# Hashitoxicosis or intolerance to thyroid medication



## shesupsidedown (Mar 18, 2017)

Hello again.

Still trying to figure out what is happening to me. Here is my latest question.

After years on NDT, I unexpectedly became hyper and toxic. I cut my dose in half, still toxic. I tried Cyotmel, which really messed me up. I recently switched to Synthroid to rule out sensitivity to T3, still reacted the same way to NDT and Cytomel with the exception being I was so HOT all the time. Burning up hot. After a particularly scary moment that felt like a thyroid storm this past weekend (though my doctors said it wasn't) where my pulse shot up, my temperature went super high and I felt nausea and crazy I stopped all medications AGAIN for 4 days. Now I am trying WP and it feels the same as all the rest. As soon as I take any thyroid meds, I feel as if I could go psychotic....thats really the only way to explain it. If I close my eyes it feels as if my brain is a TV and someone is flipping through the channels as fast as possible. I was recently diagnosed with hypoglycemia but I tweaked my diet and since then my blood sugars have been stable.

My doctors are running every test in the book to see what else it could be but so far, but so far nada. Besides a technically within normal range TSI on my last lab test, there are no other explanations for why I am suddenly experiencing this from my meds.

So my questions are: how do you tell the difference between Hashitoxicosis and a intolerance to thyroid medication? They seem to manifest the same from the forum posts I have read?

When I read about Hashitoxicosis I feel that is what I have, though my doctors say no. I kind of want to push the issue and demand I try a block and replace protocol.

Those who do not have Hashitoxicosis, but find themselves sensitive to thyroid meds, what have you done?? What works? When I am off the meds, I am exhausted. Clearly I can't stay off of them.

I just got a blood draw yesterday. I will post labs as soon as I get the latest.


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## joplin1975 (Jul 21, 2011)

If you have TSI, even if it is in the normal range, you will likely have extreme sensitivities to thyroid meds.

If you have multiple "competing" antibodies, you essentially have hashitoxicosis.

I don't know much about block and replace although back when I started posting, a couple people did try it. Seems like most posters just opt for surgery.


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## Lovlkn (Dec 20, 2009)

Do you have a few labs you could share with ranges? mention what medication you were taking at the time labs were drawn. Also if you have antibodies results post as well.


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## shesupsidedown (Mar 18, 2017)

Just got my labs in! The saga continues....

I had been off 100mg of Synthroid for 4 days when I took these labs. Previous to stopping Synthroid I had been on it for one week, previous to that, I had been on 1 grain of NDT for a couple weeks. So I stayed at the same medication amount, just switched meds to see if I was having a sensitivity to T3. I am showing VERY low thyroid but when I take meds I feel speedy, even the smallest amount! Currently on 32.5 mg of WP. Even a half dose causes racing heart rate, watery eyes and pressure, running hot. So I need to medicate but not sure how without severe panic symptoms.

The interesting thing about my labs is I tested HIGH for H Pylori which I heard can be a triggering factor in Hashis and Graves. Curious to see how I feel once I begin treatment for it.

T3 Free 1.6 (2.3-4.2)

T4 Free .66 (.84-1.55)

TSH 5.087 (.400-4.000)

H Pylori Ab IgA 134.5 (00.0-20)

H Pylori Ab IgG 8.0 (00.0-20)

Thyroglublin Ab 172.9 (00.0-60)

TPO Ab <28 (00.0-60)

Iodine 38 (40-92)

Its worth noting that for years prior to the last couple months my labs were stable: TSH was low/suppressed, antibodies were lowering, T3 free was high, and T4 was middle range. I felt fine and was seemingly doing well until suddenly I stopped tolerating meds.

Joplin1975: As for TSI, surgery is not an option for me right now. Curious how to treat Hashis in the presence of TSI antibodies without a drastic measure such as surgery? Block and replace is the only thing I have heard of...


