# Diagnosed, but unsure



## Rschlab1 (Aug 12, 2014)

Hi all! I have been recently diagnosed with Hashi's, but I'm feeling a little unsure that my symptoms are all going to be treated. I suspect that I may have hashitoxicosis or something else going on. So here's my story... I've been feeling more and more run down and tired for several months. Three weeks ago, I was extremely exhausted, dizzy, lightheaded and nauseous. I made an appointment with my GP and they immediately suspected a combination of thyroid issues and low blood pressure and sent me off for some blood work. My TSH came back very slightly increased at 3.6, TPA high at 23, Free T4 at 1.5, thyroblogulin antibodies at 1. So they said maybe this is all due to Hashimoto's and sent me off to the endocrinologist. He suspected perhaps it was hashi's and addison's and sent me off for more blood tests. Cortisol levels were fine, so no adrenal problems. Vitamin D and B-12 were slightly low. And no issues with gluten. I started 25mcg synthroid this morning, but I know that will take a while to regulate. I also added a D and B-12 vitamin to my routine last night. So my concern is that in the past three weeks, I've started to have diarrhea as soon as I wake up every morning, I still have no energy and I've lost about 10 pounds (I was small to begin with). I have modified my diet to exclude gluten (after taking the test), soy, and limit sugar (no real change in calorie intake as I've been carefully monitoring so I wouldn't lose more weight). Does anyone have experience or advice for such a strange mix of symptoms? Currently, I'm no longer nauseous, but I'm lightheaded, tired/weak, I have diarrhea every morning, no problems sleeping, but generally tired throughout the day. I've also been fairly anxious lately, but I think that's probably due to worrying about fainting. Thanks in advance for your suggestions and help!


----------



## joplin1975 (Jul 21, 2011)

Loose bowels is a common side effect when you first start thyroid meds.

Can you post your latest lab results with the reference ranges? I think we can be more helpful when we see the whole picture. Also, has anyone suggested an ultrasound of the thyroid?


----------



## Rschlab1 (Aug 12, 2014)

Thanks for the response. I've been having loose bowels for a couple of weeks before starting the thyroid meds, so I don't think it's due to a side effect. No one has suggested an ultrasound of my thyroid, but I have not had any swelling and the endocrinologist felt everything and didn't think anything was abnormal.

TSH: 3.6 (range 0.4 - 4.5 mlU/L)

T4, Free: 1.5 (range 0.8-1.8 ng/dL)

Thyroglobuli Antibodies: 1 (range < or = 1 IU/mL)

Thyroid Peroxidase Antibodies: 23 (range <9 IU/mL)

Vitamin D: 26 (range 30-100 ng/mL)

Vitamin B-12: 394 (range 200-1100 pg/mL)

Cortisol, Total: 20.0 (range 3-22 mcg/dL)


----------



## Lovlkn (Dec 20, 2009)

You might simply be losing weight because of the change in your diet.

Your TSH is fairly high - your FT-4 is not that far off. Next time you lab be sure to insist they run a Free T-3 (Free Triiodothyronine)

Lab history will help uncover what is going on. Be sure to re-lab in 6 weeks.


----------



## Andros (Aug 26, 2009)

Trab
http://www.ncbi.nlm.nih.gov/pubmed/17684583
(Copy and paste into your browser)

Blocking TRAbs (also known as Thyrotropin Binding Inhibitory Immunoglobulins (TBII)) competitively block the activity of TSH on the receptor. This can cause hypothyroidism by reducing the thyrotropic effects of TSH. They are found in Hashimoto's thyroiditis and Graves' disease and may be cause of fluctuation of thyroid function in the latter. During treatment of Graves' disease they may also become the predominant antibody, which can cause hypothyroidism.

Substances not found in normal serum (scroll down to autoantibodies)
http://www.thyroidmanager.org/chapter/evaluation-of-thyroid-function-in-health-and-disease/
(Copy and paste into your browser)

Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/health-medicine/understanding-thyroid-why-you-should-check-your-free-t3
(Copy and paste into your browser)

TPO and thyroglobulin
http://onlinelibrary.wiley.com/doi/10.1111/j.1699-0463.1994.tb04888.x/abstract
http://www.wikigenes.org/e/gene/e/7173.html
(Copy and paste into your browser)

Understanding Thyroglobulin Ab.
http://www.labtestsonline.org/understanding/analytes/thyroglobulin/test.html
(Copy and paste into your browser)

Histologic diagnosis of Hashimoto's
http://emedicine.medscape.com/article/120937-diagnosis
(Copy and paste into your browser)

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

http://www.thyroidmanager.org/chapter/hashimotos-thyroiditis/
(Copy and paste into your browser)

Welcome and thank you so much for adding your ranges as different labs do in fact use different ranges due to different methodologies used.

I am thinking that you definitely need to get an ultra-sound. And so far, Hashi's is only a guess. The true definitive test for Hashi's is FNA.

It would also be a good idea to have a Thyroglobulin test in addition to the Thyroglobulin Ab test you already have had.

And a couple more tests that I will list. Lots to read but definitely worthwhile!


----------

