Re: Once dx'd, will your thyroid still "die out" or will meds build it up again?
It depends Ö.
It is specifically TPO Antibodies that cause the thyroid gland destruction I think you speak of. These antibodies are associated with hypo, not hyper.
You donít typically go hyper from that process, except sometimes for brief periods of time as the gland is killed off. As the gland gets more and more destroyed, it has less and less capacity to keep up the level of thyroid hormone your body needs. We then take supplemental thyroid hormone medication to make up the difference. But the meds cannot do anything to repair a destroyed gland. Iím not aware of any way the gland can heal itself back into sufficient hormone producing capacity again.
Then only thing even remotely contradicting this would be that if you do have TPO Antibodies, in theory, you can slow down the destruction. If you take enough thyroid hormone medication to suppress your TSH enough, that lack of TSH will be equate to a lack of stimulation to the thyroid gland. This, in theory, lowers TPO Antibody count, and thus slows down the antibody destruction to the thyroid gland. However, Iím not sure this is a favorable scenario, for other reasons.
But this is not to say that if you are hypothyroid, that you have a dieing thyroid gland. There are other possible causes of hypothyroidism. Secondary hypothyroidism is a condition where the thyroid gland may be health, but something else, like the pituitary gland is responsible for the problem. However that condition is quite rare, compared to primary hypothyroidism. Primary hypothyroidism is where the thyroid gland is directly responsible for the problem. There are cases where this is not a dieing gland, but some other issue, usually nutritional. However that is also quite rare in developed countries.
Once your thyroid gland is killed off by the TPO Antibodies, it is usually simply left there, and not removed.
Now, on the hyper side Ė a different type of antibodies, that cause Graveís disease (hyper) Ė often the thyroid gland is either ablated or surgically removed.
Does that answer your questions?
My opinions only, not medical advice. Always follow advice of your Doctor, not what I say here.