Hashitoxicosis

[dani2776]

I saw my endo on Friday and he again went over my results with me.  I have Hashimoto's thyroiditis however he said right now I am experiencing hashitoxicosis.  What is this exaclty?  I am having more and more symptoms of hyperthyroid than hypo.  My heart rate is through the roof (He sent me for a holter monitor after my visit and I am still waiting for the results), I am very nervous, vomiting, diarrhea, and contant lightheadedness.  Is this all normal and when will it stop.  Based on my test results and symptoms he increased my Synthroid to 75mcg.  I am going crazy, I can't take this anymore!!!!!

[kidsnchicks]

From your message on May 18:  "hashitoxicosis is when your tsh is low and your free t3 and/or free t4 are high"  

So, is this the norm or exception?  My last test scores were:

TSH - 0.05 L (0.40-4.50)
T3 Uptake - 39 H (22-35)
T4 (Thyroxine), Total - 18.2 H (4.5-12.5)
4 hour uptake - 16.2% (5-15%) Feb 26 ... 4hr uptake - 13.9% (5-15%) May 21
24 hour uptake -  24 hour uptake - 51% (12-35%) ... 24 hr uptake - 41.1% (12-35%) May 22

"Today's findings are most with an automomous functioning region within the left upper two-thirds of the thyroid gland resulting in relative hypo-functioning of the right thyroid and the lower one-third of the left.  The asymmetry is unlikely for Graves' Disease.  Eitheciology would ameable to radioiodine ablation.  No focal nodules or cysts are evident.  Slight increase blood flow is seen in the left thyroid lobe when compared to the right.  Hyperemia in the left thyroid lobe could represent early thyroiditis."

Endro says Hyperthyroidism due to autonomous nodule.  Could it still be hashitoxicosis or as the doc says?

[tnj3406]

I have hyperthyroidism and have had it for years untreated. I went through 2 pregnancies and nursing with this so i didn't take meds. I had the worst symptoms. Maybe some type of relaxer might help. I never took anything(i'm not into meds) but a couple months ago my heartrate was up to 145 and had to go to the hospital they gave me ativan(awesome) I refuse to take things like that but i think i'm starting to come around. When you need it take it. Try to get a mild dose of of something like xanax or ativan. Alot of the symptoms you feel from thyroid problems are brought on by anxiety. Hope that helps.

[goolarra]

Since you're still on a very low dose, and not tolerating it, I think it sounds like a good idea.  People suggested to me that I do that since I had side-effects, but by that time I had spent about a year painfully increasing my dose, and I just couldn't face doing it all over again.  Your hypo symptoms will probably continue to increase for the next two weeks that you won't be on meds.  But starting with a clean slate and trying something else is better than suffering through all the hyper symptoms.  There are  pharmacies that will prepare thyroid meds without any fillers.  Also, if I were you, I'd research the different levothyroxine brands to see what their fillers are and how they might affect your allergies.  Best of luck.

[dani2776]

I am confused.  I just got a call from my endo and I voiced my concerns of being overly sensitive to the med increases and the possibility of reacting negatively to Synthroid because of the lactose and acacia.  He has advised me to stop the synthoid completely until my next appointment on June 15th to cleanse my system of the meds.  Does this sound right?  Will I be ok?

[goolarra]

This is strange.  When I wrote my last response, I was right under mtkst13, and your comment was not in the middle...ooh, ooh, ooh.

I definitely think the fillers could be afftecting you.  I've heard time and again about people having bad experiences with one brand, switching, and voila! no side effects.

I'd yell at you for adjusting your dose on your own, but I certainly did that for long enough myself (didn't have a choice - PCP was totally inept).

But, yes, definitely, try a different brand.  I'd still go slow, but it's worth the try.

[mtkst13]

http://www.rxlist.com/synthroid-drug.htm

it does contain the ingredients you listed above.  maybe with your allergies, you digest it differently that makes it more potent or something?  i would ask your doctor if it could cause an issue.

i still think you need to take it more slowly.  i had palpitations when i increased dosage.  i didn't have any other hyper symptoms...just the heart arrhythmias.  it subsided after a few weeks, and then of course, my heart rate became too slow.  you never can win!!

our bodies/hearts must be very sensitive to increases of t4/t3 because it really is a common side effect of having a med increased.  unfortunately yours is a lot more troublesome.  your body needs a smaller increase and needs a little longer to adjust to the dose.

[dani2776]

what do you think about the ingredients in synthroid adversingly affecting me?  I kind of on my own (i know this is not good) have stopped my meds for the past 2 days and and will resume at a dose of 37.5.  Unfortunatley I am still having some hyper symptoms but not like before but I am soooo tired and achy!  I now have constant dizziness and visual problems and have to have an MRI tomorrow.  If it is not one thing it's another.  Have you ever had dizziness with your thyroid?  I was given a prescription for a beta blocker but ahve not yet started it.  Ever since my stopping the meds my heartrate doesn't go above 90 and isn't pounding but I do have them on hand.

