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Thyroid Disorders Community
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897578 tn?1241724871

Diagnosed with Hashimoto's AND Graves disease!

I found this support group while googling about thyroid disorders.  I hope to find answers and peace of mind.  I am 47 and have always been fairly healthy.  Within the past few months, I noticed extreme fatigue, especially late afternoon.  I need a 2 to 3 hour nap daily, which is so out of character for me.  Also, since December 2008, I have gained 25 pounds and my hair is falling out at an alarming rate.  I have never had a problem with my weight, in fact, I have been slightly underweight.. until recently.  I went to my family doctor this past February, who sent me for labwork.  My TSH level came back 0.004, vitamin B12 high at 919, cholesterol 224, triglycerides 303, HDL 39, LDL 124; everything else was normal.  She then sent me for a thyroid ultrasound which came back positive for Hashimoto's thyroiditis.  Two weeks ago I had a nuclear medicine thyroid uptake scan which came back positive for Grave's disease.  Last week was my first appointment with an endocrinologist who informs me that I have both Hashimoto's AND Graves disease, which according to her, is very difficult to treat and is not that common.  Her first suggestion was the RAI (radioactive iodine), second choice was tapazole/PTU for a year to 18 months, and thirdly was surgical correction.  She tells me that the tapazole treatment will only put the hyperthyroidism in "remission" so that we can treat the hypothyroid.  

My first inclination was to proceed with the thyroidectomy.  Then I started thinking about RAI therapy.  I am really confused on what truly is the best course of treatment is for me.  I know it's a personal choice, but how do you come to a decision?  I would like to know what course of treatment(s) anyone has had that has been diagnosed with both hyper and hypothyroidism.  

I apologize for the long post.  I am just at a loss here.  Thanks in advance!
84 Responses
549681 tn?1229728099
I'm not a Dr. and I know how confusing this thyroid stuff is.
Did they do any antibody tests?  That is pretty important before confirming a diagnosis!
Go ask for copies of ALL of your labs and post them here.
You should have TSH, Free T4, Free T3, TPO, TRab, & TSI

I hope others will chime in on this one.
Avatar universal
I was sort of there as well....I was diagnosed with Hashi's in March 2006 and was happily on levoxthryine for 10 months. In Jan 2007 I went in for what I thought was a sinus infection and two weeks later got the graves diagnosis after the battery of tests.  It's rare but can happen- my body's immune system is attacking a new part of my thyroid. In your case it looks like it's attacking two different ways.  I have been treated with methimazole to suppress my thyroid hormone production for two years now, but will probably have a TT or RAI in the near future.  I think in your case, killing your thyroid seems like the best option.
897578 tn?1241724871
Just wanted to update my post on the forum.  I opted to have RAI therapy and completed it last Friday, a week ago.  So far, no side effects from the RAI.  I go back to the endocrinologist next week and then again in six weeks.  The only thing I can tell different is extreme sensitivity in my salivary glands.  Even toothpaste makes my salivary gland "spasm".  
Avatar universal
You have just told my story.  I am very perplexed myself.  I was first offed with both of the thyroid killing options when I was hyperactive thyroid.  I chose the medication, then a few months went by and I felt like the anti-thyroid medications wasn't even working anymore, so I was going to have the levels checked again, but the very next day my n3ck was swollen and I couldn't swallow food very well.  They took my levels that very day and I have NO TSH levels, my thyroid when from over active, to not active at all.  I am 31, I am so confused, and my doctor admits that he is as well,  He is an older doctor in a very small town, he has never seen anything like it, but he has heard of thyroiditus and I knw he will be working very hard to figure out what exactly is going on here.  I am glad though that I didn't chose the Radioactive Iodine.... just because of my age and the fact that you must also decide that you do not want to add to your family after that.
393685 tn?1425816122
Now that you had permanent ablation some things need to be viewed.

With RAI - please remember to drink tons of lemon water to flush the RAI out of your system. It  does effect other body parts than just thyroid tissue and can make your permanent situation hard to control.

With RAI on Graves now you will have to most likely content to the Hashi attacks coming. They do not get suppressed in that procedure and can rage up with the Graves slows down.

This IS a difficult treatment and Block and Replace with medication is most likely needed. The antibodies of Graves will not completely suppress for a while so you caould swing on both levels for quite sometime and any given time and testing can be tricky.

393685 tn?1425816122
concentrate on building up your immune system right now. A strong immune system is essential for this to stable out.
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