# Could I have Hashimotos?



## SoLiveYourLife (Oct 17, 2010)

I posted this in lab results but just read that parathyroiditis can be related to Hashi's and now that I have shown both hyper and hypo I am beginning to wonder if this could be Hashi-I'm interested in what others think:

Wow, my case just got more complicated, here's my story:

I'm 6 months postpartum.

I had hypo symptoms so I asked OB for a test a few weeks ago. Test said TSH was .06 at my OB, and the T3 and T4 were on the upper end of normal-so I was hyper then, but I KNOW I was hypo a month before.

So I went to an endo 3 weeks ago and blood was:
TSH: .009
T3 4.2
T4 2.13 (high is what nurse said)
CBC normal
white blood count 3.7 (low)
CMP (or t) normal
Thyroid antibodies 5

Today I got a neck ultrasound-thyroid appeared normal (off the record from tech). BUT she identified 2 of my 4 parathyroid glands were much larger than normal. I understand now that parathyroid are completely separate and different from thyroid, and they regulate calcium. I have had symptoms of this but never complained to a dr bc i didn't want a myriad of tests.

Then my radioactive uptake scan was 2% on the I 123 test. She said unofficially-way hypo.

So questions I have while I wait for dr appt are:

Could thyroid and parathyroid issues be related? I read about some complex disease called MEN1, but not sure how common the 2 are linked together or how common the MEN1 is.

How likely my thyroid issue is postpartum thyroiditis vs. Graves+Hashimoto's and how that can be tested/identified.

How likely I had any of these problems in pregnancy (I had an excessive amt of swelling and other issues during pregnancy), and how likely it is that one or both of my pregnancies caused developmental problems in utero of the thyroid or parathyroid.

Any thoughts, guesses, experience with these things are appreciated!
Thanks!


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## lainey (Aug 26, 2010)

Here is a little reading on postpartum thyroiditis:

http://www.thyroid.org/patients/brochures/Postpartum_Thyroiditis_brochure.pdf

http://jcem.endojournals.org/cgi/content/full/jcem;87/9/4042

The way to tell the difference from this and Graves/Hashimotos would be to do full antibodies testing--TSI (thyroid stimulating immunoglobin), TPO (thyroid peroxidase antibodies), and TGA (thyroglobin antibodies). In the presence of antibodies, it is more likely that you have an autoimmune thyroid problem rather than the more transient postpartum thyroiditis.

Your blood testing should include FREE T3 and T4, not totals as you had run at first. Not all of the circulating hormone in a total T4 test is accounted for because estrogen (which you probably have quite a bit of right now) binds with thyroid hormones and reduces their availability. However, if that was high, chances are the free T4 is high too....

The issue you have at the moment is that your blood tests (hyper) don't match your uptake (hypo). This will make it difficult to medicate you for either condition, so be prepared for that idea. It is not uncommon for thyroid function to swing from one direction to the other, but if it persists it presents several management issues, not to mention several symptom sets to deal with.

To start, you're going to need blood testing again to see if those results match the uptake.

As for the enlarged parathyroids, the key will be the blood calcium. Blood calcium tends to remain very stable, so this will have to be tested to see if the parathyroids are contributing to the problem, as well as parathyroid hormone, to see if it is elevated.

Pregnancy causes a lot of changes in a woman's body. Many women find that their body changes in many ways after a pregnancy that makes it very different from what it was before they had a baby. If you were predisposed to a thyroid problem, it's not unlikely that pregnancy simply exposed it.


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## Andros (Aug 26, 2009)

SoLiveYourLife said:


> I posted this in lab results but just read that parathyroiditis can be related to Hashi's and now that I have shown both hyper and hypo I am beginning to wonder if this could be Hashi-I'm interested in what others think:
> 
> Wow, my case just got more complicated, here's my story:
> 
> ...


I do know that low uptake does not necessarily mean hypo. There are things that interfere w/uptake such as solid nodules, thyroid meds, other sources of iodine and/or supplements or medicines. So, it is best to get the radiologist's comments and hopefully you can share w/us?

Here are some suggested tests to help sort through this.

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/unders...s/thyroid.html

Will be anxious to hear the "official" results of the ultra-sound.


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## Christinals (Sep 9, 2010)

I too am confused about a low uptake and slightly low TSH .35 (.45-4.5).
I did the RAIU. 6% at 4hrs and 3% at 24hrs. There was very little uptake (the nodule didn't uptake either and now has grown another 1cm in 6mos.) I am not or have ever been on medication and was very strict with the low iodine diet. The dr. left it up to me if I wanted to do the FNA (first one "inconclusive"), I said YES! November 9th is FNA day. I have high Antibodies (Tgab was 1283 & TPO 320) so I know that something is up! The Dr.'s first guess is Hashimotos. I thought Hashi's was Hypo?

I am going to ask the dr. a few questions myself. Keep us posted on what the Dr. says.

Your body has gone through so many changes during and after pregnancy.
Have the tests Andros suggested. It may give you a better understanding of what is going on. I believe TSI is the test for Graves, but the antibodies need to be tested as well.

Best of luck to you! Please keep us posted. :hugs:


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## Andros (Aug 26, 2009)

Christinals said:


> I too am confused about a low uptake and slightly low TSH .35 (.45-4.5).
> I did the RAIU. 6% at 4hrs and 3% at 24hrs. There was very little uptake (the nodule didn't uptake either and now has grown another 1cm in 6mos.) I am not or have ever been on medication and was very strict with the low iodine diet. The dr. left it up to me if I wanted to do the FNA (first one "inconclusive"), I said YES! November 9th is FNA day. I have high Antibodies (Tgab was 1283 & TPO 320) so I know that something is up! The Dr.'s first guess is Hashimotos. I thought Hashi's was Hypo?
> 
> I am going to ask the dr. a few questions myself. Keep us posted on what the Dr. says.
> ...


I am soooooooooooooooooooooo glad to hear your FNA is around the corner. Very concerned about the high titer of Thryoglobulin Ab. Sorry you have to go through this but is the wise course.


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## Christinals (Sep 9, 2010)

:hugs:Aww..thx Andros.
I agree...it is the best and ONLY course..lol
Thanks again.


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## Andros (Aug 26, 2009)

Christinals said:


> :hugs:Aww..thx Andros.
> I agree...it is the best and ONLY course..lol
> Thanks again.


And thank you for being such a contributing member to this board.


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