[goolarra]

I agree with mtkst13 - I think you've just increased too fast.  Of course, the problem is that when you have to slow down because of sensitivity to the meds, you're going to remain hypo for longer.  Are you on the beta blocker now?  If so, is it helping the cardiac symptoms?  I'm afraid it just takes patience.  After my last increase, it was a good two weeks after I backed off to my previous dose before my hyper symptoms went away entirely...probably a bit longer, and my endo had me not take anything for three days before resuming the old dose.

I see from your labs why your doctor wants to increase your meds...eventually that will have to be the case. But he can't just totally ignore your hyper symptoms in the process...that's cruel and unusual punishment!

If I recall correctly, you were having hyper symptoms at 50 before the increase to 75.  Is that correct?  You might even have to back off further to get the hyper symptoms under control.  

Yes, what does your doctor say now?

[dani2776]

I haven't spoken to my endo yet.  I just called the lab and got my results myself.  I am thinking of asking to try a different thyroid med beacuse I just found out through someone else's post that synthroid contains lactose and acacia.  Well I am lactose intolerant (that could explain all the problems with the diarrhea) and also the acacia from what I read is in the family of trees and grasses.  I have so many severe allergies both indoor and outdoor that I require 6 allergy shots a week.  Do you think the synthroid could be aggravating my symptoms?  I am at a loss as what to do.

[mtkst13]

it really sounds like your med increases were too aggressive for you.  what does your endo think?  what's the gameplan now?

[dani2776]

Yeah I FINALLY got my results of my Free T3 and they are 305 (230-420).  Normal right?  So now what do I do? I decreased my meds myself and although I am not as bad as I was I am still having hyper symtoms and more hypo!!!

[hope4thegoodstuff]

Thanks.  I appreciate the encouragement.  Just so you know.  This was a great day.  I hope to have many more of these.  : ) : )  I am not tired and falling asleep.  I had some energy and my mood is outstanding.  I love days like this one. Keeping fingers crossed for tomorrow.  

I love the terminology "scapethyroid"...I easily fall into that trap.  I'll work on it.  

[goolarra]

I still really want to see the FT3...try to get the range, too.

I still feel as I said above...I think your increases have been just too aggressive.  You can be hypo as hell according to your bloodwork, but if the increases are too fast and furious, you feel hyper.  The Hashi's, I'm sure, contributes its bit to the hyper symptoms, too.  However, I'm voting for meds sensitivity.

I'd give myself a chance to stabilize at 50mcg...increasing is just going to make you more miserable.

Look forward to seeing your FT3.

[dani2776]

OK I only got part of my labs back.  They are as follows:
TSH 2.750 (previously 2.630 1 week ago today)
Free T4 0.85 (previously 0.82 1 week ago today)
I am still waiting for the Free T3 which can take up to a week.  Based on these results I am obviously not overmedicated.  So would you believe my symptoms to be medication sensitivity or a hyper swing from Hashi's?  I don't know what to do about my medcation doseage.  I am soooo confused!!!!

[goolarra]

I think the problem is that thyroid research/treatment is in its infancy.  We'll probably someday find that "normal" is a much wider range than we currently accept.  In your or my lifetime...maybe not.  In the meantime, it's better than the alternative...no treatment at all.  I think, as mtkst13 said...we are more in tune to our bodies, and somtimes that's good, and sometimes it's not.  Too much introspection (of which I fully admit I am at times guilty) is not so good.  Sometimes we're just tired because we're tired, sometimes we're just down because we're down.  It's not always more than that, but we tend to make it so.  We can't blame the scapethyroid for everything!!!  But it certainly does throw a wrench into the works at times, doesn't it?

[mtkst13]

hope,  
hang in there.  thank god you have the most treatable cancer, but that doesn't mean that you're not scared, anxious, questioning why me?  and then on top of that, you have hypo yo-yo.  you want normal back, and you'll get there.  it'll take time but one day you'll say, "hey!  i feel pretty good.  i guess i'm back to normal...a different normal, but that's okay!"  i had a really bad anxiety issue for a long time.  i didn't think normally, and i wanted so badly to be normal again.  it took time, but i'm finally okay. i know you'll be okay too.

goolarra,
my thyroid should be healed...for now.  i feel that i've had flares since i was a teenager.  i've always noticed a strange pattern of symptoms:  lose weight, anxious, leg hairs growing really fast, mean eyes, can't fall asleep, pounding heart....followed by puffy, tired eyes, leg hairs suddenly stop growing, gain the weight that i lost, severe breathing problems, sleep walking/sleep hallucinations.  eventually i return to normal, but eventually the cycle starts again.  i've never had blood tests done during these phases.  any time i went to the doctor with symptoms, i was told it was anxiety.  so, as you said earlier, self-fulfilling prophecy....i have an anxiety disorder for which i take zoloft.  

we shall see what the future brings.  i guess i want the scenario above to be true because i was dismissed so many times by family and doctors.  it would make me feel validated and sane!  

