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Thryroiditis Hashimoto? Medications
My tsh is 0.0, free t3 and t4 elevated, antibodies elevated, no rai uptake on test...?thyroiditis, endo says to take Tapazole, and maybe atenolol for tachycardia and palpitations. Is Tapazole safe and effective with no uptake?
Hashitoxicosis, or overproduction of thyroid hormone may occur in the course of Hashimoto's disease, but is usually transient. Symptoms may include:
Intolerance to heat
Agitation, irritability, nervousness
Restlessness, sleeplessness
Exhaustion
Anxiety, depression, sadness
Excessive perspiration
Palpitations (rapid heart beats)
Diarrhea or loose stools
Weight loss despite an increased appetite and food intake
Weakness and fatigue
Loss of muscle mass and strength
Irregular or absent menstrual periods
Impotence or gynecomastia (breast enlargement) in the male
Infertility
Warm hands that tend to shake when outstretched
Tightness in frontal neck region (thyroid)
Shortness of breath
Smooth, velvety skin
Easy bruising
Clubbing of the fingers and toes (achropachy)
Swollen shins
Sore, watery and bulging eyes
Failure of the lids of the eyes to follow the eye downwards when looking down
Rapid nail growth, soft nails
Separation of the nails from the underlying tissue (onycholysis)
Finer hair that is less curly and tends to fall out
Sources for this information about symptoms:
Bennett, J. Claude, ed. Cecil Textbook of Medicine, 20th ed. Philadelphia: E.B. Saunders, 1996.
Harrison's Principles of Internal Medicine, 14 ed. New York: McGraw Hill, 1998.
Morgan, Brian L.G. and Roberta Morgan. Hormones: how they affect behavior, metabolism, growth, development and relationships. Los Angeles: Body Press, 1989.
Rosenthal, M. Sara. The Thyroid Sourcebook: everything you need to know about..., 2nd ed. Los Angeles: Lowell House, 1996.
Intolerance to heat
Agitation, irritability, nervousness
Restlessness, sleeplessness
Exhaustion
Anxiety, depression, sadness
Excessive perspiration
Palpitations (rapid heart beats)
Diarrhea or loose stools
Weight loss despite an increased appetite and food intake
Weakness and fatigue
Loss of muscle mass and strength
Irregular or absent menstrual periods
Impotence or gynecomastia (breast enlargement) in the male
Infertility
Warm hands that tend to shake when outstretched
Tightness in frontal neck region (thyroid)
Shortness of breath
Smooth, velvety skin
Easy bruising
Clubbing of the fingers and toes (achropachy)
Swollen shins
Sore, watery and bulging eyes
Failure of the lids of the eyes to follow the eye downwards when looking down
Rapid nail growth, soft nails
Separation of the nails from the underlying tissue (onycholysis)
Finer hair that is less curly and tends to fall out
Sources for this information about symptoms:
Bennett, J. Claude, ed. Cecil Textbook of Medicine, 20th ed. Philadelphia: E.B. Saunders, 1996.
Harrison's Principles of Internal Medicine, 14 ed. New York: McGraw Hill, 1998.
Morgan, Brian L.G. and Roberta Morgan. Hormones: how they affect behavior, metabolism, growth, development and relationships. Los Angeles: Body Press, 1989.
Rosenthal, M. Sara. The Thyroid Sourcebook: everything you need to know about..., 2nd ed. Los Angeles: Lowell House, 1996.
The cause of Hashitoxicosis- Transient Hyperthyroidism
Autoimmune Thyroiditis
With Hashimoto's thyroiditis, which typically causes hypothyroidism (low thyroid hormone) some patients can have fluctuations from hypothyroid to hyperthyroid and this can be due to having high levels of thyroid antibodies. The antibodies that are tested for, when Hashimoto's is being diagnosed are the anti-TPO (thyroidperoxidase) and the anti-TG (thyroglobulin) antibodies (either or both testing positive helps confirm the diagnosis). Some Hashimoto's patients also test positive for antibodies called the TSI antibodies (thyroid stimulating immunoglobulins) but are more commonly detected in low titers (low positive). Hashimoto’s patients who present with high titers of TSI are those who can experience Hashitoxicosis.
Thyroid Stimulating Immunoglobulin
The TSI antibody is what usually contributes to Graves’ disease or "autoimmune hyperthyroidism" however, some Hashimoto's patients have these antibodies as well as the TPO and/or TG ones, that typically cause Hashimoto's and is why they may experience spells of Hashitoxicosis or "intermittent hyperthyroidism" if the antibodies increase to high levels. You almost could say they are suffering from Graves’ and Hashimoto's, simultaneously.
