My journy from Hyper to Hashimoto...what the heck!

[sara74]

Hello everyone,
So glad to find people (patients) with similar illness! I feel strange among my friends…anyways here is my story…
I was diagnosed with hyper thyroidism over 10 years ago! Been taking the metamazol for many years and then I stopped taking it last year. Because, I did not have insurance so I needed to find a job first..
Anyways, after 1 year of being out of the medication, I went to see a new doctor …who sent me to take an exam…
Result
Total T3 86,
T3 free 2.8,
thyroxine (t4 total) 8.9,
TSH .56
T4 free .7
Thyroid antibodies 1043 (noram range 0 to 40?)
Anti- thyroid peroxidase 695 ( range max 35)
Not the last one qualifies me to Hashi  ….i think….well the dr. told me…
My long hyper thyroid is gone….and got somewhat normal result
Dr. did not say anything about the thyroid antibodies…don’t know why…
Took ultrasound and got  two nodular lesions 1.1cm and .9mm ( in 2001 my ultrasound says, no discrete cystic or solid lesion is seen)
Dr. said, the nodular is small so to keep an eye on it. No biopsy! No medicine. Get another blood test in a month…
I am so confused. I was hyper…now normal with Hashi issues….
What shall I do? Should I insist on getting biopsy (I hate needle) or should I just wait and see…
Help…thanks

[armywife92]

Most of us have some types of noudules. I've had nodules and cysts, and the last they checked me, all dissapeared except for one.

The one test that you didn't post was the graves marker test which is the TSI. If your TSI is below 100, that means that it is in remission, however many don't feel symptom free until it's below 50. There are some of us that have all three antibodies, including me. These include

ATG
TSI
TPO

If all are elevated this person is to have what's known as hashitoxicosis.

When one or more are elevated, you typically just display signs of one or the other(hypo or hyper). I have the graves and hashi antibodies, but I don't know which one came first, lol. Thankfully I've never swung back and forth week to week like some have. I've been in remission and stable most of the time. Rejoice that your labs are normal, it's ok to be happy about it:)

[sara74]

Does the range changed? After a year, i went to see my doctor again. Here is the current result..
T3 total 116 (range 80-200)
FT4  0.8 (range 0.61- 1.12)
TSH 1.97 (0.34-5.6)
T4 Tot 7.4

Dr. said I am normal and i dont need to do any thing. I insisted on having an ultrasould so i will have it done next monday.No concern.

I am having a hard time comparing it to last year since the range has changed.


Question: Am i getting better? 8 years ago, i was so bad that i was told to do the radiation. I said NO and i took methamazole for long time...I just find it hard to beleive i am doing better.

Please see below for my previous posting...VVVV

Posting from April 2010,
I was diagnosed with hyper over 10 years ago! Been taking the metamazol on and off  and then I stopped taking it last year.After 1 year of being out of the medication,took an exam…
Result
Total T3 86, range (87-178)
T3 free 2.8, (range 1.71-3.71)
thyroxine (t4 total) 8.9, range 4.82 to 11.72
TSH 0.56 (range 0.34-5.6) ....14 days before my TSH 0.09 it got better in 14 days! (did the exam again)
T4 free 0 .7 (range 0.61-1.12)
Thyroid -stimulating immune 81 (range 0-129)
Thyroid antibodies 1043 (normal range 0 to 40)
Anti- thyroid peroxidase 695 (range max 35)

Dr said I have Hashimoto. Dr. did not say anything about the thyroid antibodies.
Ultrasound result- there are multifocal nodular lesions. There is diffuse increased hypervascularity throughout the thyroid and correlations for mutinodular goiter versus hyperthyroidism and thyroiditis is recommended by correlation with laboratory values as well as nuclear medicine uptake scan. Right lobe measures with the largest lesion in the mid lobe measuring up to 9mm, the left lobe with the largest nodule measuring up to 1.1cm. Scattered perithyroidal lymph nodes identified, without evidence of enlargement of frak adenopathy. The isthmus is thickened up to 8mm...

( in 2001 my ultrasound says, no discrete cystic or solid lesion is seen, the echotexture is similar bilaterally with small diffuse hypo echoic areas intermixed with variable increased echogenicity. There is borderline thickening of the isthmus, measures 7mm)

[redheadaussie]

Hi  again Sara, I found this info for you...

