# Could this be hashitoxicosis???



## carreg (Aug 10, 2011)

I feel like I am on a roller coaster that just will not stop. First, a little background: For the last few months I have been losing weight without trying. I have also been very tired, had increased pulse but very low blood pressure. I keep getting a feeling like the "blood is rushing to my head". My general doctor ordered a TSH and based on those results ordered more labwork/procedure. After that he referred me to an endocrinologist who ordered more labs/procedure. I am scheduled to see the endo the end of August to discuss the results. Meanwhile, I am listing all the results. From what I've read I have symptoms of both Hashi and Graves??? Any input would be so appreciated!!

06/10/11
*TSH (0.12) Normal 0.40 - 4.50

07/07/11
*Thyroid Ultrasound
Impression - "The thyroid gland is not enlarged but it is heterogeneous and shows increased flow. This can be seen in thyroiditis/hyperthyroidism."

07/08/11
*Thyroid Peroxidase AB (957) Normal less than 35
*Thyroglobulin AB (1605) Normal less than 20

07/18/11
T4 (1.13) Normal 0.82 - 1.77
TSH (0.994) Normal 0.450 - 4.500 (Different laboratory)
*Thyroid Stim. Immunoglobulin TSI (215) Normal 0 - 139
Triiodothyronine, Free, Serum (3.4) Normal 2.0 - 4.4

08/02/11 - 08/03/11
Thyroid Uptake/Scan
*4 hour (20.1%) Normal 6 - 18%
24 hour (31.5%) Normal 10 - 35%


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## chopper (Mar 4, 2007)

Welcome to the world of Hashitox.....like me, you've got the trifecta of antibodies - TPO, TG and TSI.

It is going to be a roller coaster ride and I can tell you first hand, it is not pleasant. The ups and downs will make you feel like you are bi-polar or something.

What did your doc recommend?

If you haven't read my story, you can find it here:

www.thyroidboards.com/hashitoxicosis

Hashitox seems to come on with more hyper symptoms than hypo. As you go through life without getting anything done as I have, eventually all those antibody attacks eat away at your good thyroid tissue and make you hypo - but it takes years usually. Im going on about 10 years of this stuff. 8 years ago when I was first diagnosed, I was totally hyper feeling - jitters, shakes, tremors. Now I am more on the sleepy side but I still get hyper periods in between, although not as frequently as I used to get them.

Your uptake scan is high, indicating hyper. RAI ablation or surgery will probably save you years of trouble.


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## carreg (Aug 10, 2011)

Thanks,
I did read your story and I feel almost like we could be twins! I would not wish these symptoms on my worse enemy, although it is good to know I'm not alone in this battle. I really appreciate this board and I'm sorry we are on this ride together.
My endocrinologist is currently out of town. My appointment is on the 24th of August. I went ahead and picked up my results from the hospital because I did not want to wait to find out what I already suspected; my thyroid is on a "wicked roller coaster ride". . .
I do remember at my initial appointment with the endo, he was discussing all the scenerios and hashitoxicosis was the one he was really hoping I did not have!! I am, at least, glad he is familiar with the disease . . . .


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## McKenna (Jun 23, 2010)

Wow, those are some high antibodies! I hope you and your doctor can work out a plan of action.

I was hashitoxic as well, and it's a nightmare. It's good that your endo is familiar with it. Mine was as well, and DX me with it at my first appointment. From what I've read around, not many doctors use that term or are very familiar with it.

I did wind up getting mine removed.


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## Andros (Aug 26, 2009)

carreg said:


> I feel like I am on a roller coaster that just will not stop. First, a little background: For the last few months I have been losing weight without trying. I have also been very tired, had increased pulse but very low blood pressure. I keep getting a feeling like the "blood is rushing to my head". My general doctor ordered a TSH and based on those results ordered more labwork/procedure. After that he referred me to an endocrinologist who ordered more labs/procedure. I am scheduled to see the endo the end of August to discuss the results. Meanwhile, I am listing all the results. From what I've read I have symptoms of both Hashi and Graves??? Any input would be so appreciated!!
> 
> 06/10/11
> *TSH (0.12) Normal 0.40 - 4.50
> ...


