# Hashimoto's or Postpartum Thyroiditis (PPT)?



## Jamie (Aug 18, 2010)

Hi all,
Glad this site exists! Thanks in advance for taking the time to read this and reply.
I am a "new" member of the Hashimoto's community. I was just diagnosed last week. I have some questions, though, re: whether I really have Hashimoto's or if it is Postpartum Thyroiditis (PPT)....here's my story:

I had my second son 8/17/09. I recall my OB/GYN telling me that my TSH level was slightly off (I don't recall high or low), but that it was of no concern. In April, I had some extremely strange symtpoms which sent me to a neurologist; I had a burning skin sensation down my back with no outward appearance of any rash/skin condition...a few days later I had a feeling of internal shakiness throughout my body that would not go away. These symptoms lasted 3.5 weeks. During this time I had MRIs, and lotso bloodwork. Thankfully, MRIs were normal, but showed a large lymph node in neck and TSH of 6.77 (glad my neuro checked this, as my gp only tested T3 and T4)....I was finally referred to a specialist, as I had been requesting, when it was found I was positive for thyroid antibodies (I had to specifically request testing for what I thought might be PPT).

Fast forward to now, the endocrinologist has diagnosed me with Hashimoto's based on TSH of 4.96 and TPOab of 475 (normal <35). I thought this number looked really high, but looking at sites/threads have found that it can go into the thousands. When I asked the Endo how we know this is not PPT he just pointed to the TPO number.

My main question, then, is:

How do you distinguish PPT from Hashimoto's?

I'm concerned about this because per what I've read PPT can go away; whereas, Hashimoto's is a lifelong condition.
I want to add that my thyroid is not typical of Hashimoto's-- there seems to be no enlargement/swelling...and I have not had many symptoms, other than feeling tired sometimes (which seems normal to me) and shakiness once in awhile (which I thought happened more with hypeRthyroid??)

Thanks for your time and replies!

Jamie


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## chopper (Mar 4, 2007)

Your TPO Ab's are high - it's Hashi's.

It's not normal to have any antibodies running around that attack your thyroid and that's what TPO antibodies do. Granted, everything tends to flare up during and after pregnancy but if they are there, they're not going away.

My last TPO was like 2150 or something insanely high....they can get high, that's true but they will also fluctuate greatly. I've had a TPO as low as 900 and something as well.

To distinguish the two, PPT has no antibodies and if it does, its no longer PTT and is Hashi's or graves or something autoimmune.

It's Hashi's unfortunately and swelling and shrinking IS very typical of Hashi's. I get that all the time as well as the shakiness. It's all due to those darned antibody attacks. When they attack, pieces of your thyroid die off quickly and all that hormone gets dumped into your system making you temporarily hyper. Once the attack is over and the hormone is used up you get sleepy and tired and the cycle repeats...over and over again...


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## JAYQ (Aug 4, 2010)

nasdaqphil said:


> Your TPO Ab's are high - it's Hashi's.
> 
> It's not normal to have any antibodies running around that attack your thyroid and that's what TPO antibodies do. Granted, everything tends to flare up during and after pregnancy but if they are there, they're not going away.
> 
> ...


This is exactly what i go through. Hyper symptoms of anxiety shakiness, lightheadedness, followed by extreme fatigue. Well these are the most common anyway, others include chest pain and shortness of breath at times.

My question is how long does this repeated cycle last? Seems like eventually there wont be any more to die off your thyroid making these hyper symptoms. Is that correct?


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## Andros (Aug 26, 2009)

Jamie said:


> Hi all,
> Glad this site exists! Thanks in advance for taking the time to read this and reply.
> I am a "new" member of the Hashimoto's community. I was just diagnosed last week. I have some questions, though, re: whether I really have Hashimoto's or if it is Postpartum Thyroiditis (PPT)....here's my story:
> 
> ...


Jamie; welcome. I don't think if you had PPT that you would have antibodies. And while high TPO can suggest Hashimoto's, it can be suggestive of other things as well.

I am going to suggest other tests and include a link. You can read all about the TPO on that link and all the other pertinent stuff too.

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/understanding/conditions/thyroid.html


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## chopper (Mar 4, 2007)

Jay, that's exactly right. The idea is that with every repeated attack, eventually your thyroid dies off on its own and you will become hypothyroid and require meds. Unfortunately this can take forever. Im going on 8 years now and my thyroid is STILL fighting back although the hyper is a hell of a lot less now than it was 8 years ago and now my levels are starting to drop finally.

As for the cycle, everyone's different. It also depends on what stage of the disease you are in, stress, physical activity, general health, etc. I personally tend to toggle about every 3 to 6 days it seems and I usually know the hyper phase because it almost always starts with me getting heart palpitations.

For instance, 2 days ago I had about 12 heart palps during the day and felt really shaky and crummy. Now, as the "juice" wears off I feel normal - I actually feel good - upbeat, still slightly hyper but not uncomfortably so....in 2 days from now I'll have trouble staying awake and will feel real dizzy and out of it as I toggle towards hypo land.....then it repeats....Im so used to it by now I can almost set a watch to it.

JayQ - Read an article I wrote a little while back that describes the whole deal....you might find it interesting...

http://www.thyroidboards.com/hashitoxicosis/


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## JAYQ (Aug 4, 2010)

nasdaqphil said:


> Jay, that's exactly right. The idea is that with every repeated attack, eventually your thyroid dies off on its own and you will become hypothyroid and require meds. Unfortunately this can take forever. Im going on 8 years now and my thyroid is STILL fighting back although the hyper is a hell of a lot less now than it was 8 years ago and now my levels are starting to drop finally.
> 
> As for the cycle, everyone's different. It also depends on what stage of the disease you are in, stress, physical activity, general health, etc. I personally tend to toggle about every 3 to 6 days it seems and I usually know the hyper phase because it almost always starts with me getting heart palpitations.
> 
> ...


GREAT ARTICLE! Thank you so much for sharing and taking time to put that together for everyone. So when are you scheduled to have your thyroid taking out?


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