# Total Thyroidectomy 1/23 - Hashimoto's To Graves' Disease



## rmunoz (Jan 26, 2014)

New here, but thought I would share my story in hopes that it may help anybody or maybe somebody can help me. I'm 41, male, and just had a total thyroidectomy on 1/23/2014. Not sure I can make this story very short, but here goes...

I was diagnosed with Hashimoto's disease in 10/1997 while in the Navy. It was discovered from high TSH and antibodies and through very high cholesterol. However, my family knew something was wrong with me but couldn't pinpoint it. I was lethargic with a lot of water retention (puffy face). I guess it just happened so slow. I was put on .150-.175 micrograms levothyroxine and all was balanced over the next 16 years thyroid-wise. I went through some bouts of depression during this time. Between the antidepressants and levothyroxine, everything seemed to be OK during this time.

That was until over the past year. At first, I thought either one or all of my antidepressant, cholesterol med, or high blood pressure med was causing something to go wrong with me. Mentally, I was anxious with brain fog and poor memory. Physically, I had heart palpitations and very red eyes when I wore my contacts. I went cold turkey on everything except the levothyroxine (which I discovered later was something I should have stopped). I got some lab work done and TSH was low undetectable. My primary care physician lowered my levothyroxine to .137, then TSH lab low again, .125, then TSH lab low again, .112, then TSH lab low again, then .088...at which point I just asked to see an endocrinologist. The endo recommended that I stop levothyroxine and work my way back up. After 3 weeks without levothyroxine, labs showed my TSH was still low undetectable. Antibodies also showed that it was Graves disease. In the end, I was exacerbating the symptoms by taking levothyroxine when I needed to be off of it. However, I don't blame the doctors since most people who have low TSH with Hashimoto's usually just need a lower dose adjustment. They just kept lowering and, unfortunately, it wasn't getting anywhere.

Over the past 6 months, I've tried methimazole which had the unfortunate side effect of causing rash so I had to go off of it. They then asked if my preference was surgery or RAI...I chose surgery particularly after reading about how bad antibodies flare up with RAI, and mine were bad enough as it was since my eyes turned bright red when I wore my contacts. Some might find it interesting that I had to go on LITHIUM to lower my thyroid hormone prior to surgery since my body wouldn't take methimazole (with the high chance of not being tolerant to PTU). For those that don't know, lithium is proven to basically take up iodine space in the thyroid which results in lower thyroid hormone output. It did lower my thyroid hormone, however I was a zombie for a couple of months prior to the surgery.

My work was very accommodating to my condition. My surgery was in the Seattle area and the surgeon is considered one of the best in the world. 3 days out and I'm a little sore. I will be back at work full time tomorrow morning. I still have brain fog and will be a zombie over the next couple of weeks. The surgeon does not want me to stop taking lithium for another couple of weeks to ensure that I don't have any thyroid storm. After that, I will be on levothyroxine. I'm hoping the brain fog will go away sometime after I start getting the thyroid hormone balanced out. I'm not sure, but I'm hoping that any depression has been taken away with the thyroid, but that might not be the case and I may need to go back on antidepressants (amongst other things).

*So, if anybody ever wonders if it is possible to have Hashimoto's disease that turns Graves disease dominant, it can occur and I'm a living testament to it. *Both my endo and surgeon stated the normal change is usually from hyperthyroid to hypothyroid and that it was very abnormal to be initially hypothyroid and then turn hyperthyroid.

I'm done babbling. If anybody wants any information, let me know. If anybody has any advice on the brain fog remedy, let me know.


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## Octavia (Aug 1, 2011)

Hello, and welcome. That's a fascinating story. We've had several members here who have dealt with both Hashi's and Graves, and it seems like it could be quite a nightmare to deal with.

Please keep us posted on your progress. You'll likely get a full pathology report within the next week or two. I'm interested to see what it says.


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## Andros (Aug 26, 2009)

Welcome!!! You have had a difficult journey, indeed. Very glad to hear you had the ablation though as cancer could have been a concern as well. I trust your pathology came back all clear?

Thank you for the heads up! It happens to be very true. I always say that Hashi's and Grave's are " brothers in the 'hood!" Also, both are in fact prone to cancer.

Glad you joined us and thank you for thinking of "others!" So rare in today's world.

Lithium is a huge goitrogen as is L-Carnitine. That is the first time I have ever heard of this treatment plan for thyrotoxicosis. I find that to be very innovative thinking.


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