I am going from hypo to hyper, what would be causing this?

[Jenkt]

I am going from hypo to hyper, I have also gained weight and feel like a slug.  My synthyroid dosage has been decreased from 125 to 100 and now on 88.  I am also taking cytomel 5mg fpr the last month in half.  Don't really feel much different I was wondering how long it would take to see if the cytomel would help with the weight loss and energy

[Alittleblues]

When you say hyper, what are the symptoms? It would be helpful to see your rcent labs but others know much more than I do.

However, when I am at my most hypo, I get racing heart/panic, and I never do at any other time. Most consider that a hyper symptom but for me it is a hypo symptom. I also have a racing heart when I am overdue for a dose of thyroid. Once I take it, it slows down.

[Barb135]

It would be helpful if you could post your recent thyroid blood tests so we can understand why your doctor is continually reducing your dosage of Synthroid, in spite of the fact that you have hypothyroid symptoms.  Please be sure to include reference ranges with posted results as ranges vary from lab to lab and have to come from your own reports.

It's important to note that some symptoms can "cross over" i.e. apply to both/either hyper and/or hypo.  

[Red_Star]

Here is some information on Hashitoxicosis...

Excerpt from the article: The Medical Journal Of European Endocrinology - Hashitoxicosis – Three Cases and a Review of the Literature...

"It should be pointed out that, especially in the US literature, the term ‘hashitoxicosis’ is sometimes used to describe an autoimmune thyroid disease overlap syndrome of Graves’ and Hashimoto’s disease.  In this article the term is strictly limited to the ‘leakage’ symptoms of active Hashimoto’s disease."

***

Excerpts from the book: Thyroid Disorders and Related Health Conditions by James M. Lowrance...

"Some Hashimoto's Hypothyroid Patients Experience 'Hashitoxicosis'

While Hashimoto's typically causes hypothyroidism (low thyroid hormone levels) some patients can have fluctuations in their thyroid hormones, that go from hypothyroid to hyperthyroid (from abnormally-low to abnormally-high thyroid hormone) and this can be due to them having high levels of a certain type of thyroid antibody. The condition I refer to is "Hashitoxicosis".

The antibodies that are blood tested for, when Hashimoto's is being determined/diagnosed, are the anti-TPO (anti-thyroidperoxidase) and the anti-TG (anti-thyroglobulin) antibodies (also referred to as "autoantibodies"). Either or both of these testing positive helps to confirm presence of this hypothyroid disease.

However some Hashimoto's patients can also test positive for autoimmunity cells called "TSI" antibodies (Thyroid Stimulating Immunoglobulin). This antibody is what usually contributes to Grave's Disease or "autoimmune hyperthyroidism" however, some Hashimoto's patients have these antibodies at high levels, as well as having the TPO and or TG ones, that typically cause Hashimoto's.  

You could say they are suffering from Grave's and Hashimoto's, simultaneously, usually for a limited period of time. This phenomenon is most prominent during the early stage of Hashimoto's and for many patients, the hyperthyroid phases will diminish over time."

'Block and Replace' Treatment for Non-Resolving Hashitoxicosis

Even without having TSI antibodies present, Hashimoto's thyroiditis patients can potentially experience flares of thyroiditis, which can also cause mild hyperthyroid type symptoms that are not as severe as those caused by Hashitoxicosis, if phases of hyperthyroidism symptoms are severe.  Some patients who have both Hashimoto's thyroiditis and Grave's antibodies that cause continually unstable thyroid hormone levels and that do not resolve over time, are sometimes placed on a treatment called "block and replace".

This is a treatment in which they will block the hyper-stimulation of the thyroid with an anti thyroid drug (the medication slows hormone production) and afterward, at the appropriate timing, they will give the patient thyroid hormone therapy (replacing the diminished thyroid hormone levels).  This is an alternative treatment to thyroid removal (thyroidectomy and ablation), however, if the treatment fails, once given an ample trial, thyroid removal might be recommended as a follow up treatment."

For Most Hashimoto's Patients - Hashitoxicosis Resolves on Its Own

Some Hashimoto's patients have been known to actually transition over to Graves Disease over time, when having both types of antibodies (those that destroy thyroid cells and those that stimulate thyroid hormone production) and they become progressively hyperthyroid (not common).

Most Hashimoto's thyroiditis patients who experience Hashitoxicosis however, will have intermittent hyperthyroid phase for periods of weeks or months but they will still become progressively hypothyroid afterwards and there comes a point at which the Hashitoxicosis resolves and never returns."