Hypo/Hyper - Hashitoxicosis???

[carreg10]

Hello,
My family doctor was very concerned because I have been rapidly losing weight in spite of eating more.  It was very frustrating because, at first, he accused me of intentionally not eating until my husband told him otherwise.  I've also been experiencing hair loss, fatigue, "brain fog", dry skin, joint pain.  Based on labwork ordered, my family doctor referred me to an endocrinologist. I saw the endocrinologist the middle of July and he ordered more labs/procedures.  I will be going back to see him the end of August.  Meanwhile, I have received the results from the hospital.  After doing research and looking at other forums, could this be hashitoxicosis.  I've told my husband I feel like I am on a roller coaster that just will not stop . . . . . .


06/10/11
*TSH (0.12) Normal 0.40 - 4.50

07/07/11
*Thyroid Ultrasound
Impression - "The thyroid gland is not enlarged but it is heterogeneous and shows increased flow. This can be seen in thyroiditis/hyperthyroidism."

07/08/11
*Thyroid Peroxidase AB (957) Normal less than 35
*Thyroglobulin AB (1605) Normal less than 20

07/18/11
T4 (1.13) Normal 0.82 - 1.77
TSH (0.994) Normal 0.450 - 4.500 (Different laboratory)
*Thyroid Stim. Immunoglobulin TSI (215) Normal 0 - 139
Triiodothyronine, Free, Serum (3.4) Normal 2.0 - 4.4

08/02/11 - 08/03/11
Thyroid Uptake/Scan
*4 hour (20.1%) Normal 6 - 18%
24 hour (31.5%) Normal 10 - 35%
No hot or cold nodules noted

[goolarra]

Since Graves', like Hashi's, is an autoimmune disease, TPOab and TGab can both be elevated if you have Graves'.  Elevated TSI is what distinguishes Graves' from Hashi's, unless, of course, as I mentioned earlier, you have both (highly unlikely).  Those of us with Hashi's don't have elevated TSI.

Although symptoms can be similar in both Hashitoxicosis and Graves', my bet's on Graves'.  TSI is pretty definitive.

[carreg10]

That's the confusing part.  The TSI is high indicating Graves, but the TSH is now 0.994 and the antibodies are really high, which I thought leaned more toward Hashi's.  From what I've read, this is the markers for hashitoxicosis?? I do have increased BP, heat intolerance, insomnia, and intermittent diarrhea and hand tremors.  My blood pressure, however, has been very low.  I have been getting intermittent feelings like the "blood rushing to my head."  I was hoping to get in with the endo. sooner than the end of the month, however, he is currently on vacation . . . .

[goolarra]

It is possible to have both Hashi's and Graves', however, it is quite rare.  

On 7/18/11 you had a positive TSI (thyroid stimulating immunoglobulin).  TSI is the definitie test for diagnosing Graves'.  So, I'm not a doctor, of course, but my guess would be Graves' rather than Hashi's.  Do you have other hyper symptoms besides weight loss...heat intolerance, insomnia, diarrhea, hand tremors, increased HR and/or BP, etc?

[carreg10]

Thanks for responding daniel17075m.  At this point, there is no treatment until I go to the endocrinologist the end of this month and he reviews the results of the labs/procedures.  I have had symptoms for years, but have finally been able to tie it all to the thyroid.  I really cannot afford to lose anymore weight and the symptoms are really wearing me down.  I've always had a high pain threshold, but I feel like the pain/symptoms have taken over.
I know you are relieved to finally see an end to your NIGHTMARE!  I read some of your earliest post and you have really been going through this for a long, long time!! I hope everything goes well with the surgery and I hope you have a very speedy recovery!!

[danie17075rm]

I have hashitoxicosis at the moment, and have had it a lot in this last year.  It is a NIGHTMARE!!!!  From what I have learned , hashitoxicosis is ONLY in the times you are hyper.  I switched back and forth, but stayed mainly hyper, and my uptake took in too much iodine (also hyper).  Now that you are hyper, you would be in hashitoxicosis.  What is there treatment plan for you?  I have tried just about everything in the last year and am scheduled to have my thyroid removed on the 17th (ahhhhh 5 days).  They told me I could do RAI, but I wasn't interested in that (I have a child around me all the time).  The antithyroid drugs have their own side effects and you can't stay on the forever so I am just ready to get rid of this hyper feeling and my thyroid at this point.