It looks to me like you are hyperthyroid (thyrotoxic.)

You have the TSI and you have a high uptake on the RAIU.

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

Were there any comments on the RAIU printout?

Understanding Thyroglobulin Ab. (yours is very high)
http://www.labtestsonline.org/understanding/analytes/thyroglobulin/test.html

TPO also very high.

TPO Ab
http://www.nlm.nih.gov/medlineplus/ency/article/003556.htm

The reason I ask about comments on RAIU is because it gives a much better picture than a sonogram and some of your labs do point to being sure that you do not have cancer.

It would appear though that your doc is ordering and doing all the right things.

You could just have hyperthyroid.

Read Nasdaqphil's Special Report on Hashitoxicosis here........ http://www.thyroidboards.com/hashitoxicos

If you have any TSI, even if it is below the range, that is "definitive" for hyperthyoid. As to the reason, that's another story. It could be because of cancer, Hashimoto's or Graves'.

Hashimoto's is diagnosed by FNA. If certain Hurthle Cells indigenous to Hashi's are present, then you have Hashi's.

Histologic diagnosis of Hashimoto's
http://emedicine.medscape.com/article/120937-diagnosis

Hashimoto's Hurthle cells
http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675(06)71549-2

The criteria for Graves' is clinical. You must exhibit..........goiter, exophthalmos, pretibial myxedema and thyrotoxicosis as per Dr. Robert Graves' of the 1800 era. 3 out of the 4 qualify.

Hope the above is helpful and welcome!


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## carreg (Aug 10, 2011)

Andros,
Thanks for the links. Thankfully the uptake/scan showed no hot or cold nodules.


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## Andros (Aug 26, 2009)

carreg said:


> Andros,
> Thanks for the links. Thankfully the uptake/scan showed no hot or cold nodules.


What very excellent news and you are welcome. We are here to help however we can.


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## I DClaire (Jul 31, 2011)

I've just about come to the conclusion that I'm either going to get well or die before I ever actually know what my diagnosis is! :ashamed0001: I made a second request yesterday for copies of my latest test results.

That being said though, when I read nasdaqphil's report of his experiences, etc., to my husband we both said the same thing carreg shared - if I didn't know better, I'd think nasdaqphil had written my medical biography. AND, what he said was written infinitely better than I could have ever composed my thoughts.

Several points nasdaqphil made jogged my memory - they reminded me of things I've been told pretty much since all this started, even things said by the internist I find so much fault with and the first endocrinologist I saw who was so rude. I went into this not knowing one earthly thing about thyroid disease and I feel like what little I know today is basically bits and pieces of information members here have shared or information I've read online.

Comparing my experiences to nasdaqphil's:

1. Recently I called my endocrinologist because I understood her to say I had Toxic Multinodular Goiter/Hashimoto's. I'm at the point where I'm faulting myself as much as anyone else - maybe I'm the one missing the facts and not understanding the terminology or maybe there is blame to share.

She had recently told me my lab numbers were normal with medication. I had asked how that could be true and me feel so horrible? Phil's "You are here" diagram makes total sense to me.

2. The very first time I saw my current endocrinologist she said something to the effect that I might be hyperthyroid and hypothyroid at the same time - Phil explained the "cycling" process to perfection. I believe with every ounce of my being that that's what I'm going through. The doctor never elaborated - I never really understood.

3. The first endocrinologist (the one and only time I saw her) very flippantly said, "Well...you may have Hashimoto's and/or Graves Disease." I thought she was rude when she said, "I don't know but what your best bet is just to have your thyroid removed." Maybe she was right...her bedside manner left a lot to be desired but maybe I should have just gone with her recommendation, which at the time seemed awfully drastic for someone with one nodule too small to measure.