Even without having the TSI antibodies present, Hashimoto's 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 but are still concerning. Some in the medical community do not recognize mild Hashitoxicosis but hypothyroid patients commonly complain of experiencing spells of mild to moderate hyperthyroid symptoms. For some of them the hyperthyroid spells can also be due to a spike in thyroid hormone levels from their replacement therapy to correct hypothyroidism
Autoimmune Thyroiditis
With Hashimoto's thyroiditis, which typically causes hypothyroidism (low thyroid hormone) some patients can have fluctuations from hypothyroid to hyperthyroid and this can be due to having high levels of thyroid antibodies. The antibodies that are tested for, when Hashimoto's is being diagnosed are the anti-TPO (thyroidperoxidase) and the anti-TG (thyroglobulin) antibodies (either or both testing positive helps confirm the diagnosis). Some Hashimoto's patients also test positive for antibodies called the TSI antibodies (thyroid stimulating immunoglobulins) but are more commonly detected in low titers (low positive). Hashimoto’s patients who present with high titers of TSI are those who can experience Hashitoxicosis.
Thyroid Stimulating Immunoglobulin
The TSI antibody is what usually contributes to Graves’ disease or "autoimmune hyperthyroidism" however, some Hashimoto's patients have these antibodies as well as the TPO and/or TG ones, that typically cause Hashimoto's and is why they may experience spells of Hashitoxicosis or "intermittent hyperthyroidism" if the antibodies increase to high levels. You almost could say they are suffering from Graves’ and Hashimoto's, simultaneously.
Even without having the TSI antibodies present, Hashimoto's 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 but are still concerning. Some in the medical community do not recognize mild Hashitoxicosis but hypothyroid patients commonly complain of experiencing spells of mild to moderate hyperthyroid symptoms. For some of them the hyperthyroid spells can also be due to a spike in thyroid hormone levels from their replacement therapy to correct hypothyroidism
Block and replace is method they generally use for someone who has both hashimotos and graves which is hashitoxicosis. They also use it for hyper patients who are sensitive to a small amt of ATD and go hYpo quickly. They will put you on a thyroid med as well as an ATD . So in a sense you would be medicated for hypo and hyper simutaneously.
I think your doctor has confused you with too much information.
Methimazole is the generic name for Tapazole which is the brand name. They are the same thing. It is used to treat HYPERthyroidism. It is commonly used for Graves, but that does not mean you have Graves. You would have to have a TSI test done to prove that.
Doctors use the Tapazole to get the levels prepared for either surgical removal of a goitre or getting ready for an RAI ablation. (radioactive Iodine kills off the thyroid)
It would appear on the face of it, that your thyroiditis is one where the damage has been great and now your goitre is leaking out thyroid hormone. I can see your doctor is on the path of surgery and is now getting your thyroid to 'shut-up' by taking the Tapazole.
On the internet many hits for thyroiditis automatically bring up Hashimoto Thyroiditis as it is the most common. Don't confuse yourself. You do not have this and I do not believe you have Grave's but a leaky thyroid causing hyperthryoidism., It is called Thyroiditis. You will take the Tapazole, get to a normal-ish level,see how you are, and probably have surgery.
Hope that clears it up for you.
Methimazole is the generic name for Tapazole which is the brand name. They are the same thing. It is used to treat HYPERthyroidism. It is commonly used for Graves, but that does not mean you have Graves. You would have to have a TSI test done to prove that.
Doctors use the Tapazole to get the levels prepared for either surgical removal of a goitre or getting ready for an RAI ablation. (radioactive Iodine kills off the thyroid)
It would appear on the face of it, that your thyroiditis is one where the damage has been great and now your goitre is leaking out thyroid hormone. I can see your doctor is on the path of surgery and is now getting your thyroid to 'shut-up' by taking the Tapazole.
On the internet many hits for thyroiditis automatically bring up Hashimoto Thyroiditis as it is the most common. Don't confuse yourself. You do not have this and I do not believe you have Grave's but a leaky thyroid causing hyperthryoidism., It is called Thyroiditis. You will take the Tapazole, get to a normal-ish level,see how you are, and probably have surgery.
Hope that clears it up for you.
Sorry, but I don't understand what does Block and replace med mean? Is that the same a methimazole? Or another med? I am supposed to have some more labs drawn in 2 weeks. Thanks for the info.
This sounds more like a Hashitoxicosis senerio and a Block and replace medication outlook would be more common.
Sorry forgot to mention hot flashes, insomnia
wired and tired and weight gain. Too tired to exercise
and eat often due to crazy hunger and thinking food will
energize And of course forgetful.
wired and tired and weight gain. Too tired to exercise
and eat often due to crazy hunger and thinking food will
energize And of course forgetful.
I have had border line hyper labs for a couple years.
Over last 2 years or so my thyroid enlarged a lot.
I requested another ultrasound due to difficulty
swallowing and neck pressure. But, i only had tsh
and t4 in past, never any antibodies until last month
have actually noted goiter growing about 4 years
but increased in size from about 4cm each side to
about 7 cm each side. Also have obvious hair loss
fatigue, anxiety, multiple aches. Every day major struggle
to get through. Wake up exhausted. I have attributed
most to chronic anemia from heavy menses. Tachycardia
and palps a while with short of breath. Started
tapazole 10 mg and 25 atenolol tues. Feel little better
with pulse70s instead of 92-130s. Still palps though.
To have labs rechecked 21st then see endo
she says need surgery due to size. But hate the
thought but may have to. Thanks. Appreciate all input!
