# Hyper to Hypo after stopping meds.



## itslaksh (Dec 11, 2009)

Hi,

My husband was diagnosed with Graves disease in 2003. Since then until 2009 he was on methimazole and for some time on PTU as well. Initially the doctor kept titerating his dosage levels but finally told him he will be hyper life long. Since 2009 he was on 2.5 mg of methimazole. He was stable for a year on that dose and then the doctor told him his disease might have gone into remission and he would not need methimazole. He was taken off metimazole and 2 months later he tested hypo. The doctor did not put him on any meds and again did his blood work after another 2 months. The results came out hypo again. My husband was put on levothyroxin (not sure if I got the spelling right).

We are stumped by the results. How did his thyroid go hypo after methimazole as stopped. Till then it was normal. Now I have a doubt on whether he has Hashismotos or Graves disease. I went through a very bad phase of my marriage because my husband was on a low dosage of methimazole. He become emotionally unstable. What do I watch out for when he is having hypothyroid. In such cases is surgery a better option. The doctor told him RAI is not an option. Please advise.

Regards,
Kavya.


----------



## Andros (Aug 26, 2009)

itslaksh said:


> Hi,
> 
> My husband was diagnosed with Graves disease in 2003. Since then until 2009 he was on methimazole and for some time on PTU as well. Initially the doctor kept titerating his dosage levels but finally told him he will be hyper life long. Since 2009 he was on 2.5 mg of methimazole. He was stable for a year on that dose and then the doctor told him his disease might have gone into remission and he would not need methimazole. He was taken off metimazole and 2 months later he tested hypo. The doctor did not put him on any meds and again did his blood work after another 2 months. The results came out hypo again. My husband was put on levothyroxin (not sure if I got the spelling right).
> 
> ...


Hi Kavya and welcome. Well; it could be hubby has Hashimoto's rather than Graves'.

The criteria for Graves' is clinical as per Dr.Robert Graves'.

That would be exophthalmos,goiter, pretibial myxedema and thyrotoxicosis. Does hubby fit the clinical criteria?

Has he ever had TSI (thyroid stimulating immunoglobulin labs) which would indicate hyper?

Has he had radioactive uptake scan to rule out cancer?


----------



## itslaksh (Dec 11, 2009)

Hi,

Thanks Andros. The doc does believe my husband has Graves disease. He does seem to have a bit of exophthalmos and goiter. I will bring it up with him again. Is it common to go from hyper to hypo with graves?

Thanks,
Lakshmi


----------



## Lovlkn (Dec 20, 2009)

itslaksh said:


> Hi,
> 
> Thanks Andros. The doc does believe my husband has Graves disease. He does seem to have a bit of exophthalmos and goiter. I will bring it up with him again. Is it common to go from hyper to hypo with graves?
> 
> ...


The first thing I would do is get copies of all labs that have ever been run on your husband or at least the last 3*4 years.

I would also like to see his labs and ranges from 2009 until now.

How often did he have lab's while on the methimazole?

Sometimes a thyroid can burn itself out and it is not unheard of for someone to go from hyper to hypo. If your husband is having emotional stability issues he may not be on proper thyroid medication and the only way to tell that is to have a look at his lab work.

Many times my doctors would tell me my labs were "normal" when in fact I was at bottom range therefore having hypo symptoms but because I was in the range they felt it was fine to leave me there despite my not feeling well.


----------



## Andros (Aug 26, 2009)

itslaksh said:


> Hi,
> 
> Thanks Andros. The doc does believe my husband has Graves disease. He does seem to have a bit of exophthalmos and goiter. I will bring it up with him again. Is it common to go from hyper to hypo with graves?
> 
> ...


I very much agree w/ our moderator Lvlkn's response to you. And it would be wise for your hubby to get w/ a board certified ophthalmologist for there is much to be done to prevent the eyes from worsening and the eyes must be treated independently at this stage.


----------



## hashigirl (Apr 30, 2007)

I am doing the same thing going from hypo to hyper and back hypo, and vice versa. I was orignally diagnosed with Hashimoto's, but because when I was treated with smallest dose of thyroxine, i went hyper no matter hard little i took. I asked to be tested for graves, since one side of my family had graves and the other had hashi's. Enough I came positive for TSI's flagged high! I have learned it to just figure the two Hashi's and Graves cancel each other out and trying to treat it only makes it worse for me personally. That's my experience. Hope that helps!


----------

