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Old 05-13-2006, 08:31 PM   #1
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JoanneV HB User
Teenage daughter has Hashimoto's but now hyperthyroid

My daughter was diagnosed with Hashimoto's at age 11. at age 16, her thyroid was producing enough hormones to come off of her synthroid. After about 5 months of being off synthroid, (and now 17 years old) she was having signs of hyperthyroidism. Her TSH is 0.08, Free T4 is 1.5, Thyroglobulin antibodies are 23, Thyroid Peroxidase antibiodies are 140. Her Thyroid uptake scan show markedly decreased thyroid uptake and her sonogram showed a normal sized thyroid. Her doctors are taking their time giving us an answer or treatment. She has trouble falling asleep, has a rash, no menstral cycle for months(and no, she is not pregnant), and is nervous. Is it normal to convert to Graves disease after having Hashimoto's for 6 years? Does anyone know what could be going on?
Thanks,
Joanne

 
Old 05-14-2006, 12:15 AM   #2
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Re: Teenage daughter has Hashimoto's but now hyperthyroid

Quote:
Originally Posted by JoanneV
My daughter was diagnosed with Hashimoto's at age 11. at age 16, her thyroid was producing enough hormones to come off of her synthroid. After about 5 months of being off synthroid, (and now 17 years old) she was having signs of hyperthyroidism. Her TSH is 0.08, Free T4 is 1.5, Thyroglobulin antibodies are 23, Thyroid Peroxidase antibiodies are 140. Her Thyroid uptake scan show markedly decreased thyroid uptake and her sonogram showed a normal sized thyroid. Her doctors are taking their time giving us an answer or treatment. She has trouble falling asleep, has a rash, no menstral cycle for months(and no, she is not pregnant), and is nervous. Is it normal to convert to Graves disease after having Hashimoto's for 6 years? Does anyone know what could be going on?
Thanks,
Joanne
Hi Joanne, That sounds like a huge thyroidal rollarcoaster ride that shes been on. Poor thing. There may be an explanation for the switch from hashimotos to Graves, both are thought to be autoimmune related and so it isnt that uncommon for people to experience both, I have myself.

I had hashimotos thyroid with hypo symptoms but with elevated antibodies, and normal TSH, and then I went hyper for a short period afterwards before I recovered.

Somtimes with hashimotos when the thyroid is being attacked antibodies in the immune system, the thryoid goes into a transient state of hyperthyroid, where excessive amounts of thyroid hormone, T3 T4 get relseaed from the cells within the thyroid, and which circulate into the blood stream making you have hyper symptoms like shakiness, rapid heart rate, nausea, and anxiety, sweating and eye pain etc etc. This usually goes away after the antibodies go down and the thyroid has recovered. Or the body can become hyper for quite sometime before becoming premantly hypo, but this is uncommon.

It can be transient, or permanant, the chances are more likely for them to be transient.

Also, I know its scary and the doctors prob arent giving you the answers you need or else you wouldnt be posting on this forum.

11 is a young age to have thyroid complications, but that is usually around the time of puberty also. Does thyroid illness run in your family?

The best advice I can give you is to keep going to the doctor and watch her for these fluctuating symptoms, keeping track and writing in a journal everyday, or at least the bad days, so you have somthing to show the DR's next time you go in for a visit. And you must keep getting blood tests done including antibody panel for a while, keep track of them. You want them do drop.

Somthing she can do in the meantime is adjust her diet, and go on a low iodine diet. Avoid dairy, white bread, eating out, and iodized salt, that includes processed soups, etc.

The low iodine diet is what drasticly reduced my antibody levels by half, and made me feel better, and if she is brave enough try going gluten free.
Avoiding gluten has helped me so much, the gluten free diet also helped more than anything else and without it, I still may need drugs. But I dont have to take thyroid pills anymore.

Has she been tested for Celiacs also?

Christina

Last edited by christine25; 05-14-2006 at 12:27 AM.

 
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Old 05-14-2006, 11:04 AM   #3
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Re: Teenage daughter has Hashimoto's but now hyperthyroid

Quote:
Is it normal to convert to Graves disease after having Hashimoto's for 6 years?
Nothing is "normal" about thyroid disease, but this scenario does sometimes happen.

Has she been tested for TSI antibodies? Those are the ones associated with Graves'. If she doesn't have them, it's not likely her Hashi's has "converted to" Graves'. It's more likely to be a case of a renewed TPO and Tg attack on her gland in the time the Synthroid was discontinued. That attack can release extra amounts of T4 amid the destruction, causing the hyperactivity. Look up "Hashitoxicosis" on the web. It may be a case of that.

Whatever you do, don't allow her gland to be ablated with radioactive iodine. If she has a good doctor, that recommendation isn't likely to be suggested; but there aren't many good thyroid doctors in the world, so be aware it can happen.

 
Old 05-17-2006, 01:28 PM   #4
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JoanneV HB User
Re: Teenage daughter has Hashimoto's but now hyperthyroid

Christina,
Wow...thank you for the very helpful and much appreciated information. Yes, she has a gluten intolerence and was on a gluten free diet for over a year. She now has small amounts of gluten because it is a very difficult diet to stay on, especially for an Italian-American! She had more lab drawn yesterday and seems to be sleeping better. I think she may be coming out of her hyper state. I am concerned however, that she hasn't had a menstral cycle in so long. When her TSH levels were in the 2-3 range, she had a normal cycle. The gynecologist said that her thyroid was not the problem and, that hypothyroidism causes missed periods (WRONG). The opposite is true....hyper equals scant or absent periods. I KNOW her thyroid is the problem. Mom's get real good at knowing their child's symptoms.

We will limit her gluten and iodine and see if she feels better.

Yes, thyroid disease runs in my family...my aunts have it, but no one ever had it at age 11. I'm sure puberty ignited the disease.

Thank You SO much for taking the time to help a stranger!
JoanneV

 
Old 05-17-2006, 04:37 PM   #5
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Re: Teenage daughter has Hashimoto's but now hyperthyroid

Midwest1,
Everything finally makes sense...after reading more on Hashiotoxicosis, I believe you hit the nail on the head. I am printing up information on this and bringing it in to her doctor. Why couldn't they diagnose this years ago?
THANK YOU!!!!!!!!
JoanneV

 
Old 05-17-2006, 07:22 PM   #6
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K9Mom HB User
Re: Teenage daughter has Hashimoto's but now hyperthyroid

With Graves disease she should have a markedly HIGH uptake scan. (Mine was in the 70's. Normal is less than 30)

Midwest is right, TSI (Thyroid Stimulating Immunoglobulin) is the antibody responsible for Graves disease.

Pituitary problems can cause a low TSH too.

Puberty and all the hormonal changes that go with that can trigger thyroid disease, but her LOW uptake scan really kind of rules out Graves disease.
__________________
Dx Graves 4/99, tx w/Tapazole & Atenolol - Remission 7/03; Relapse 1/06, back on Tapazole, remission & off meds again 11/06.

 
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