[hope4thegoodstuff]

"well maybe this is normal".   When I read that in your comment, I thought..."wow, there are people who truly understand what I am going thru"  and I know that is true from spending so much time out here with you all, but last Sunday, I had this very uncharacteristic mood swing that took me so low.  I told my husband at one point that everyone says that thyca is so treatable and I should be fine, but part of me just wondered if it was the beginning of the end.  I was really down and for just a short time, I thought "this is me for the rest of my life."  It was a sad moment.  Then it went away and I got back to a more normal me.  Well, you know, hypo normal.  : )   Up, down, tired, not so tired....But I swung back up nearly as quickly as I got that down.  Honestly, I haven't done that before.  Thank God.  I don't want to feel like that ever again.  

[goolarra]

Very interesting...we don't hear a lot from people with temporary thyroiditis like silent or DeQuervain's (which is what I was convinced I had for a while, but no, it's Hashi's).  If your thyroid is coming back to life, that might explain your hyper/hypo swings.  I imagine it huffs and puffs for a while before it evens out and gets back to 100%.

I know what you mean about being more in tune, and it sometimes being good and sometimes not.  If I sleep well, I'm afraid I'm getting hypo, if I don't, I think I'm overmedicated.  Tired is never just tired...it has to mean something!

I really hope your thyroid is coming back...lots of luck with your decrease!

[mtkst13]

the waiting is tough when you start treatment because you want to feel better and lose the weight and etc, but it takes awhile.  patience is so important, but it's hard to be patient when you have a yo-yo of symptoms.  and then you forget what "normal" feels like, and then you think, "well maybe this is normal".

for me, treatment has been 85% effective.  i feel a lot better.  i have periods where i feel hypo and periods where i feel hyper.  it's strange, but i'm getting used to my "new normal".  i'm definitely more in tune with my body...sometimes that's a good thing and sometimes it's not.  

today is my first day of switching from 112 to 88 of synthroid.  we'll see how things go.  i'm optimistic.  if i can have my thyroid hormone production restored, i'll be ecstatic.  i'm keeping my fingers crossed!!!!!  maybe i'll get back to my "old normal".

[goolarra]

I understand what you're saying.  We definitely don't get enough respect.  I just feel bad for people just starting out who look at us and think they're about to enter the worst nightmare of their lives  Lots of people don't have our miserable experiences.  Maybe if someone tells them it's "easily treatable" they'll believe and it will become true (self-fulfilling prophecy).  Enough philosophizing!

[mtkst13]

it's great that there are meds to help.  i can't imagine what happened to people before meds!  so, in that regard, the meds help a lot.

my frustration is that people who do not have thyroid issues dismiss people with thyroid conditions, and because it is supposedly easily treatable, it's not taken seriously.   like, "oh, it's just your thyroid...no big deal" mentality.  therefore, non-thyroid illness people don't realize and sympathize with symptoms.  when i mention thyroid to my husband or mom (who's a nurse so she should know better), i feel like they roll their eyes like, "oh boy...not this subject again!"  

i guess i need to get over it.  it's just frustrating.   but, yes, overall, thank god for thyroid replacement meds.  who knows where we'd all be without them!

[goolarra]

Everyone needs a good scapethyroid!

For so many people, it is easily treatable, though, don't you think?  We here on this forum are the exceptions to the rule.  I know a number of people who just pop their pills every day and go about their life as if nothing's going on.  Sometimes I feel bad for people who are undiagnosed or recently diagnosed and get on this forum.  I'm sure they feel like everyone goes through meds nightmares, flip-flops daily from hypo to hyper, etc.  Really, we are the tip of the iceberg.  Some people do have a seamless transition onto meds and meds regulation.  Or do you just think I've been being told that I'm whacked for so long that I'm beginning to believe it?  ;-)

[mtkst13]

thank goodness.  that has to be a big weight lifted off your shoulders.

it's funny that when you look up hypothyroidism, it says it's easily treatable.  now that i've gone through this and have read about what others are going through, i find that statement to undermine and trivialize the condition.  it bothers me a little.

hopefully these new labs will shed some light on what's going on (free t3) so that you can get better soon.  and if the free t3 is normal, maybe the dose increases have been too aggressive for you.  everyone is different.  i tolerated no meds to 88 to 112 fairly well, but i definitely had palpitations for several weeks.  i know goolarra is very sensitive to dose increases, and you sound very similar to her.

keep us posted.  i'm anxious to see your latest labs.  take care.  and remember to blame everything on your thyroid! ;)

[goolarra]

Hurray for your heart and your cardiologist!  You just have to get it checked out to put your mind at ease.

I'm very sensitive to meds, too, but the BB was no problem whatsoever.  They lowered my HR the first couple of weeks down to the 50s, but that went back up very shortly afterward.

It sounds like things are going better for you, and you're going to get some help.