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Graves or Hashimoto's

I was recently diagnosed with Graves. I think its Hashimoto's and I am seeking another opinion.

Blood test on 9/30:
Tsh- 0.02
T3 free- 255
T3 total- 111
T4 free-1
T4 total- 6.5
TSI- 394

After 1 week of Paleo diet ran new tests on 11/7/16

TSH- 31.93
T3 free- 176
T3 total- 83
T4 free- 0.7
T4 total- 4.3
TSI- 250

Quest Diagnostics normal ranges
TSH- 0.04 to 4.50
T3 free- 210 to 440
T3 total- 76 to 181
T4 free- 0.8 to 1.8
T4 total- 4.5 to 12.0
TSI- 900. I have always been hypothyroid. I have done nothing in this past month for treatment other than switching my diet to paleo and adding vitamin D3 and Shatavari root supplements. At the time of the test in September, I was only 3 weeks off of my 50mcg Levothyroxine. So it was still in my system.
My thyroglobulin antibodies were 1.

Recently I had a patch of white skin appear. Is vitiligo a symptom of thyroid issues?
2 Responses
649848 tn?1534633700
COMMUNITY LEADER
What makes you think you have Hashimoto's?  What's the reference range for the Thyroglobulin Antibodies (TgAb)?  Most labs are something like < 60.  If your TgAb was only 1, that would be considered negative.

Have you had a Thyroid Peroxidase Antibodies (TPOab) test?  That's the other antibody that can diagnose Hashimoto's.  Some people have, both TPOab and TgAb and other have one or the other...

Your TSI at 394 is definitely positive for Graves, even if it might be under the reference range... Diagnosis is based on a percentage of the reference range.

Some people have both Hashimoto's and Graves.

How long were you on the Synthroid and why were you taken off it?

Vitiligo is not a symptom of a thyroid condition; it's an autoimmune condition of it's own, that can co-exist with a thyroid condition, because when one has one autoimmune condition, it's very common to get another...
2 Comments
My thyroid peroxidase were >900. I was on levothyroxine for about 10 years.
The doctor took me off because my tsh was 0.02 in September and I had the blood tests confirming Graves with hyperthyroidism. Now, a month later and my Graves is in remission and I'm hypothyroid again but my TSH is the highest its ever been!
649848 tn?1534633700
COMMUNITY LEADER
Was the TSH, at 0.02, the only thing that indicated hyperthyroidism or did you have symptoms of being hyper, as well?  When one is on replacement thyroid medication, TSH often becomes irrelevant... Your Free T3 and Free T4 do not indicate hyperthyroidism, at all.  

As I noted before, some people have, both, Graves and Hashimoto's, with one or the other being dominant.  Apparently, for you, Hashimoto's is dominant.
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649848 tn?1534633700
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