# From hyper to hypo, same symptoms



## styler (Nov 3, 2010)

When I did my first thyroid test last spring, my thyroid was hyper(tsh<0.01), then hypo last fall(tsh>12), and now close to normal.(tsh~6) Funny thing is I haven't felt any change mentally or physically. My symptoms virtually remained the same for many years, although I might not remember slight changes because I'm so forgetful. Can someone give me a possible reason?

p.s.: I don't remember the numbers, but free t4 hasn't gone out of range significantly.


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## Andros (Aug 26, 2009)

akstylish said:


> When I did my first thyroid test last spring, my thyroid was hyper(tsh<0.01), then hypo last fall(tsh>12), and now close to normal.(tsh~6) Funny thing is I haven't felt any change mentally or physically. My symptoms virtually remained the same for many years, although I might not remember slight changes because I'm so forgetful. Can someone give me a possible reason?
> 
> p.s.: I don't remember the numbers, but free t4 hasn't gone out of range significantly.


Antibodies will cause this fluctuation. Have you had any antibodies' tests run? It is very important to do so.

TSI (thyroid stimulating immunoglobulin),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/unders...s/thyroid.html


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## styler (Nov 3, 2010)

I was asking about why my symptoms have remained the same regardless of my thyroid state, hyper or hypo. Actually I did get new symptoms and some of them worsened over time, but no symptom disappeared or decreased in severity during the transition from hyper to hypo to near euthyroid. Other than the possibility these have nothing to do with the thyroid, what are other possible explanations?

And yes, I did every one of those tests except TBII.


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## Andros (Aug 26, 2009)

akstylish said:


> I was asking about why my symptoms have remained the same regardless of my thyroid state, hyper or hypo. Actually I did get new symptoms and some of them worsened over time, but no symptom disappeared or decreased in severity during the transition from hyper to hypo to near euthyroid. Other than the possibility these have nothing to do with the thyroid, what are other possible explanations?
> 
> And yes, I did every one of those tests except TBII.


I do believe it is because of antibodies for there are blocking, binding and stimulating antibodies and autoantibodies which maintain the status quo regardless of what the Thyroid Panel (TSH, FT3, FT4) might say.


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## styler (Nov 3, 2010)

I see. All of the antibody tests were negative except TSI, which was not high enough to confirm Grave's. Does this mean antibodies are not likely the reason?


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## Andros (Aug 26, 2009)

akstylish said:


> I see. All of the antibody tests were negative except TSI, which was not high enough to confirm Grave's. Does this mean antibodies are not likely the reason?


If you have TSI, it is probable that you have TBII and Trab. TSI is stimulating, TBII are binding and Trab is stimulating.

http://www.thyroidmanager.org/Chapter6/Ch-6-6.htm

And as you no doubt know, the healthy person should have no TSI.

TSI (thyroid stimulating immunoglobulin),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/unders...s/thyroid.html

I can only speculate which I love doing but it may not be the answer to your question. I think it is a good idea to talk to your doctor about this and since "inquiring minds" would like to know, perhaps you will share the answer with us!

Graves' is usually a clinical determination as per Dr. Robert Graves. The patient must present clinically w/ 3 out of the 4 listed:

Exophthalmos, goiter, pretibial myxedema and thyrotoxicosis. Otherwise, with TSI on board, the patient is deemed hyperthyoid.


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## Defeat The Curse (Jun 30, 2011)

Andros, i'm bringing alive another old post here

I'm curious what happened to skyler and his situation.

For you andros, Question???

If skyler didn't have graves but had positive TSI at different points, although low TSI.
What did he have going on and what would the treatment be if having TSI is considered hyperthyroid even if it's low and even if the TSH is elevated with low range t4 and t3.

I'm going by his other long post.

OP was told he had subacute thyroiditis, as was I.

I think this diagnosis is a crap shoot usually, It seems to me from many cases of people online i've read about that with subactue thyroiditis you can still have some antibodies that are always low in range.


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## Andros (Aug 26, 2009)

Defeat The Curse said:


> Andros, i'm bringing alive another old post here
> 
> I'm curious what happened to skyler and his situation.
> 
> ...