4. Like Phil, I "toggle" hyper to hypo all the time. I share Phil's symptoms, his body temperature, his heart palpitations, blood pressure numbers, everything. Today, for example, I'm so hyper I cannot be still. Tomorrow, who knows whether or not I'll have the energy to do anything?

5. I share Phil's neck discomfort from time to time.

Phil does not mention a symptom I haven't experienced myself. I haven't had the tests he's had. I remember being told something about my thyroid trying to die but every so often it would swing into overdrive. Phil said his thyroid was slowly losing function but wouldn't give up the ghost.

6. I'm not fat but I have been overweight for several years and nothing would help as far as diet and exercise. This summer I've lost 22 lbs. I've been hesitant to believe it and expect every morning to weigh myself and the weight will be back. I'm eating everything I want to eat - the weight is just disappearing.

Sometimes I still find myself stupidly thinking do I REALLY need surgery, will all this "get well" if I wait long enough, am I imagining my symptoms, maybe I'm sleep deprived instead of brutally exhausted half the time and so hyper other times that, like right now, I simply cannot be still?

Nope! Irregardless of my diagnosis, there are three words in Phil's post I think say it all for me personally - "Never Ending Cycle". I don't see this as a treatable condition - you can't medicate something you can't capture. You can chase it indefinitely but even if you do catch it, are the weeks, months and years you've lost or had compromised going to be restored?

Even though I didn't walk away from the first endocrinologist's office two years ago with one ounce of understanding about thyroid disease, I almost regret not following her advice. Had she explained things better or been more professional with a most worried and confused patient, maybe I would have been spared what I've been through. Maybe if the internist had known what she was talking about she wouldn't have told me I didn't have anything to worry about because my nodules were "cold" and most women enjoyed being hyperthyroid I wouldn't have missed signals.

I feel blessed to have stumbled in the door to this website - my only regret is I didn't find this site three years ago this summer.


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## webster2 (May 19, 2011)

According to HIPPA, you are entitled to copies of your test results. Both times, I have been diagnosed with hyperthyroid have been very different, and far form enjoyable! Best to you!:hugs:


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## Andros (Aug 26, 2009)

I DClaire said:


> I've just about come to the conclusion that I'm either going to get well or die before I ever actually know what my diagnosis is! :ashamed0001: I made a second request yesterday for copies of my latest test results.
> 
> That being said though, when I read nasdaqphil's report of his experiences, etc., to my husband we both said the same thing carreg shared - if I didn't know better, I'd think nasdaqphil had written my medical biography. AND, what he said was written infinitely better than I could have ever composed my thoughts.
> 
> ...


Believe it or not, your post provoked a tear or two. This is the goal; "To help someone!"

I am very happy!


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## I DClaire (Jul 31, 2011)

I feel very emotional myself, Andros. I honestly don't know where I'd be right now if I hadn't found this website.

Y'all have opened my eyes to things I need and want to become familiar with and your personal stories have given me hope that I can get my life back. Right now I am still worried, I'm learning but I have a long way to go, I'm a little unsettled about having surgery - but - I'm better than I was a month ago and I feel like there is reason to hope.

I was reading an article I found on the Internet this afternoon that was released in 2001 but I found myself wondering has anything improved dramatically?

"The under-diagnosis of thyroid disease handicaps research as well as the lives of affected patients. Researchers need to understand the proper function of thyroid hormone and the pathology of thyroid disease to fully understand how our bodies, brains, and immune systems develop and work, in health and in illness. It is impossible to know the prevalence of thyroid disease and figure out all the causes if patients take years on average to be diagnosed."

I find it all intriquing but also tragic that so many lives are impacted by a problem people have no idea they have and apparently few physicians even suspect until so much damage has been done. I read somewhere else that it may take 17-20 years before a thyroid imbalance developes to the point where lab tests may detect it or the patient becomes symptomatic. One of the first tests required for patients entering mental hospitals is thyroid. Isn't it tragic that an undiagnosed health problem can potentially wreck havoc on an individual to the point that they're being admitted to a mental institution?


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