# Hashimoto's + TSI, please help



## hashistruggles (Jul 14, 2011)

hi all,

Thank you for this forum. Very recently I bumped into the word Hashitoxicosis and ow my how much do I recognize of this. it's completely what I tried to tell those doctors, endo's in my own words. They tried to make clear to me that "ain't possible".

My TPOab: unmeasurable; TG AB: unmeasurable; TSI present but not that high, they swing up and down and needless to say I swing with them.
Yet as I say, nobody even beliefs me, I'm diagnosed Hashimoto, in the meantime also developed Graves Eyes Disease. I figured that would wake them up, needless to say, still did not happen. 
I swing from hypo to hyper and back again. There is no stability whatsoever. I feel so sick, constantly. Those constant switches are going on for 5 years in the meantime, my body feels worn out. My bloodlevels are either subclinical hypo but these days normal. ( I take 125 mcg thyroid medication and it sure did not make me better. The trap is, I cannot without medication, but cannot be with either). I really don't know it anymore. What can be done? please help!


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## Andros (Aug 26, 2009)

hashistruggles said:


> hi all,
> 
> Thank you for this forum. Very recently I bumped into the word Hashitoxicosis and ow my how much do I recognize of this. it's completely what I tried to tell those doctors, endo's in my own words. They tried to make clear to me that "ain't possible".
> 
> ...


Hi there!!! And welcome!










Do you have your most recent thyroid labs TSH, FREE T3 and FREE T4? If so, can you post the results and the ranges. We need the ranges as they differ from lab to lab.

If you have TSI, you probably have TBII as well ( (Thyrotrophin Binding Inhibiting Immunoglobulin.) Which off sets the TSI (thyroid stimulating immunoglobulin); therefore the rollercoaster ride.

As you probably know, you should not have one tiny drop of TSI.

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism. 
http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html

Are you seeing an ophthalmologist for your eyes?

Hashimoto's and Graves' are often regarded as very close relatives.

If you have any TSI, even if it is below the range, that is "definitive" for hyperthyoid. As to the reason, that's another story. It could be because of cancer, Hashimoto's or Graves'.

Hashimoto's is diagnosed by FNA. If certain Hurthle Cells indigenous to Hashi's are present, then you have Hashi's.

Histologic diagnosis of Hashimoto's
http://emedicine.medscape.com/article/120937-diagnosis

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

The criteria for Graves' is clinical. You must exhibit..........goiter, exophthalmos, pretibial myxedema and thyrotoxicosis as per Dr. Robert Graves' of the 1800 era. 3 out of the 4 qualify.

Have you had a sonogram or radioactive uptake scan?

Have you ever heard of "block and replace?"
http://www.ithyroid.com/graves_treatments.htm


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## hashistruggles (Jul 14, 2011)

thank you for your warm welcome and quick reply!

My *most recent labs are*
TSH 0.7 (ranges 0.40- 3.50)
FT4 0.8 (ranges 0.54-1.24)
Antibodies
TSI 5.9 (ranges < 1)
The other antibodies all unmeasurable (I beat the lab there). 
TBII I think I have those too, but no results by hand of those. they were only measured once or so.

TSH and FT4 not too bad, but feel as sick as a dog. FT3 is only measured if the other ones are out of range, needless to say that's not the case being.

I never became pure hyperthyroid, always been primarly hypothyroid.

I see ophthalmologist for the eyes yes, currently I have a mild form and would like to keep it like that. The thing is the ophthalmologist also points out the importancy of my underlying thyroid condition being under control. From where I'm standing and in my experience, that never happened. According to the endo's all is fine. This so ain't true. As I say, I so recognize everything about Hashitoxicosis and yes every time I feel hyper, I feel like they flare up, my eyes start aching worse. different then the 'regular' aching.

As for Graves:" goiter, exophthalmos, pretibial myxedema and thyrotoxicosis as per Dr. Robert Graves' of the 1800 era. 3 out of the 4 qualify."
goiter: not present
pretibal myxedema: this ain't even funny, but I did have that for years on my leg. (not constantly) That's pretty much the only complaint that disappeared since I'm on thyroid meds. 
exophtalmos: yes present
thyrotoxicosis: I tend to think that's the whole problem with Hashitoxicosis. I sure used to have some real ones like that (had a real bad one 2 weeks ago) but it's never recognized as such, SINCE I'm diagnosed Hashimoto and consequently hypoT and those don't have that. 
I do have flare ups of hyper, but no attention is given to those, after all, I cannot be (according to them).

when I just got sick, think they did a radioactive uptake scan. resulting in a colored chart, that's the one? if not, it was something else.

I have heard of block and replace, but again the same story. Hashimoto is to slow so "Mrs your thyroid already works to slow, we have to supplement extra, no need to put anything down". As I say the hyper flare ups "are not possible", not existing, for them that is, for me they are daily reality.


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## hashistruggles (Jul 14, 2011)

Another question: how do TSI can be part of Hashimoto? thank you


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## Andros (Aug 26, 2009)

hashistruggles said:


> thank you for your warm welcome and quick reply!
> 
> My *most recent labs are*
> TSH 0.7 (ranges 0.40- 3.50)
> ...


Thank you so much for posting the labs and the ranges. There is something notable. With TSH in the basement, we expect to see FREE T4 high. Because yours is so low; it would seem you are converting very very fast to FREE T3. But, only a FREE T3 test would tell. You are not taking any exogenous T3, are you? This would make FREE T4 low as would adrenal fatigue, certain antibodies skewing the results by attacking the receptor sites or even pituitary.

What did your sonogram or uptake scan show? There should have been "notes" on that as to the findings. It is important to rule out cancer.

Your 2 lab test results are definitely not hypo; especially when you factor in that you have TSI.

I am much relieved that you are under the care of an ophthalmologist.


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## hashistruggles (Jul 14, 2011)

Thank you for your reply.

currently my labwork is not hypo, yet I'm on 125 mcg thyroid medication, without my TSH goes up, differs how high though. So that's why I'm treated as hypo. yet instead of better the medication seems to make me worse, well depends really. It's really those flare ups that are so heavy. Hypo I would say feels intense, but more sluggy. Hyper is just plain heavy and rough.

I don't take any additional T3 medication so I agree, for example.
TSH 6 FT4 0.8 (I go up with meds 25 mcg, in little pieces of 6 mcg, cannot take more) and end up TSH 0.7 FT4 0.8 according to me, something does not add up there. (TSI increase again).

That's what makes me wonder whether it's the scan you guys talk about. It's something like a picture, several colors and the explanation given is that the leftside is a bit swollen/enlarged. Nothing more. that's taken in the beginning, being 5 years ago from now.

The ophthalmologist would be a relief and it is. At the same time as pointed out higher, they emphazise thyroid needs to be under control. Endo says all is good. I keep telling and experiencing it's everything but under control. every time I feel the thyroid flares up, the eyes are part of it too.

ps my mothertongue ain't English so I apologize if I make 'silly' language mistakes.


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## crissypoo74 (Oct 4, 2011)

Hypo is extreme sluggishness. I compare it to being a child and swimming all day and getting sunsick. That is the only experience I have to compare to thius level of sluggishness.


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