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Avatar universal

graves/hashimoto? confused

I was diagnosed hypo thyroid  with hashimoto's about 7 years ago and have done fine on synthroid 50 mg since that time.  About August of this year I noticed the sudden growth of my thyroid, huge and noticeable goiter where only the month before I had nothing, so I made an emergency appointment to my doctor.  She tested my tsh (only, no other thyroid tests) and got a reading of .02 and discontinued my synthroid.  I went in for a repeat TSH four weeks later and it was still .02.  I went four weeks later and it is .02.  My doctors says she suspects Graves AND Hashimotos.  How is this even possible?  She called today and recommended repeat testing in 6 weeks.  

I am uncomfortable with this plan.  First off, the huge goiter appeared nearly overnight, and that doesn't sound good.  Second, nothing is changing, so what exactly is she waiting to find out?  She hasn't answered these questions, just ignores me.  Can the goiter shrink?  If not, what are my options to get rid of it?  I don't like it or want to keep it.  Is there a possibility it is more serious?  Is doing the TSH only acceptable?  I mean, if it not changing, it seems like maybe more information is something to think about, but she doesn't think I need anything by TSH test.  Should I just keep on going for another 6 weeks (which is really more like 8 because of the holidays) and not treat this very low number?

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Avatar universal
What's the range on your TSI?
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Avatar universal
The 7/13 extra testing was done only because I insisted something else be tested, or it would have only been TSH.
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Avatar universal
These are my most recent results.  When I see that my thyroid was so low over a year ago, I question why I continued treating as hypothyroid.


7/12  TSH .02 continue Synthroid 50mcg
7/13  TPOab  900  confirmation of Hashimoto
7/13  TSI  4.6  you may well have both disorders
7/13 TSH .02 retest in 4-6 week discontinue synthroid
7/13 ultrasound - thyroid unchanged

Goiter was huge and discoved in August, so I notified her, and she just said to continue with retest.

9/13   TSH .02  retest in 4-6 weeks
11/13  TSH 02  retest in 4-6 weeks

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Avatar universal
I am going to go back and pull my test results, but you really confirmed what I was thinking anyway.  With a retest, she gave no explanation as to what to expect or what would indicate making a change, and no testing done beyond the TSH.  Time to hunt for a new doc.  Thanks.
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Avatar universal
So, in addition to TPOab, she tested TSI (thyroid stimulating immunoglobulin) as well?  Do you have the results of that?

Your doctor simply is not testing adequately.  TSH is, at best, a screening test for asymptomatic individuals.  It cannot be used alone to determine thyroid status once you are diagnosed with thyroid disease.

I think you need a new doctor.  Between not testing properly and her "wait and see" attitude, this doctor appears not a very good thyroid doctor.  I agree with you that waiting 6-8 weeks to do nothing but test TSH again is unacceptable (at least without an explanation of what she expects to happen in 6-8 weeks).  Due to the sudden appearance of the goiter, ultrasound (or some form of imaging) would also be in order.  I'd find someone else soon.  This doctor sounds like a waste of time.
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Avatar universal
I have tested positive for Hashi several years ago.  My doctor did the TPOab two month ago and tested positive for Graves.  This is the only time she has ever done anything different from TSH.  The two followups to that TPO were TSH and that's it.  Now she wants me to repeat it yet again, no other thyroid testing of any type and no discussion about the sudden appearance of the goiter.
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