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HYpo or Hyper

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Thyroid Disorders
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scorpio-girl
Regular Member
Joined : Jan 2012
Posts : 180
Posted 7/19/2016 1:31 PM (GMT -6)
I am curious as to what my numbers mean...I already know I have Graves antibodies. HAve been on Tapazole several months and have been taken off in May because dr said I was in remission.

Readings when taken off Tapazole were
In May:

Free t4 - .70
TSH- 16

I had bloodwork done yesterday. I do not know the results yet but was curious as to what the May readings mean...am I on neutral ground or close to it with those readings.

Thanks..
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scorpio-girl
Regular Member
Joined : Jan 2012
Posts : 180
Posted 7/19/2016 6:13 PM (GMT -6)
Just found outmyreadings of yesterday:

TSH- 85
Free t4 - .48

The numbers have really changed since getting off Tapazole 2-1/2 months ago...not sure what it means.
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hypoHashimoto
Veteran Member
Joined : Jul 2012
Posts : 786
Posted 7/19/2016 9:59 PM (GMT -6)
Hi scorpio,

A TSH of 85 is indicative of severe hypothyroidism, this is supported by the very low Free T4.

With these values you should not be put on Trapazole, but on Levo instead to lower your TSH to around 2.5 .

What antibody exactly you were positive for ?
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scorpio-girl
Regular Member
Joined : Jan 2012
Posts : 180
Posted 7/20/2016 6:19 AM (GMT -6)
I tested positive for Graves, Hashi. I go to the doctor Monday in hopes of being put on
Levo.

I suppose the low reading is what has caused the inability to lose weight, brittle hair and skin dryness....and wondering if it causes rise in glucose. THose are differences I have noticed in the past month.
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hypoHashimoto
Veteran Member
Joined : Jul 2012
Posts : 786
Posted 7/20/2016 8:42 AM (GMT -6)

Somebody said...
I suppose the low reading is what has caused the inability to lose weight, brittle hair and skin dryness....and wondering if it causes rise in glucose

One of the classical hypo symptoms is weight gain, dry skin also.
It can cause hyperglycemia as well, you can see a very detailed list of possible hypo symptoms at the link bellow.

http://hypothyroidmom.com/300-hypothyroidism-symptoms-yes-really/

Best of luck,
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scorpio-girl
Regular Member
Joined : Jan 2012
Posts : 180
Posted 7/20/2016 9:47 AM (GMT -6)
Is Graves causing this hypothyroid issue? If so, what might be the medicine of choice?

Please explain the difference between Hashi hypothyroidism and Graves hypothyroidism.
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hypoHashimoto
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Joined : Jul 2012
Posts : 786
Posted 7/20/2016 9:54 PM (GMT -6)
Hashimoto's disease can cause both hypo and hyperthyroidism, whereas Graves causes only hyperthyroidism, so in view of your high TSH, it is very likely that you are positive for the Hashimoto's disease antibodies, those are TGab and TPOab, if either is positive then you have it.

The treatment of hypo is Levothyroxine, a synthetic form of the T4 hormone made by your thyroid gland, if you live in the US then there are many brand names availabe, like Levoxyl, Tirosint and Synthroid.

Also you need to perform thyroid and neck ultra sound to make sure you have no nodules on your thyroid gland.

What doctor is treating you? is he/she an Endocrinologist?

Best of luck,
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scorpio-girl
Regular Member
Joined : Jan 2012
Posts : 180
Posted 7/21/2016 6:48 AM (GMT -6)
I have tested positive for Graves antibody. SEeing an endocrinologist. I have had ultrasound that found 2 small nodules..have biopsied and everything okay there. DUe for another ultrasound next week. THis is the first major change in my thyroid since last August when diagnosed with Geaves and treated successfully with TApazole....

I am wondering if RAI is in my future as I do not want it. I had rather be on medicine, but it sure seems like my TSH level of 85 has a long way to get to a normal status!

ON a side note, yes I am US citizen from Texas

YOur comments Hashi are very helpful..thanks.
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hypoHashimoto
Veteran Member
Joined : Jul 2012
Posts : 786
Posted 7/21/2016 8:47 AM (GMT -6)

Somebody said...
I have tested positive for Graves antibody

Was that TSIab (Thyroid Stimulating Immunoglobulin), if not then you have hashimoto and not graves .