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## joplin1975 (Jul 21, 2011)

As far as I know, you are absolutely correct. The only option is block and replace. I don't know much (well, anything really) about it.

For the record, I totally acknowledge that surgery is a crazy extreme option. I'm only saying that because I really and firmly believe that TSI is sort of a fatal blow to the management of autoimmune thyroid disease. Nothing is perfect and everything has its pros and cons...but I do believe TSI is a game changer. That all said, I'm fully supportive of you finding a medication protocol that works.


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## Lovlkn (Dec 20, 2009)

> Thyroglublin Ab 172.9 (00.0-60)


Have you had an ultrasound lately?

Is this the 1st time Thyroglobulin has been run on you?


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## shesupsidedown (Mar 18, 2017)

Joplin1975 of course! I got a urgent endocrinologist on Monday, which in Portland OR is AMAZING (we have a major shortage of endos here) so I am hoping she may shed more light on the TSI dilemma. ..but then again, I have very low expectations for western doctors of any kind.

Lovlkn, I expect I will get a ultrasound Monday. At least I hope.

As for Thyroglobulin:

In March after dropping my meds it was 60 h (< or = 1IU/ml)

The last time it was tested before that was in June 2016 and it was 160.4 H (0.00-60.0)

before that in Dec 2015 it was 136.6 H (0.00-60)

My only choice at this point is to stay on meds and weather the speediness and panic. Its just choosing what meds. I can stick with WP, or I can switch to a compounded T4 and take at night with maybe a sleeping pill so I skip the speediness? Or keep taking Xanax as needed with the WP to get over the panic attacks? This is a tough situation.


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## Lovlkn (Dec 20, 2009)

And this is your 1st ultrasound ?

How old are you? Wondering if it could be related to peri menopause.

You need to share more lab's. 1 lab without taking Synthroid for 4 days is useless.



> After years on NDT, I unexpectedly became hyper and toxic. I cut my dose in half, still toxic.


What does this mean? Post labs related to this comment please.



> I am showing VERY low thyroid


What does this mean? Post labs related to this comment please.


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## shesupsidedown (Mar 18, 2017)

Yes 1st ultrasound.

I am 42, hormones are normal.

When I say "I am showing VERY low thyroid" I am referring to the labs at the beginning of the thread taken last week...

T3 Free 1.6 (2.3-4.2)

T4 Free .66 (.84-1.55)

TSH 5.087 (.400-4.000)

H Pylori Ab IgA 134.5 (00.0-20)

H Pylori Ab IgG 8.0 (00.0-20)

Thyroglublin Ab 172.9 (00.0-60)

TPO Ab <28 (00.0-60)

Iodine 38 (40-92)

I did get labs a few weeks prior though my doctor told me they would not be accurate due to messing with my medication so much. These were the labs:

T3 free (2.3-4.2) 2.5

T4 free (.8-1.8) .8

T3 reverse (8-25) 10

Antibodies:

TSI: (<140) <89

TPO (<9) 1

thyroglobin (< or = 1) 60

TSH (no reference range given?) .05

Ferritin: (10-232) 49

D, 25 (30-100) 42

As for when I say "After years on NDT, I unexpectedly became hyper and toxic. I cut my dose in half, still toxic." I was having symptoms of hyper (restlessness, insomnia, over-exercersizing as I had endless energy, eye pressure and weird floaters (I actually had an MRI), loss of weight fast, just generally felt maniac) but because I had never been hyper, I thought that was how feeling healthy was supposed to be! I attributed emotional issues like the severe panic attacks, sense of doom, social anxiety (I don't usually have, I am a very social person), as stress related. When these symptoms became even worse two months ago, I thought I may be pooling T3 and stopped my meds for a few days returning at a lower dose (1 grain)..thus leading me down this medication rollercoaster of the last couple months. Nothing stops the panic attacks and social anxiety except NOT being on medication.

