# Hashi's AND Graves??



## rem22 (Jul 3, 2012)

Does anyone have both of these?

I saw my endo yesterday who thinks I have Graves now too.. ugh.. I was just diagnosed with Hashi's in May and have had my meds lowered from .125 to .88 Synthroid. I've gone hyper and he can't figure out why so he left me hyper for a month hoping I'll regulate but the past 2 wks have been feeling terrible (hyper symptoms) He sent me for the reg routnine bloodwork, along with the antibody test for Graves (Trab?) Get the results Tuesday. He also lowered my meds to .75 of Synthroid. I go back in a month for bloodwork again & to see him. He also commented on how he really wonders whats going on with me?

I assume if it comes back that I have Graves, that my body is just going in and out between the 2?

I meet with the surgeon in Oct and he's the one who determines whether I need the surg for the next week or next 1-2 mos. I'm going in there guns a blazin to book me in asap, I'm sooo done with this thyroid.

Goiter, Hashi's, nodule (lrg & little ones) indeterminate biopsy, and now possible Grave's, it needs to come out.

If I have Grave's, how does it work medication wise? Do I continue on Synthroid or change to something else?

Thanks


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## Andros (Aug 26, 2009)

rem22 said:


> Does anyone have both of these?
> 
> I saw my endo yesterday who thinks I have Graves now too.. ugh.. I was just diagnosed with Hashi's in May and have had my meds lowered from .125 to .88 Synthroid. I've gone hyper and he can't figure out why so he left me hyper for a month hoping I'll regulate but the past 2 wks have been feeling terrible (hyper symptoms) He sent me for the reg routnine bloodwork, along with the antibody test for Graves (Trab?) Get the results Tuesday. He also lowered my meds to .75 of Synthroid. I go back in a month for bloodwork again & to see him. He also commented on how he really wonders whats going on with me?
> 
> ...


I know only one thing; you absolutely should not be on Synthroid or any other thyroxine replacement with Graves' and/or hyperthyroid.

The patient should be placed on antithyroid med and a betablocker and advised of their options for the long term.

Just in case....................

Thyroid storm symptoms
http://www.emedicinehealth.com/thyroid_storm/page3_em.htm
http://thyroid.about.com/od/hyperthyroidismgraves/a/thyroidstorm.htm

Keep us in the loop; this is quite worrisome to me. I am sure others will agree.


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## rem22 (Jul 3, 2012)

Thanks so much for replying. He wants me to stay on a lower dose? but I get results Tuesday. I thought me being on Synthroid while being a bit hyper wasnt right.

Will definitely let you know what he says. I am so confused with these meds. If its Graves, am I going to have to keep switching between opposite meds based on bloodwork/symptoms. Thyroid meds take so long to work as it is.


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## Andros (Aug 26, 2009)

rem22 said:


> Thanks so much for replying. He wants me to stay on a lower dose? but I get results Tuesday. I thought me being on Synthroid while being a bit hyper wasnt right.
> 
> Will definitely let you know what he says. I am so confused with these meds. If its Graves, am I going to have to keep switching between opposite meds based on bloodwork/symptoms. Thyroid meds take so long to work as it is.


That won't work as antibodies interfere w/ the receptor sites giving numbers that don't reflect the true status of the patient. There are binding, blocking and stimulating antibodies.

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism. 
http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html

TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/

blocking antibodies
http://www.suite101.com/lesson.cfm/19330/2899/4

TBII (Thyrotrophin Binding Inhibiting Immunoglobulin)
http://www.ncbi.nlm.nih.gov/pubmed/1969138 (good test for TSHR)

Trab (Thyroglobulin antibody) TSH receptor antibody
http://jcem.endojournals.org/content/83/11/3781.full

Have you had an ultra-sound? If not, I highly recommend it. One wants to be sure they don't have cancer.


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## rem22 (Jul 3, 2012)

Thx again, Yes I've had one & my biopsy report showed lots of follicular neoplasms (bad cells) but can't tell if they are cancerous until its out under a microscope. 
Thanks for all the links, do u suggest I get different antibody test?


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## Andros (Aug 26, 2009)

rem22 said:


> Thx again, Yes I've had one & my biopsy report showed lots of follicular neoplasms (bad cells) but can't tell if they are cancerous until its out under a microscope.
> Thanks for all the links, do u suggest I get different antibody test?


It might be worthwhile to get TSI and Trab.

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism. 
http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html

Trab
http://www.ncbi.nlm.nih.gov/pubmed/17684583

Yeah; see we don't know which came first, the cart or the horse. Hyper or cancer, cancer or hyper!

You may want to consider getting your thyroid removed.


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## rem22 (Jul 3, 2012)

My thyroid is definitely coming out, but my surgeon consultation appt isn't until October (I'm in Canada).

I know my endo tested trab antibodies for Graves, but can't remember what else was on the list. He always tests Tsh, free t3 & t4. Off to check out your links


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## rem22 (Jul 3, 2012)

Got my results back today. He said my Free t4 was 22.9 & a bit hyper.

He said the Trab (for Graves) came back low.. around 2 but said that's not a true indicator/doesn't mean that I don't have it too.

Last night was awful for me, I couldn't sleep all night, my heart was racing for 4 hours, I almost went to the ER because it felt like it was going to come out of my chest. Today I have a headache, I'm hot, hands are twitchy, etc. He said to stop the Synthroid for 3 days, start back up & call him next Tues.

:confused0024:


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## Andros (Aug 26, 2009)

rem22 said:


> Got my results back today. He said my Free t4 was 22.9 & a bit hyper.
> 
> He said the Trab (for Graves) came back low.. around 2 but said that's not a true indicator/doesn't mean that I don't have it too.
> 
> ...


You should not have any Trab. And I will continue to worry about you going back on "any" thyroxine replacement. I am not a doctor but I do believe taking thyroxine at this time could land you in the ER.

Humble opinion.


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## rem22 (Jul 3, 2012)

So you don't think me stopping the meds for 3 days then back on my normal dose of .075 is ok? (I'm still so new to this all & trying to understand it)

My endo doing that should bring my free t4 right down to 14 or so?

I certainly don't want to end up in the ER.


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## Andros (Aug 26, 2009)

rem22 said:


> So you don't think me stopping the meds for 3 days then back on my normal dose of .075 is ok? (I'm still so new to this all & trying to understand it)
> 
> My endo doing that should bring my free t4 right down to 14 or so?
> 
> I certainly don't want to end up in the ER.


If anything, that will push the FT4 higher and the TSH lower. That's how I understand all of this.

Hopefully some others will comment.


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## rem22 (Jul 3, 2012)

I really appreciate you taking the time to post, your advice means a lot.

And that was a typo on my last post, it was supposed to say my endo SAID it would bring it down to 14 or so.

I guess only time will tell. Right now I have a headache, tired, trembly hands & running 99.6. Feel so hot.


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## kacha303 (Aug 28, 2012)

I guess I am in a similar but a different boat. Always was treated for hyper but having antibodies of both (discovered recently). Until now I am on Methimazole even though most of the times I feel more hypo than hyper. The symptoms you describing will get worse if you continue taking the hormon. Imagine the car speeding and you keep pushing. Please be careful with the drug.


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