You provide contradicting information, if you have Graves, then you should be hyperthyroid and have a very low TSH and maybe even an undetectable TSH, since your TSH is extremely high, then you are hypothyroid, it goes counter intuitive.

The treatment for hypo and hyper is totally different, the 85 TSH was after stopping the Tapazole for how much time?
You need to wait six weeks (off Tapazole) and only then to repeat TSH.

for hypER, there are three options, anti thyroid medication, like Tapazole which increases the TSH, but it can cause other complications, there is also RAI, which kills your thyroid gland permanently and thus your TSH will rise and you will need to be put on Levo to lower it to around 2.5 , in some cases surgery might be done to remove all or part of your gland.

You need to repeat the ultra sound every (I think) six months, if the nodules are growing then your Endo might recommend a surgery, I don't now regarding hypER ( low TSH), but with hypo (high TSH) starting Levo shrinks the nodules in third of the cases, in an another third they remain the same size and thus after few years that they are not growing they are just left as they are, but of course you should be sure you are balanced properly with the Levo and taking it regularly, in the last third they grow and need to be addressed by surgery.

Best of luck,

Post Edited (hypoHashimoto) : 7/21/2016 9:17:19 AM (GMT-6)

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scorpio-girl
Regular Member
Joined : Jan 2012
Posts : 180
Posted 7/21/2016 11:40 AM (GMT -6)
Hashi, the following are results of thyroid tests of which I am aware:

August 2015 - put on Tapazole:


Free t4-thyroxine 2.09 range 7.3-1.95

TSH <0.1 range .5-4.7

Free t3-7.6 range 2.3-4.7

Thyroid stimulating IMM -thyretain

Interpretation: Positive Negative
Sample: Ref Ration 704 <140

Thyroglobulin,Quantitative and Antibody
Thyroglobulin 149.8 range <50
Thyroglobulin AB <1 range <4

Above results diagnosed with Graves

September 2015 results:

Free t4 .56 range 7.3-1.95
TSH .2 range .5-4.7
Free t3 2.1 range 2.3-4.2

May 2016 results:

Free t4 .70 range .73-1.95
TSH 16.0 range .5-4.7

Taken off Tapazole (which had been gradually decreasing) at this time.

July 2016 results

Free t4 .48 range .73 - 1.95
TSH 85.0 range .5-4.7

I was off tapazole 7-8 weeks when July readings were performed.

During this 10 month period of thyroid trouble, I have had an ultrasound which did show nodules and they were later biopsied. I cannot remember if I have had a second ultrasound.

However, on Monday I note the doctor has several tests pending including full metabolic panel, peroxidase antibodies and another ultrasound.

One question is can Graves turn into Hashimoto's or can a patient have both?

I can see how patients get so confused with the thyroid - it isn't easy to understand. Some doctors do not do a good job of explaining it, plus some patients do not really know which questions to ask. Hope these readings will help you understand what is going on so you can explain it to me in simple terms.

Thanks!
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hypoHashimoto
Veteran Member
Joined : Jul 2012
Posts : 786
Posted 7/21/2016 9:50 PM (GMT -6)
Hi scorpio,

Yes, You are positive for graves and actually was hyperthyroid with a very low TSH, I think that your doctor was right on putting you on Tapazole to get your TSH higher in the range.

It seems that your dose of Tapazole was higher than needed and hence your TSH climbed to above range, however, I do not know why you were still severely hypo 7-8 weeks after stopping the Tapazole, all I can think about is to wait at least six weeks from the test that showed 85 TSH and to repeat TSH, Free T4 and Free T3, maybe 7-8 weeks is not enough time, I have no experience with graves.

You should also perform the TPOab, as I remember, some people have both hashimoto and graves, but I do not know how does that work and which one will dominate.

You need also to ask your doctor about when to repeat the ultra sound.

Best of luck,
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scorpio-girl
Regular Member
Joined : Jan 2012
Posts : 180
Posted 7/22/2016 6:27 AM (GMT -6)
THanks for your time, Hashi..will probably check in here Monday after the doctor visit to report in and most likely need more clarification!!
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hypoHashimoto
Veteran Member
Joined : Jul 2012
Posts : 786
Posted 7/22/2016 8:42 AM (GMT -6)
Hi scorpio,

Do take with you a list of symptoms that you have, and the question that remained open above, like why you became hypo after being hyper and despite you have stopped the Tapazole, regarding the antiTPOab test and the Ultra Sound of your thyroid and neck !