My T3 free had been very high for quite a long time but we thought I was feeling ok and left it alone. Labs in Feb (before I started messing with my meds) were:

T3 free (2.3-4.2) 4.8 (had been as high as 9 in Sept)

T4 free (.8-1.8) 1.10

TPO: (00.0-60.0) <28.0

TSH: (.400-4.000) .008

Ferritin: (10-232) 24

D, 25 (30-100) 56

Hope that helps. I am currently on 32.5 mg of WP. I NEED more medication! Just don't know how quickly to raise up my dose or how to tolerate the symptoms. But currently I am VERY depressed and just cry every day. This is a nightmare. I feel so disheartened.


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## Julied1071 (Mar 31, 2017)

I skipped my synthroid dose today... and feel better! I'm sensitive to all medicine. I'm not sure if it's a coincidence. I experience symptoms of to much synthroid. Besides my vitamins I only take Zantac and Nexium. I didn't sleep well last night and strangely I feel better.


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## jenny v (May 6, 2012)

You are pretty darn hypo right now, but having changed your doses around so much it can be hard to tell with accuracy how off your thyroid labs are. You'll need to stay on one dose of one medicine for at least 4-6 weeks (even better would be 6-8 weeks) before you test again. And with antibodies going on, it can make things harder. Have they ever run a TSI test?

Also, did the doctor say anything about those H Pylori antibodies? If you've got H Pylori you'll need antibiotics to fix that and it can affect absorption of medicine. Your ferritin and Vitamin D are also extremely low and need to be treated, did the doc mention that?

You've got a lot going on, unfortunately! It looks like it's going to be a step by step, long fix that will require some patience to get through.


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## Lovlkn (Dec 20, 2009)

Try getting your D and Ferritin to 3/4 of range and I bet you don;t have any more issues.

Seems to be a developing trend I keep hearing from posters, me included.


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## Julied1071 (Mar 31, 2017)

I know I just been posting for symptoms and questions for myself, and not contributing much to help others. But I just want to say that if it weren't for this forum I think I would be going crazy because I don't know anyone else who has thyroid issues and I feel like things are off, I feel like I'm going crazy. I just want to say thanks to the moderators iand administrators and all who have contributed.


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## shesupsidedown (Mar 18, 2017)

Julied1071 I completely agree! THANK YOU to everyone who responds...it really makes a HUGE difference.

So today after a completely f**ked morning where my emotional state crashed and burned and I ended up yelling at my roommate, followed by a hour-long crying jag and a coma-like nap, I called my doc and asked if I could jump straight to 1 grain. We agreed I am too low, and I need to get to one grain again, panic be damned. There I can hold steady for a moment, then slowly raise as needed. I will just have to use Xanax for the speediness until my thyroid is in a stable range...crossing fingers if I start to fix these issues one by one, the panic will subside.

Jenny V: Yes, my last TSI was (<140) <89. I just started on a natural treatment protocol for the H Pylori (DGL, S. Boulardii, and mastic gum) and I am taking D and Iron supplements. After a few days of the H Pylori treatment I will also start Iodine and Selenium as my Iodine was low.


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## Lovlkn (Dec 20, 2009)

Julied1071 said:


> I know I just been posting for symptoms and questions for myself, and not contributing much to help others. But I just want to say that if it weren't for this forum I think I would be going crazy because I don't know anyone else who has thyroid issues and I feel like things are off, I feel like I'm going crazy. I just want to say thanks to the moderators iand administrators and all who have contributed.


All the Admin and Mid's have been in your shoes - WE GET IT!

Thank YOU!!


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## jenny v (May 6, 2012)

Ooof, with a TSI that high it's going to be very hard to stabilize. TSI that high can make taking any kind of T3 drug almost impossible. You have to get it much lower before you can take a T3 drug without those feelings of anxiety and hyper symptoms.


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## Lovlkn (Dec 20, 2009)

I don;t see the ultra sound results - what did they say?


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