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What my hypo to Grave's experience is?

I was diagnosed last spring with HYPOthyroid. That was caused by the interferon treatment I had just completed for the Hep C.  Was prescribed Levothyroxine (generic Synthroid), which I absolutely hated. I hated the way it made me feel. It made my fingertips numb, then, a week later, it moved up to my whole fingers, then, after that moved up to my arms and legs. I convinced my endo to allow me to gradually wean off of it. Which I was able to successfully do. For about 4 mon., my thyroid levels were completely normal. Then, they gradually begin to change and eventually, became abnormal in the HYPERthyroid range. This was OFF of all the Synthroid.  For about 6 mon., I was just getting periodic labs, and hoping it would stabilize. It didn't and now they are saying I have Grave's. I've had a thyroid uptake scan, which showed my thyroid functioning normally. It reacted like a normal thyroid. On the left lobe, there was a slightly lighter area on a small section that was just very slightly lighter than the right lobe. I had no nodules or goiters. My T4 is normal. My T3 is abnormal and my TSH is hyper. My TSH last one was 0.015. My free T3 was 5.2, which was high by my labs standards.   My TSI test  was 128% of baseline, which by my labs range <140, was considered normal.  And yet, my doctor still said, you have Grave's..  I told him right now, I don't want to do anything about it. I have no symptoms at all of Hyperthyroid. No heart palps. No weight loss. No sweats.   I do have anxiety, but I've had anxiety for over 20 yrs, long before I ever had any thyroid issues. I do have insomnia, but I've been treated and diagnosed with that for over 20 yrs as well, there again, long before the thyroid problem was ever there. The weird thing is that prior to the interferon/Riba/Sovaldi treatment, I had no thyroid problems. During my treatment, with the Inter/Riba/Sovaldi, thyroid was normal.  It didn't start to act up until 3 mon after the treatment had stopped.  Anyhow, my doctor did not seem very happy with me when I informed him that I did not want to treat this at this time. I told him that all I wanted to do was to monitor it and that if I wasn't having any symptoms, I didn't see there was any problem with my doing this.  

3 Responses
649848 tn?1534633700
I'm not sure what your question is...

What are the reference ranges for your T4 and T3?  Ranges vary from lab to lab and have to come from your own reports.  Also, were those Free T4 and Free T3 or were they Total T4 and Total T3?  The Frees and Totals aren't the same tests and don't give the same information.

Were you ever tested for Hashimoto's when you were going through the hypo phase?  The tests you should have had were Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb).  

The TSI test is, somewhat, controversial, since those without Graves Disease should have TSI of less than 2, even though the lab says the range is < 140%...

It's entirely possible for a person to have, both, Hashimoto's and Graves Disease, with one or the other being dominant at a given time.

Treatments for Hep C are known to cause hypothyroidism and possibly trigger Hashimoto's.  With Hashimoto's, one can swing back and forth from hypo to hyper numerous times, before finally settling into permanent hypo.  

It's not unusual for thyroid activity to malfunction after treatment with interferon or other Hep C drugs, as it can take a while for the damage to actually appear.
Avatar universal
The tests that I've had most recently were the free T3, free T4, TSI, TSH, and the thyroid radioactive iodine uptake scan.  I was never Hashimoto's previously, as my results were just indicating a regular variety hypo-thyroid, as a result of the Hep C treatment. I did not have the antibodies that would have indicated any Hashi's and my endo did not see it as Hashi's.  My lab results range:

Free T4, their range 0.76-1.70  Mine was: 1.43  (normal)
Free T3, their range 2.3-4.2      Mine was: 5.2   (which was just barely high)
TSH, their range 0.270-4.200   Mine was: 0.015 (which is hyperthyroid)
TSI, their range <140% baseline  Mine was: 128%baseline (which in my interpretation is normal range by their lab's definition

Again, my thyroid scan was normal, by the report that I have, from the radiologist, which says, Normal Thyroid uptake values at 2 hrs and 6 hrs

Which is all why I am not understanding why he's calling this Grave's.  Anyhow, I guess all hyperthyroidism is Grave's?  

I just have no overwhelming desire to do anything about this, other than watch it, monitor it, see if any symptoms develop, which thus far, even after 3 mon. of being hyperthyroid, I've had no symptoms.  I'm hoping and praying this all resolves on it's own w/o doing anything.
649848 tn?1534633700
No, not all hyperthyroidism is Graves Disease.  As I noted, many people with Hashimoto's swing back and forth between hyper and hypo numerous times before finally settling into hypo, which is why I asked if you'd been tested for Hashimoto's.  You should probably ask to get tested for TPOab and TgAb again to make sure you still don't have those antibodies.

As I noted, those without Graves have less than 2% of TSI, so at 128%, you're close enough to be considered positive...

Even though your FT3 is high enough to be considered quite hyper, if you aren't having any symptoms, nobody can force you to start treatment and it "is" possible that it will resolve on its own or it's possible that you'll swing back to hypo, at some point.
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649848 tn?1534633700
Avatar universal
1756321 tn?1547095325
Queensland, Australia
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