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748728 tn?1277297869

What Causes Hashimoto's Thyroiditis?

I have Hashi's or so they beleive and have had it for about 25 undiagnosed years of sheer hell.....

In later years I found TSH lab results dating back to 1989 where my TSH was 48.7 while in the hospital for anxiety and debilitating insomnia, along with weight loss,,,ya weight loss. The endo in the hosp told me I was hypo and wanted to put me on thyroid medication, but I told him 'what are you kidding me??? I felt severely HYPERthyroid,so much so my parents hospitalized me. My other symptoms were hot flashes, ice cold hands where I would run them under near scalding water to warm them, heart palp's and a few other choice things, but the insomnia was the worst, I never slept and if I did it there wasn't any REM sleep. My urine calcium was also elevated but not my serum or PTH,however, I have had issues with kidney stones since I was a teen. Go figure.

I never went on thyroid medication and tho I sought help from doctors over the years for the above symptoms, my TSH then shifted into the quote"normal range" or sometime's be a little low, even tho I was terribly symptomatic. The quality of my young life went from an outgoing pretty girl with a great career, to functioning on auto-pilot at work and socially while feeling as tho I was about to lose it and off myself because I couldn't live like that anymore.

Then, I was diagnosed with a few nodules in 2000 with one being dominent on my left lobe,currently measuring 2.5cm. Previous FNA's showed it to be a multinodular goiter, but last years FNA showed Hurthle cells and the little beast has changed somewhat in appearance, now with course calcifications. I have had a chronic sore throat for about a year now and my voice cracks more often then it used to, but the sore throat is most bothersome. Last year with the stress of my fathers dying of prostate cancer and commuting back and forth east to west coast, my hyper symptoms returned with a vengence along with an enlarged lymph node and have since stuck around for the most part. My thyroglobulin levels rose from 40 to 160 as well indicating some inflamation.Another endo also recommended I have the nodule removed and am going back to the surgeon next week to finally I guess I have to do it,schedule a surgery date. Grrrrr.

The hyper symptoms have lessened since I am approaching the 'perimenopausal years', altho, when I was prescribed progesterone for hormonal issues my hyper symptoms worsened. I've read that progesterone facilitates the thyroid hormones and think it has something to do with that. Estrogen on the other hand interfere's with the thyroid hormones.Just some FYI, our female hormone's are involved here as well.....

So my question is, how did I get Hashi's? Was it the acute strep throats I had when young untimately leading to my tonsils removed at 18y/o..was it the Mono I also came down with as a teen or the Hepatitis I contracted while in the hospital for my tonsilectomy? Or did I inherit this,one of my sisters has MS? What happened?

Also, if my immune system is attacking my thyroid what can I do to stop it? I can't take thyroid medication in this hyper-like state.They hospitalized me last year when I went in for the flu because of heart palps. I had over 7000 in a 24 hour period w/bigeminy and quadrageminy,,thats like every other beat of my heart was skipping with PVC's,,and then POOF,,they magically stopped again. One doc thinks it may have something to do with the nodule,maybe a little toxic. Anyway, can't take thyroid meds with it in thats for sure, maybe they should take my whole thyroid and just place me on meds,altho I do still have quite a bit of functioning thryoid parenchyma on ultrasound and via bloodtests.

Any advice would be appreciated as I head into new uncharted territory with this pending surgery. Knowledge is power and thus far until the discovery of why my thyroid has been malfunctioning I've had little understanding of what was happening to me. Great website to check out tho is STOP THE THYROID MADNESS....I've learned alot there. Thanks! Cindy

Oh, I forgot to mention that I have a microprolactinoma that's well controlled with mendication...I know I'm a wreck!

3 Responses
649848 tn?1534637300
No one can say why you got Hashimoto's.  It's an autoimmune disease, in which the antibodies mistake your thyroid for invading tissue and they set out to destroy it.  

I don't understand why you say they "think" you have Hashimoto's.  This can be confirmed very easily with tests to check for antibodies.  Those tests are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab).  In your case, I would also ask to have a Thyroid Stimulating Immunoglobulin (TSI) test to check for Graves Disease.  

Don't forget, some symptoms can "cross over" (i.e. be the same for both hyper and hypo, so when you think you are hyper, you might not really be.  

What thyroid tests have you had done?  If you've had recent TSH, Free T3 and Free T4, please post the results, along with the lab's reference ranges for each test.  Those results would help members comment more fully on your situation.
748728 tn?1277297869
I've been diagnosed with HT via FNA not antibodies and I've copied the below information with regard to that from the journal of clinical endocrinology and metabolism:

Preexisting goiter or autoimmune thyroid disease and markedly elevated anti-TPO antibodies are helpful clues to diagnosing HT. However, anti-TPO antibodies are absent in 5% of patients with HT, many patients with SAT have moderate increases in antithyroid antibodies, and both SAT and HT could occur simultaneously by coincidence. Thus, biopsy showing diffuse lymphocytic infiltration with differing degrees of fibrosis and follicular cell destruction, but without giant cells and granulomas characteristic of SAT, remains the diagnostic gold standard.

Also, the TSH and T4 is not always a reliable indicator of thyroid function.The TSH is a pituitary hormone and a good guide to reveal if you have a malfunctioning pituitary gland, especially if you have a very low TSH and low free T3, accompanied by raging hypothyroid symptoms. I have a pituitary microadenoma so this may apply to me.

There is a huge body of hypothyroid patients who have a so-called “normal” TSH lab along with classic hypothyroid symptoms. And because doctors have become lab-obsessed rather than giving credence to clini¬cal presentation, patients like me remain undiagnosed for years before the number rises high enough or low enough to reveal the condition.

I highly suggest thyroid patients check out the website Stop The Thyroid Madness. I have learned so much there.cjs
649848 tn?1534637300
Most of us will totally agree that TSH is a pituitary hormone and does not indicate actual thyroid function.  

Also agree that there are many who have "normal" TSH levels, but low FT3 and/or FT4, an therefore go untreated for long periods of time.  

In relation to your original question as to what causes Hashimoto's, the point I was trying to make is that Hashimoto's, as you know is an autoimmune disease, which, over time destroys the thyroid; I'm not sure anyone knows exactly what "causes" it.  In many instances, it's genetic.
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