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Old 02-14-2005, 02:52 PM   #1
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Hashi Diagnosis with these labs?? Input Please!!

I've been trying to get diagnosed for a couple months now, and have had my first endo appointment. I've had a undetectable TSH all along, and my T4 and T3 levels have fluctuated up and down but within the normal range. Currently they're centered within the range, which is lower than they were on the 1/12 reading. See below.

Now, based on the antibodies, the endo is thinking I have Hashi's. First he thought Graves, but then after receiving the TSI number, he thinks Hashi. At this point he's basically saying we should just repeat the same tests, not do a scan, and just wait and see. He thinks we're catching it very early and have time.

Questions.... Has anyone seen numbers like this at the early onset of Hashi's? Is waiting and seeing the course of action commonly taken at this point?

2/2/05:
TSH: <0.01 (0.35-5.5 mcIU/mL)
Free T4: normal
Free T3: normal
TSI: normal

1/12/05:
TSH: <0.01 (0.35-5.5 mcIU/mL)
Free T4: high normal
Free T3 high normal
TPO Ab: > 70 (0-2 IU/mL)

Thanks!!

 
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Old 02-14-2005, 04:36 PM   #2
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Re: Hashi Diagnosis with these labs?? Input Please!!

That sounds a lot like Graves' to me. If you were not having a particularly Hyper episode, your TSI antibodies might not have been flaring during test time, showing normal. It does not necessarily mean you do not have Graves'. It could have been the case that your antibodies were not flaring up when you happen to give blood.

You need to retest your TSI during a hyper episode and get a sono to see if you have nodules causing the hyper. Hashi's doesnt usually give you prolonged hyper....you toggle back and forth usually between hyper and hypo.

 
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Old 02-14-2005, 05:34 PM   #3
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Re: Hashi Diagnosis with these labs?? Input Please!!

I don't have nodules. There was an ultrasound ordered by my primary doc already that didn't yield anything interesting.

He feels that with the current level of TSI that I have Hashimoto's - not Graves - and the thyroid destruction process is just beginning. He says that during the early phase of the thyroid destruction process, there can be a release of stored thyroid hormone, resulting in hyperthyroid symptoms and lab results. But the immune destruction of the thyroid eventually leads to an underactive thyroid in most cases and I'll probably eventually require thyroid hormone supplementation. In the meantime he'll just treat the fluctuations as appropriate...

Text book western medicine? Or the truly the only game plan available? Hmm.

Last edited by bulldog101598; 02-14-2005 at 05:34 PM.

 
Old 02-14-2005, 06:25 PM   #4
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Re: Hashi Diagnosis with these labs?? Input Please!!

Tough call. I too have fairly clear hashi's with antibodies through the roof. I too go hyper at times for a few days, but always go back to hypo eventually. Most I was ever hyper was like 9 days in a row. He could be right. Hashis is difficult to diagnose for certain cause test results fluctuate so much. The thing that gets me with your labs is that there is no hypo phase shown, which is odd for hashi. For instance, in a given week my TSH can go from 5 to 15 to 7 back to 16. Something like that is more indicative of hashis. For you, it seems your TSH is always supressed which is more indicative of Graves', or at least the early stages of graves.

You might just need to hang tight and see where the chips eventually fall for you. It took me about 9 months of hell before my thyroid decided to go one way or another...now, Im finally mostly hypo.

 
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