Hyper and Hypo at the same time?

[criswatk]

I was diagnosed with Hashi and have blood tests to support with antibodies anywhere from 1500 to 300 (both globin and peroxidase) depending on the day of the test.  Also have TSH levels between 4.3-5. Symptoms cover both hypo and hyper.  Weight gain, fatigue, heavy periods, intolerance to cold, but also infrequent heart palpitations, tremors(mostly in left hand), dry skin, hair loss, insomnia just to name a few.  Doctor (GP) ordered a thyroid uptake test to rule out Graves and get a better picture of what was happening.  Test came back normal for the scan but Hyper for the uptake test.  So now I'm really confused.  The blood test taken the same day showed my TSH at 4.8.  Antibodies consistant with Hashimoto's. The doctor recommended that I get Radioactive Iodine Therapy to zap my thyroid because he says it will give us a level playing field to start medication and will get rid of swings from hyper to hypo due to Hashimotos.  I haven't been able to find anything that supports this treatment.  I can only find RAI for treatment of Graves.  Does this seem to be the right approach or should I consider something else?  I've had untreated Hashi for probably 10 years and had definite swings between hyper and hypo.  Just didn't know it at the time and have never been on thyroid meds.  These recent seemingly conflicting tests though have perplexed me.  I also have quite a bit of memory issues, forgetfulness, like I'm preoccupied and miss stuff I didn't used to miss.  I'm 36 and have always been very sharp so this part scares me a little. I'm ready to start feeling better. help

[nelsonchatham]

I found it interesting that you had breast cancer after being on a T4 med only.  Since low T3 has been associated with breast cancer (and T4 med folks often have low T3), I would want them to be checking my Free T3.

There is some evidence that low T3 levels may be associated with breast cancer. A study in Molecular Carcinogenesis (Gonzalez-Sancho et al. 2002) stated that T3 down-regulated the expression of T1, a gene that is over-expressed in human breast adenocarcinomas. The study concluded that T3 reduced the proliferation of mammary epithelial cells and inhibited the expression of cyclin D1 and T1 genes. Another study in the Annals of Medicine (Smyth 1997) indicated that although the exact mechanism for the association between thyroid and breast cancer is not quite clear, there is the possibility that the presence of thyroid abnormalities may influence breast cancer progression, and this should stimulate awareness into the coincidence of the two disorders. Finally, according to the World Health Organization, 45.5% of patients with a breast carcinoma had thyroid enlargement compared with only 10.5% of controls. Antithyroid peroxidase autoantibodies were twice as common in breast cancer patients as in controls. These findings provide evidence of a relationship between thyroid disease and breast carcinoma, although the mechanisms require further study (Shering et al. 1996).

[pitcrew]

This thread has been very interesting. I too have hashimotos. For 6 years I was treated with synthroid up to 150mg, which worked great. 2 years ago I was diagnosed with Breast Cancer and went through chemo. After that battle was finished my thyroid seems to level out but my symtoms got very bad. My doctor switched my to Armour 90 mg, which at first worked very good. Last Janurary I was diagnosed with BC Mets and started on chemo xeloda. After a month of being on xeloda I started gaining massive weight (over 10lbs in 10 days), my doctor didn't think it was my thyroid. After 4 months and another 20 lbs, he ran a thyroid panel, it came back THS .05 so they lower my dose to 60, 6 weeks later they did it again and this time it was 6.12, so they raised my armour back up to 90. Well I just got a call from my doctors office and now my TSH is .0898. I have goiter (found by a MRI, but not biopsied) and have restart chemo in 2 weeks because of a tumor in my neck. anyone ever had this experience? do you think the chemo caused all they problems? what do I do now? my Doctor is suggesting going back to synthyroid to try to level me out... I'm wondering if I should just have surgery to remove it along with the tumor in my neck and that way maybe I can get it back to normal..... PLEASE HELP, I CAN'T HANDLE ANOTHER WEIGHT GAIN.. not that and chemo too!!!!

[nelsonchatham]

instead of posting a question in a thread, you might want to copy and report your query in a new post to dr. mark.

I have read that TSH can flucutate as much as 200% over the course of a day - so i have no idea why they use this lab to diagnose or dose.  But your symptoms are sorta screaming hypo, aren't they?

[reni1]

I am 35 years old with two children. I was diagnosed with an elevated TSH after the birth of my second child.  I was diagnosed hypothyroid.  I was started on Levoxyl 50 mcgs. in 2001 and has stayed on the same medication until now.  I was fine in June 2005 with thyroid being in normal range.  In July, I had a bad cardiac episode and they found that my TSH was 0.00 negative (undetectable).  Within 6 weeks, I went from hypo to severe hyper.  I was taken off all medication for 4 weeks and my TSH went up to 3.4 and then 2 weeks later it had went up to 5.8 and then 2 weeks later 8.9.  I was then put back on Levoxyl 25 mcgs. and my level went to 4.8 in 2 weeks.  Then, my TSH went back up to 6.4 and I was put on 50 mcgs. My TSH came down to 4.6 and then I was put on 75 mcgs. and it brought my TSH down to 1.8.  My doctor decided to change my medication to Synthroid since Levoxyl was still a new drug and thinking that it might be causing it to bounce around.  I started taking Synthroid November 4th, at 75 mcgs. with a TSH of 1.8 and on November 22nd it was 3.3.  I just had my blood drawn tonight, December 3rd and my TSH is 3.8.  What is going on?  I was diagnosed with Hashimoto's with antibodies.  I was tested for Grave's and it was negative.  I do have a cold intolerance, I freeze all of the time, I have severe dry skin and hair loss.  MY BIG ? is, can your TSH flucuate this much.  PLEASE HELP

[criswatk]

I understand. I wish there was an article or something I could bring in to back myself up on the uptake thing...I will look in a database I have access too.  I'm a researcher for my job so I probably won't be that difficult...anyone have anything that would help.  It would need to be something that is not from a page off the internet but from a medical journal something that he wouldn't scoff at. Thanks.  I really am glad I found this forum.

[criswatk]

thanks - that does help.  It is a confusing disease.  So the RAI will take me from borderline hypo to real low hypo in a matter of months and will make me more dependent on medicine or at the very least higher doses of medicine.  *sigh*  I was on one hand so happy that I had a responsive doctor...someone who didn't ignore me when I told him all of my symptoms...it seems his approach is too aggressive for my labs.  Now what?  I just want to feel better.