Best of luck,
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scorpio-girl
Regular Member
Joined : Jan 2012
Posts : 180
Posted 7/26/2016 5:58 PM (GMT -6)
I have new thyroid results that need explaining to me....I think doctor was testing for hashimoto's disease..have already tested positive for Graves.

New labs :
Thyroid stimulating Inn

interpretation-positive. Negative
Sample ref ratio 369 < 140

Thyroid Peroxidase Value REF
82 <91u/ml

TSH. 117.5. .5-4.7

Started 50mg Synthroid today in AM. Return 6 weeks
PRevious labs listed in my past post.

Thanks for any explanation to help me understand this jargon! I do know I am extremely hypo with a high TSH.
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hypoHashimoto
Veteran Member
Joined : Jul 2012
Posts : 786
Posted 7/26/2016 9:41 PM (GMT -6)
Hi scorpio,

Yes indeed you are severely hypo, 350 mcg per week is the right starting dose, you need to take it at the same time each day, first thing in the morning on an empty stomach, with a full glass of water and not to drink or eat any thing for at least one hour.

It looks like you do not have Hashimoto's disease since both your TPO and TG ab are negative, but you do have Graves, Graves causes hyper but you are hypo and I do not know why, have you asked your doctor this question?

Best,
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scorpio-girl
Regular Member
Joined : Jan 2012
Posts : 180
Posted 7/27/2016 6:24 AM (GMT -6)
Hashi, in about 20 percent of Graves cases, the patients go to the other end of the spectrum. I did ask the doctor, and it does not happen often. it can be caused by body shock of stopping meds, but most likely it will improve greatly within 6 weeks with the Synthroid.

Hoping meds kick in very soon! I will admit, however, I had more symptoms with hyper than I have with hypothyroidism. MAin symptoms now are inability to lose weight normally, sensitive to cold, dry skin and elevated glucose...and fatigue. considering how high the TSH is it seems like I would hardly be able to function, but fortunately, I am doing okay...with room for improvement!
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hypoHashimoto
Veteran Member
Joined : Jul 2012
Posts : 786
Posted 7/27/2016 8:44 AM (GMT -6)
Hi scorpio,

It will improve in six weeks but be prepared to the possibility that 350 mcg per week is only an initial dose and you might need to increase the dose several times.

Regarding hyperglycemia, do you have your exact values of the glucose test? have you showed it to your endo? he/she treats diabetes also, I would recommend that you test for HbA1C .

Best of luck,
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scorpio-girl
Regular Member
Joined : Jan 2012
Posts : 180
Posted 7/27/2016 9:07 AM (GMT -6)
Glucose level was 156. Going to PCP for bi -annual checkup tomorrow who will deal with this level....will inquire about the test! I am aware synthroid may be increased..just wish you did not have to wait 6 wk for meds to work before being retested!

Appreciate your knowledge, Hashi.
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hypoHashimoto
Veteran Member
Joined : Jul 2012
Posts : 786
Posted 7/27/2016 10:23 PM (GMT -6)
Hi scorpio,

You do need to wait at least six weeks after each change in the dose to feel the effect of the new dose, and in case of autoimmunity three month is the time needed between increments.

Best of luck and keep us updated,
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scorpio-girl
Regular Member
Joined : Jan 2012
Posts : 180
Posted 9/9/2016 12:55 PM (GMT -6)
Latest labs after being on 50 mg levothyroxin since July 25 and I see my endocrinologist Monday, the 12th.

TSH has dropped 117 to 50.8
Free T4 has gone from .48 to 1.15

This leads me to think there is improvement. I am feeling much better, however doctor just called and said I need to double the dose of Levothyroxin to 100mg.

I was surprised to hear this as I am feeling pretty good. What should I expect after this increase?
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Newdawn
New Member
Joined : Feb 2016
Posts : 13
Posted 9/21/2016 1:16 PM (GMT -6)
Wow hypoHashimoto You are so smart! Thanks for sharing your ideas and inspiration!
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scorpio-girl
Regular Member
Joined : Jan 2012
Posts : 180
Posted 9/22/2016 3:39 PM (GMT -6)
Hypo hash has educated me more than my endocrinologist....and in a way I can understand!!
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