# New Endo wont treat Hashis until TSH is 10 or above!



## Sazco (Jan 7, 2013)

Hi everyone. I have Hashis and my TSH was about 6 and high TPO antibodies. As soon as I started meds I got SEVERE hyper symptoms for 8 weeks. Worst 8 weeks ever. Panic attacks and heart issues so bad I barely left the house. I got off of all meds. I am finally starting to feel better and function now that they are off of my system. I found a new Endo and he was GREAT! He ordered labs for EVERYTHING that my other Endo did not.
Free T4, Free T-3, TSH, TSI, TPO-AB, and Vitamin D. So that made me feel hopeful. But he told me that he does not like to medicate people with Hashi's while their thyroid is still working until their TSH is over 10!! He said that way when their thyroid leaks they do not go hyper like I did. This make sme a little nervous because my former endo medicated me at a 6 and said I needed to be under 4. However...I did go hyper within 2 weeks. Perhaps I have TSI which I will know soon since he tested me. But it is so stressful hearing 2 completely different things from the same type of Dr:/ Thoughts? I have recently cut out gluten and feel so much better from that alone. I also take Selenium, Vitamin D, and magnesium.


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## BlindMag (May 17, 2013)

Oh man, I sympathize. Panic attacks suck so much.

My first thought reading your subject line was RUN FAR, FAR AWAY! but after reading your whole post, I think I would give him a chance to explain. Do you have a follow up appointment anytime soon, or can you call and ask a few questions? In particular, I'd ask if 10 is a hard and fast rule, and if so, that you'd be more comfortable if you could treat the symptoms rather than relying on TSH. 
Hopefully your TSI results will shed more light on how to treat you! 

Maggie


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## Sazco (Jan 7, 2013)

BlindMag said:


> Oh man, I sympathize. Panic attacks suck so much.
> 
> My first thought reading your subject line was RUN FAR, FAR AWAY! but after reading your whole post, I think I would give him a chance to explain. Do you have a follow up appointment anytime soon, or can you call and ask a few questions? In particular, I'd ask if 10 is a hard and fast rule, and if so, that you'd be more comfortable if you could treat the symptoms rather than relying on TSH.
> Hopefully your TSI results will shed more light on how to treat you!
> ...


Thanks Maggie! I am just waiting for the results of my labs (1-2 weeks). He said once he gets them back he will call me to let me know when he wants to see me again. I felt so so awful with my TSH at 6 (granted my free t4 was low also) and I cannot even imagine being at a 10:/


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## bigfoot (May 13, 2011)

Be careful here. I know with a TSH around 6.9 I was a downright zombie.

The idea is you medicate and keep the TSH suppressed, thus keeping the antibodies quiet, thus keeping the autoimmune attacks low, thus leaving you with fewer signs & symptoms.


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## joplin1975 (Jul 21, 2011)

My TSH was at 5-something or other and then, a week and a half later, 8-something or other. I was started on 50mcgs of Synthroid and lost my freakin' mind. Panic attacks, sweats, sleeping for only two to three hours a day, heart palpitations...you name it, I had it. The absolute worst week, physically, for me ever.

My TSI was also 129% (Graves = greater than 140% per my lab) and that was the culprit. My endo tells me there was no way I could stay stable with that much TSI. I am very thankful I had cancer and we could just pull the sucker and be done with it.


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## Andros (Aug 26, 2009)

Sazco said:


> Hi everyone. I have Hashis and my TSH was about 6 and high TPO antibodies. As soon as I started meds I got SEVERE hyper symptoms for 8 weeks. Worst 8 weeks ever. Panic attacks and heart issues so bad I barely left the house. I got off of all meds. I am finally starting to feel better and function now that they are off of my system. I found a new Endo and he was GREAT! He ordered labs for EVERYTHING that my other Endo did not.
> Free T4, Free T-3, TSH, TSI, TPO-AB, and Vitamin D. So that made me feel hopeful. But he told me that he does not like to medicate people with Hashi's while their thyroid is still working until their TSH is over 10!! He said that way when their thyroid leaks they do not go hyper like I did. This make sme a little nervous because my former endo medicated me at a 6 and said I needed to be under 4. However...I did go hyper within 2 weeks. Perhaps I have TSI which I will know soon since he tested me. But it is so stressful hearing 2 completely different things from the same type of Dr:/ Thoughts? I have recently cut out gluten and feel so much better from that alone. I also take Selenium, Vitamin D, and magnesium.


It's true; if you have TSI, it may not be wise to take thyroxine BUT............talk to the doc about "Block and Replace!"

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

Also, taking Vitamin D can exacerbate the antibody activity in some patients.

Vitamin D
http://www.eurekalert.org/pub_releases/2009-04/arf-vdm040809.php


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## Sazco (Jan 7, 2013)

Thanks everyone. I am feeling hypo again so I hope my labs come back soon. I am still shaky/mild anxiety like when I am hyper but I am starting to feel weak with bad foot pain like when I was hypo:/ I just want to figure out what is going on so I can feel better. I am a bit afraid of the TSI results because how in the heck do you treat that if you have both?!


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## bigfoot (May 13, 2011)

Well, some folks with Hashi's will have both TPO antibodies, Thyroglobulin antibodies, *and* TSI. But I think that's more of the exception than the rule. And if they test for both TSI and TRAb, I believe that is more suggestive of Graves'. From what I've read here and elsewhere, it is possible to have both Hashi's and Graves'. The answer to that is removing or ablating the thyroid. The "block and replace" method requires a very, very attentive doctor who is keen on lots of adjustments up/down and lots of lab work.


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## Sazco (Jan 7, 2013)

Well my Endos office just called and it appears that I have an elevated TSI and TPO antibodies test. I see him a week from today to discuss everything:/


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## bigfoot (May 13, 2011)

Well, I still would be cautious, but at least you will have some data to go on.


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## BlindMag (May 17, 2013)

Hooray, new info! Hopefully that will help them get to the bottom of everything! 

Maggie


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## Andros (Aug 26, 2009)

Sazco said:


> Well my Endos office just called and it appears that I have an elevated TSI and TPO antibodies test. I see him a week from today to discuss everything:/


Ultra-sound is probably in order. Let us know how the discussion goes.


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