo, M.D.]

Symptoms are nonspecific - so often people have symptoms of both hyper and hypo --- and in many cases have not thyroid problem at all.

The hashimoto's (which is what this appears to be) may be contributing to the hives and often this improves with TSH normalization (even w/ normal T4).  however with the "hyper" symptoms you describe, starting at a low dose of 12.5 - 25mcg per day of levothyroxine should be considered.

[beacon800]

A follow up:  I just went to an endocrinologist at Stanford Hospital and she elected to put me on a small dose of synthyroid, starting at 25mcg and going to 50mcg.  This I will start tomorrow.   She does not think it will fix my hives but she wants to do a trial run of the medication to see if it improves.

Meanwhile, I started taking Zyrtec and it is producing excellent control of my hives.  I take one Benadryl in the morning and one Zyrtec in the early afternoon.

My blood work will be repeated in 60 days to evaluate any changes.

I will let the forum know if this treatment improves my hives.

[beacon800]

I am very grateful to hear your reply doctor.  Thank you.  I will discuss with my doctors.  I so appreciate your insight.