Stylar has disappeared on us so it's unlikely that we will ever know.

We see here his/her lab tests from April 21, 2011

Post # 44 http://www.thyroidboards.com/showthread.php?p=23745#post23745

5 weeks later...everything is in the normal range for the first time.

TSH: 3.68(ref. 0.40-4.50)
FT4: 1.5(ref. 0.8-1.8)
FT3: 3.6(ref. 2.3-4.2)
TSI: 33(ref. <140)

The "oddity" is in fact that the FT3 is above the mid-range with a TSH of 3.68 and the FT4 is also slightly above the mid-range. There is a lag time between the TSH and the FREES and with the blocking, binding and stimulating antibodies at play the labs don't necessarily represent how sick the person really is.

I am not sure there would be any treatment at this stage other than waiting to see if the person continues to go clinically hyper and do more labs. And I believe I strongly recommended an ultra-sound as these labs are common with cancer. We don't know what comes first; the cancer or the hyper but the medical community is aware of the fact that they are often bedfellows.

Grave's is a phenomenon observed and noted in some hyperthyroid patients by Dr. Robert Graves.

http://en.wikipedia.org/wiki/Robert_James_Graves


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## Defeat The Curse (Jun 30, 2011)

Does it not ever happen that a TSH rises and actually compensates successfully....

Like lets say his thyroid needed a TSH of near 4 to be successfully stimulated enough to produce T4 and T3 levels in or above the midrange.

Or does TSH always come down if Optimal T4 and T3 levels are reached ...

It really is confusing

What's interesting about Subacute THyroiditis is my endo told me something that sounded crazy to me.... He said a Doctor named Paul Wolf (spelling of wolf could be wolfe or some other way) did some research and tested many many people's thyroid levels that came into where he was stationed somewhere in the portsmouth naval base in the 1970s ... MY endo said the results were that many many people get subacute thyroiditis after colds and upper respiratory infections and never know it being asymptomatic .. he said the study showed a large percent of people get it after upper respiratory viruses and such..

I tried to find this article or research and never could .. ANd i don't really believe it for a second and kind of think it was some BS my endo was trying to pass on me.


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## Andros (Aug 26, 2009)

Defeat The Curse said:


> Does it not ever happen that a TSH rises and actually compensates successfully....
> 
> Like lets say his thyroid needed a TSH of near 4 to be successfully stimulated enough to produce T4 and T3 levels in or above the midrange.
> 
> ...


I have heard "chatter" to that effect about a virus or cold causing subacute thyroiditis but I never believed it and I still don't. I do think that if the patient was taking some sort of Rx it could zap out the thyroid. There are so many meds out there now and "most" of them have horrible side effects.

One would think the side effects are sometimes worse than the diagnosis.

No......................never heard if a high TSH doing any single thing except making the person very very very ill. If not treated, the outcome is tragic.


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## Defeat The Curse (Jun 30, 2011)

Well they have done the research about finding virus particulates and such in the thyroid

http://www.virologyj.com/content/6/1/5/

http://jcem.endojournals.org/content/27/9/1275.abstract

BUT .. the thing is

When a virus moves into the thyroid if that's what's happening .. the body ends up making some antibodies against it's own cells i believe in confusion at times.

What i'm saying is i theorize that myself and others with subacute thyroiditis probably end up with some level of Hashimotos

I have had my thyroid antibodies test three times..

always in normal range . /BUT not zero
I read somewhere this happens with subacute thyroiditis that antibodies may be present at very low levels.

Well if that happens .. it can probably eventually elevate to full blown hashi's ... which is what i fear.. but hopefully me being on thyroid meds for the rest of my life anyway will decrease that chance.

BUT i do think it's odd styler had TSI , that doesn't really make sense with subacute thyroiditis because the hyperphase is from damage to thyroid follicules i believe releasing T3 and T4 that it's not supposed too... NOT from thyroid stimulation.. That's why RAIUS is always less that 1%

Styler never posted his result for the RAIUS i don't think did he?


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