The Thyrotropin (TSH) Receptor Antibody Test (TRAb)

Thyrotropin (TSH) receptor antibodies are a class of thyroid autoantibodies directed against TSH receptor protein, a protein primarily found on thyroid cells. Thyrotropin receptor antibodies include blocking, binding, and stimulating antibodies. Blocking antibodies block the action of TSH on thyroid cells; binding antibodies bind to the TSH receptor and prevent TSH and other TSH receptor antibodies from reacting with the TSH receptor; stimulating TSH receptor antibodies stimulate thyroid cells, acting in place of TSH and ordering the production of excess thyroid hormone.

Thyrotropin receptor antibodies are increased in Graves’ disease, atrophic thyroiditis, postpartum autoimmune thyroid disease, neonatal Graves’ disease, and transient neonatal hypothyroidism. The normal reference range is less than 10% inhibition. In Graves’ disease the range is 10-100% inhibition.
[edit] The Thyroglobulin (TG) Antibody Test

Thyroglobulin antibodies are autoantibodies directed against thyroglobulin, the major protein found in thyroid cells. Thyroglobulin antibodies are found in nearly all patients with Hashimoto’s thyroiditis and in about 70 percent of patients with Graves’ disease.

The thyroglobulin antibody test is used to confirm that a patient’s diffuse goiter and/or hypothyroidism is due to autoimmune thyroiditis. The test may also help distinguish Graves’ disease from hyperthyroidism caused by toxic nodular goiter. The normal reference range is less than 2 IU/mL.

http://graves.medshelf.org/Lab_Tests

So you should ask for those tests to be done.

You can go from Grave's to Hashi's then back again. I wish they would name that weirdness but there is no label for it!

[annie234]

Hi Sara don't freak out it is not bad at all. I had a biopsy twice on 2 nodules you just turn your head and you never see the needle. I wanted to have it done for peace of mind.I was lucky no cancer but, very inflamed and DX Hashimoto thyroiditis. Now I just get a sonogram every year to make sure they don't get any bigger. I was Hyper like you and then turned hypo. Hang in there!

[sara74]

Thank you all! It feels good to be here and reading your postings. I have a Dr. Appt on May 3rd. I will wait for his opinion. Right now, I am more bothered by the 1.1cm nodular (?) they found. Based on my medical record, I did not have that back in 2001. Even if I may be ok now, it may grwo to the point it needs biopsi. And beleive it or not, it is not the cancer that is freaking me out...it is the niddlein my neck! Oh, God! I hope they will come up with a different technology to check on the cancer staff. I can't take needle. No one in my family had the cancer (even if they have a big orange size goiter)...it is the process that stress me out.

Hugs to you all...

[redheadaussie]

Yep, can understand where you are coming from! It is possible that your hyper is turning into Hashi's, I know it happened to me. I'd still go for a second opinion though. Hang in there! You have my support and many others here as well!

[Galsal59]

I had the same thought as RedAussie...that doesn't look like Hashi but Graves instead.  Or perhaps swinging between hyper and hypo because of the autoimmune that needs to get controlled?

[sara74]

Thanks for your time!

I was told  I have Hashi because my Anti- thyroid peroxidase 695 ( range max 35)..
my result shows I am normal ( always  accourding to the DR i saw) the only concern is my hyper (grave's) may be turining in to Hypo....the trend is toward that...Phew! who knows! I DON't want to do the biopsi ...God Please help me!

[redheadaussie]

I would not say you were Hashi, rather the opposite, Grave's. I have Hashi's and the TSH is never in those ranges, rather more like 4.00 or higher. (Mine was at 2.75 and I felt crud!)
The anti-bodies at that range do mean you have an auto-immune issue going on but with your other labs I would not say it is Hashi's.

Most nodules at 1cm or under are not biopsied as they are too small to be of concern. BUT having said that, they do need monitoring for any change in growth.
Biopsies aren't fun, so unless there is a concern, I would not get one done just yet.

I'd suggest either an endocrinologist or get a 2nd opinion by a different doctor.

Welcome to the forum, we are a happy bunch of miserable people! LOL!
Cheers!