Graves or Hashimotos?

[mary447]

Hi. Two months ago my TSH was 0,04 and started taking propanolol 10 mg and PTU 50 mg a day. 6 weeks later I had a TSH of 15 mIU/L  and anti TPO  Ab of 662 UI/ml and anti TG Ab of 176 UI/ml, now I don´t know if I can have Graves disease or Hashimoto`s disease or nothing, since my T4 levels are normal. I haven´t been tested for T3.I think my doctor doesn´t know what to do either, and doesn´t do anything about it. I feel tired, can barely sleep, stressed all the time, and have a lot of skin, hair (dry and falling a lot), eyes (always red and in pain) and circulation problems. My doctor says my thiroid is enlarged and sent me an ultrasound. I feel awful. Any advice?

[mary447]

Thank u very much! You are right. I better wait until I get the ultrasound. I will probably take it in two weeks, since the hospital has been having problems with the machine for about a month. Also I will ask for the FT3 test, since I know it's also important. I will let u know about the results.

[goolarra]

I think you should be tested again as soon as possible and include free T3 as well as FT4 and TSH.  Both your TPOab and TGab are elevated, but these can indicate both Grave's and Hashi's, so you should have TSI tested...this is the definitive test for Grave's.  Without TSI, you can't be sure it's Grave's.  

Have you had the ultrasound?  

All your symptoms could be thyroid related (and probably are).  With the elevated antibodies, I'd get further thyroid testing before seeing an immunologist (or any other type of doctor).  If your doctor doesn't seem to know what he's doing, he probably doesn't, so it might be a good idea to ask for a referral to an endo.  Don't waste your time with someone who has no idea how to treat thyroid.

[mary447]

I was diagnosed with graves, because of the ophthalmopathy and the antibodies. The test was for free T4. It is from the same test, but I started being hyper (with a TSH of 0,004). Due to the PTU, I became hypo and they lowered my medication. I suffer from a lot of skin and allergy afections. Currently I have keratosis pilaris(in all my body), very dry skin, circulation problems. urinal infections and my eyes hurt a lot. I cannot tolerate hot weather (I sweat a lot and my skin hurts and feel bloated)  or cold weather (I start shaking awfully and become purple!). It´s hard to swallow and my mouth is very dry, specially in the morning. I´m thinkin of seeing an inmmunologist to check for food allergies. There most be a way out for all of these (that´s my hope)

[goolarra]

Have you been diagnosed with Grave's?  Was the diagnosis based on TSI testing?  Were you having hyper symptoms when they started you on PTU?

Is that a total T4 or free T4?  If it doesn't specifically say "free" or "FT4", then it's total.  It's 11.5 with a range of 4.5-11.2, correct?  Is the TSH of 15 from the same blood draw as the T4 of 11.5?

[mary447]

Does anyone think that hyperkeratosis might be related to an autoinmune thirods disease?

[mary447]

Thank you for your answer. My level was 11.5 and the normal range is 4,5 to 11.2. The weird thing is that my symtoms are more from hipo than hyper. It doesn´t matter how much cream I use, or how good I eat, my skin is falling apart and always have acne and keratosis all over. I´m getting desperate now...

[laura1967]

When were your last tests done? What was the actual tsh and free t4 numbers with ranges used by your lab?
You can have both hashi's and graves. But you will swing all over and the beginning of Hashimoto's as well, until the anitbodies start to destroy your thyroid tissue.