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Hashimoto's Toxicosis and going hypo and hyper

This is kind of a survey/question to those of you diagnosed hypothyroid Hashimotos but who feel or actually are cycling into a hyper (not hypo) state. Do you seem to have symptoms of hyper like red in the face, hi b.p., shakiness, depression, hot all the time not hot flashes, hot tempered, double vision or poor vision etc etc but yet you feel run down, tired, fuzzy mentally, slow gastro processes so you go to the doctor and he/she says you are right in target range for tsh below 3.0 or thereabouts and great free t4 free t3 levels and all else looks good so maybe they raise your thyroid med dose thinking you're still a little hypo (not hyper) or have you lower dose in case you are actually hyper and for a short while you feel better or feel worse right away so now you don't know if you're up or down ? Yes, that is a run on sentence but hopefully I'm clear - here is my theory - maybe you have gone so hyper your body is shutting down or slowing down to protect itself or it's just breaking  down altogether - Has anyone had this experience and if so what do you do about it or what does your doctor do or say to help you? And if our thyroid gland worked normally would pituitary and other supporting systems output consistently same amounts ? I know this is a good question for Dr. Lupo as he actually believes there is a phenomena as Hashitoxicosis unlike my past 3 endos. I'm curious what you folks think about this and what your experiences have been.
83 Responses
Avatar universal
Well, before my Dr caught my high TSH, and reading what symptoms were what.  I think I experienced hyper symptoms with a high TSH, when I was on Levo, I accually had normal TSH but felt yucky, rundown, lazy.  Now I have been off Levo for 6 weeks and I think I feel more hyper again. I have energy, quite the appetite. But I also feel normal, like before all this thyroid nonsence.  I have to rest soon, not sure what it will say.
The endo said I probably had postpartum thyroidis. (shrugg) Don't know I am just hoping my results come back normal and I can forget about all of it.
Avatar universal
thanks for your response - yeah I was hoping for post partum thyroiditis but mine was permanent - you may be a lucky one - I'll keep my fingers crossed for ya :) T.
213044 tn?1236531060
I have Hashimoto's toxicosis and have cycled up and down a lot. A whole lot. Forever. Well, not forever, but it seems like forever.

The only significant indicator I have when I first turn Hyper is heart symptoms. Not racing heart. Pressure on the heart. A dull ache. Skipped beats and once in a while a little rev up for two seconds. A feeling that the heart is way past tired, and ready to just stop. Normal blood pressure and heart rate.

The depression is worse, and eventually I get shakey, am hungry a lot and need to sleep a lot.

I am tired and can't stand heat or cold whether I'm Hyper or Hypo. When I'm Hypo, my muscles hurt.

I haven't tried playing with my meds. I'm sure it would help if one could anticipate one's hormone levels a day ahead, but I can't. The symptoms lag behind the actual levels. I'm sure I'm nearly euthroid right at the moment, but my heart still feels like I'm very Hyper.

Hope I understood the question.
I'm not thinking too fast today.
Avatar universal
thanks for your quick post - yes you answered my questions exactly and yes the symptoms do seem to lag behind the levels - I see internist soon and am requesting an mri of my thyroid as not even the endos have looked at it so I just want to cover all bases - I am also going to talk to her about taking my Levoxyl on as needed basis like I have been doing past week -( after last hyper episode even being only on 1/2 dose thought I would have a heart attack )- this as needed seems to be working so we'll do bloodwork again and probably in a couple more months and see if this works (this is the one method I havent tried in 6 years) so its worth a shot - I still believe there is a way to work with our body and avoid destroying it - I'm not giving up and hope you won't either - thanks T.
Avatar universal
I was diagnosed with Hashimotos about 10 years a go, but I seem to go through phases of hypo where I put on weight, I'm tired, I lose my memory, I'm become unmotivated & depressed, all I want to do is sleep and I feel the cold.  Other times I am hyper and I can't stop eating yet I don't put on weight and lose it easily, my muscles ache, I can't sit down to a meal or watch TV without getting up and I have very little sleep etc.  I'm go,go,go and I'm full of ideas, enthusiasm and motivation.  So contrasting - like two different people and yet my T3, T4 and TSH levels appear to be the same regardless of what mode I am in.  I have just gone from Hyper back to Hypo and given my blood test results are unchanged, my Drs are just saying, 'things have caught up with you, that's why you are tired' but it's happened so many times before that I'm not convinced that it's unrelated to my thyroid condition.  Do you know of any way to manage which mode one is in apart from looking at blood test results?  My Drs seem unaware of this ability to 'switch' between hyper & hypo  Could I have Hashitoxicosis?  Any ideas on how it is diagnosed, managed & treated please?
213044 tn?1236531060
Hashitoxicosis is diagnosed by demonstrating a presence of anti-thyroid antibodies indicating Hashimoto's, along with a history of hypothyroidism that cannot be regulated along with frequent or prolonged bouts of Hyperthyroidism such that Thyroid replacement hormones must be discontinued by times.

One method of treatment, that seems to fail consistantly, is to shut the thyroid down with Methimazole or Tapazol, and use replacement hormones like Synthroid or Armour to treat the drug induced Hypothyroid state.

It can be very hard to diagnose. I was first diagnosed with a "slow thyroid" and put on Synthroid even though my chief complaints at the time all pointed toward Hyperthyroidism. My bloodwork said Hypo, so that's what I was treated for. I was tested every three months for a year and a half, and my bloodwork showed a need to up my meds every so often.

Then I went in quite ill one time and my bloodwork showed I was extremely Hyperthyroid. Suddenly I had Grave's disease instead. After a lot of frequent bloodwork and a lot of horsing around with several doctors it was discovered that my levels were swinging up and down every week, and what my tests showed just depended on what day I walked into the lab.

That "one time" was sixteen months ago and it has been hell ever since trying to treat it. After having lived with it for over three years trying to get regulated, I have decided the only way to treat it is surgery and RAI.

My hope is that it will be controlled by Synthroid after the treatments, but I am starting to wonder if it will ever really settle down. I can't see how one could bounce up and down weekly if one does not have a thyroid, but the more I read the more complicated it seems.
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HI, I was diagnosed with Hashimotos, in 2014, just recently I had a weird crazy hyper attack where my heart was tachty, 150's + and BP 170/112. I had tremors, palpatations, sweating, posturing and I was just sick for about 5 days, then checked into the ER, they thought panic attack then the TSH came back .06 so I stopped taking the levo and then they said take half, now taking half. Symptoms slowly subsided. 5 days after labs showed TSH 2.0 but now im so exhausted and depressed. I just am at a loss on what to do. The endo thinks the .06 was a mistake. I don't think so. What do you think.  Can this happen again?
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