Over last 2 years or so my thyroid enlarged a lot.
I requested another ultrasound due to difficulty
swallowing and neck pressure. But, i only had tsh
and t4 in past, never any antibodies until last month
have actually noted goiter growing about 4 years
but increased in size from about 4cm each side to
about 7 cm each side. Also have obvious hair loss
fatigue, anxiety, multiple aches. Every day major struggle
to get through. Wake up exhausted. I have attributed
most to chronic anemia from heavy menses. Tachycardia
and palps a while with short of breath. Started
tapazole 10 mg and 25 atenolol tues. Feel little better
with pulse70s instead of 92-130s. Still palps though.
To have labs rechecked 21st then see endo
she says need surgery due to size. But hate the
thought but may have to. Thanks. Appreciate all input!
I was just diagnosed with Hoshimoto's and you can be hyper first before you go hypo... I was hyper in my first test and they tested me again 2 months later and now am hypo .. They said that it could be that the way that the antibodies are attacking the thyroid is making it produce to much and then eventually it will make the thyroid crash and no longer produce any thyroid hormones.
If you have the TRAB antibodies it could show a low uptake but you can still have graves/hyper. Have them do a TSI antibody test. What were your symptoms leading up to this?
Elevated TPO can be Hashis or Graves. In your case this should be followed with TSI antibody testing as this is Graves only - then you and the doc will not be guessing. That is what needs to be done. Every graves person here will tell you this.
Then if you dont have graves it can be:
1) Hashimoto in the beginning can start out hyper, but rare to be as hyper as your labs. Then eventually turns hypo.
2)Hashimoto with low thyroid production (which is normal Hashi) , but add a possible leaky nodule that is leaking thyroid out making you hyper. I know a person here that had this - very, very rare.
Then if you dont have graves it can be:
1) Hashimoto in the beginning can start out hyper, but rare to be as hyper as your labs. Then eventually turns hypo.
2)Hashimoto with low thyroid production (which is normal Hashi) , but add a possible leaky nodule that is leaking thyroid out making you hyper. I know a person here that had this - very, very rare.
I haven't started the tapazole yet. The endo said that she thought I had graves, but... The low iodine uptake contradicts that. So she is calling it thyroiditis, which there are three type of, from what I've read. Elevated antibodies. I am in the hyper phase after which most likely thyroid will become hypo. She Rec surgery due to large goiter.
OK, hold on thyroid disease 101. Are you aware that thyroid disease fall into two main catagories ?(some people are only aware with what they have and dont know this).
Hashimoto is a form of hypo where the thyroid stops producing hormones on its own from antibodies destructing it.
If you are on Tapazole that is med for hyperthyroid, and this med decreases hormone production. Hyperthyroid is Graves....did they ever tell you this? to much of this med could make you hypo. Hypo from to much Tapazole does not make you a Hashimoto patient. And your labs look hyper. Did you have a TSI antibody test that ruled Graves disease.
You dont have Hashimoto. And very few have both. Re-post you question since you are on hypEr thyrtoid meds (Graves disease). There is nothing in your resluts that indicate hypo - you are hyper.
I am not 'studied' in hyper thyroid or the meds for it, since I have and know about Hashimoto.
Re-post your question since you are on hypEr thyrtoid meds, leave the Hashimoto out of it. You will then get Graves people answering you as your post will then make more sense.
Hashimoto is a form of hypo where the thyroid stops producing hormones on its own from antibodies destructing it.
If you are on Tapazole that is med for hyperthyroid, and this med decreases hormone production. Hyperthyroid is Graves....did they ever tell you this? to much of this med could make you hypo. Hypo from to much Tapazole does not make you a Hashimoto patient. And your labs look hyper. Did you have a TSI antibody test that ruled Graves disease.
You dont have Hashimoto. And very few have both. Re-post you question since you are on hypEr thyrtoid meds (Graves disease). There is nothing in your resluts that indicate hypo - you are hyper.
I am not 'studied' in hyper thyroid or the meds for it, since I have and know about Hashimoto.
Re-post your question since you are on hypEr thyrtoid meds, leave the Hashimoto out of it. You will then get Graves people answering you as your post will then make more sense.
It is confusing. My labs are slightly hyper. Tsh 0.0.
Free t3 6.7. Ref (2.0-4.0)
free t4 2.02. (0.5-1.5)
tpo auto abs 73.7. (0.0-35.0)
but there was only 0.8 uptake of rai. Which is hypo
endo says thyroid too inflamed to work. But treatment is not clear. Do I really need
meds or will it calm down without?
Free t3 6.7. Ref (2.0-4.0)
free t4 2.02. (0.5-1.5)
tpo auto abs 73.7. (0.0-35.0)
but there was only 0.8 uptake of rai. Which is hypo
endo says thyroid too inflamed to work. But treatment is not clear. Do I really need
meds or will it calm down without?
can you post what the actual reference range and the results of the Free T3 and Free T4 was please?
That will help see whats suggestions I can offer you.
That will help see whats suggestions I can offer you.
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