Is there a difference between Hashitoxicosis and Hashimotos?
Is there a difference between the two? If so, what is it?
I am trying hard to understand everything I need to know about the thyroid.
Does Hashitoxicosis mean that you have BOTH Graves and Hashimotos? And if I understand correctly, Hashimotos will eventually win the battle and leave the person with hypothyroidism as their tissues/cells have been killed off.
Re: Is there a difference between Hashitoxicosis and Hashimotos?
Given I have both Hashimoto's and Graves, and lived through this HADES... I will bite and give my 2 cents here.
By definition: Hashitoxicosis is an autoimmune thyroid disorder that is being recognized more and more. However some MDs refuse to acknowledge it at this time. This disorder I will label HTC is in which individuals with autoimmune hypothyroidism (Hashimoto's thyroiditis -HT ) experience intermittent or sporadic periods where they also have symptoms of hyperthyroidism. These sufferers can be described as having both HT and Graves' disease if the antibodies associated with both diseases are present.
How does HTC manifest? Well it can be complicated, but the disease process in focuses around the thyroid cell destruction and periodic thyroid tissue stimulation. Thyroid peroxidase and thyroglobulin antibodies cause thyroid cell inflammation and destruction. As thyroid cells die, their stored supplies of thyroid hormone (T4) are suddenly released into the blood circulation. These sudden bursts of thyroid hormone are responsible for the fleeting symptoms of hyperthyroidism. It makes medicating difficult, often a patient thinks that they need to have their medications adjusted and they suspect that their thyroid medication is too high. On other days, when they're dragging, depressed and experiencing weight gain, they suspect that their thyroid hormone replacement dose is too low. It is a sucky thyroid roller coaster.. but that is the Hashimoto's component to this issue.. what if you have the Graves antibodies as well? How do they play in the game?
Blocking TSH receptor antibodies, Thyroid binding inhibiting immunoglobulins (TBII) and thyroid stimulating immunoglobulins (TSI or stimulating TSH receptor antibodies) that are present as have one purpose. They trick, fool, and expect the thyroid to make more T4 and T3 for release and use in the body. Well how is this bad? How does this play well with Hashimoto's? It doesn't. Increasing the tissue TPO and TG activity to increase T4 production and shipment ticks Hashimoto's TPOAb and TGAb off big time. They increase and have to work harder to kill off that which they consider dangerous and foreign invaders. As a result your periods of hyperT due to reserve T4 release become more dramatic and violent.
All in all if you have TSI, TRAb, TBII and TPOAb and TGAb you are in for a long ride. Your thyroid is a battle ground and your body will have to hand the fall out. You will have to watch your Ft3 and Ft4 levels like a hawk and treat your resultant symptoms accordingly. This tends to mean managing each separately. I have to treat heart issues with a short lived beta-blocker. I also had a standing order of prednisone to take and suppress my immune system when the war between hyperT and hypoT got to difficult. It's not uncommon in one's lifetime to have HT, GD, primary myxedema and Hashitoxicosis manifest and be dominant at different times. My GD was dominant during my pregnancy.. then HTC took over, now I am pretty much HT. I did enjoy many a day with myxedema.. and that sucks as well. It is all controllable and treatable. You just have to stay up on your own care and not let an MD ignore your issues as they arise. In the end Hashimoto's will win because it will see all thyroid tissue destroyed.. no matter what. Graves antibodies and effects depend on having living functional thyroid tissue. If there is not thyroid the antibodies sit and twiddle their psuedothumbs.
MG
__________________
If we learn by our mistakes, I am working on one hell of an education.
Re: Is there a difference between Hashitoxicosis and Hashimotos?
MG,
I'm assuming you've had an ultrasound of your thyroid. Out of curiosity, is your thyroid shrunken? What I mean is, were you told you had a very small thyroid?
Re: Is there a difference between Hashitoxicosis and Hashimotos?
I have Hashimoto's but not Graves. I have something else affiliated called chronic urticaria. You sound like you know a lot about the thyroid so here is my situation, maybe you can put your two cents in...
I am euthyroid. I have 450-550 TPO AB, have been on synthroid since January in an effort to suppress thyroid. My urticaria leads to angioedema (massive swelling) that leads to anaphylaxis, if I am not on massive amounts of antihistamine. My consequent treatment should be immunosuppressants, but I am against that route.
I met with a surgeon to have my thyroid taken out. They would like to wait longer to see if the synthroid helps. I have been on 100 mcg's so far, kind of aggressive, and they are getting ready to lower it because my TSH has fallen to 0.05.
Instead of this hyper to hypo, hives/swelling/, I am opting to have the thyroid removed, but all the endos/specialists want to wait. This would be a publishable case study because of the tie in between urticaria and thyroid. Am I nuts for wanting it out?
Re: Is there a difference between Hashitoxicosis and Hashimotos?
Hashihelp I feel your pain. I am 100% Hashi with outrageously high antibodies and a TSH of 43 currently (it was 60!!). I was put on 75 mcg of Synthroid and after 6 weeks I began the hyper swing. I wasn't clinically hyper, of course, but I had the shaking, trembling, heart palps, arrythmia, etc. Doctor lowered the dose to 50 mcg. Well I guess at some point while on the 75's my own poor dying thyroid sputtered out some hormones and now it must be on vacation or the antibodies are winning the war. The 50mcg don't seem to be enough - I'm exhausted, itching like crazy, my eyes are swollen, etc. I asked to be raised to 62.5 mcg, but the endo wants me to stay on the 50's for the next 5 weeks until my next blood test. Well that seems pretty dumb to me if I'm suffering from hypo symptoms. I went to her BECAUSE I was experiencing hypo symptoms. I understand she wants a baseline, but my last blood test was based on 75 mcg of Synthroid, so she has a baseline. That's what annoys me to death about most endos - they go by the numbers and not the symptoms. My Free T4 is mid-range, which is good, but my Total T3 is low and hasn't budged. I can't get her to give me anything with T3 in it because she claims I'll go "hyper symptom" again. I give up! I don't carry the Graves' antibodies (I had my TSI tested....at my insistence). It's just the swing between when our dying thyroid spits out hormones and when it doesn't. It's the worst experience of my life. I'm gonna call again tomorrow and ask about either an increase to 62 mcg or something with T3 in it. That is, if I can stay awake long enough to make the call.
Last edited by Scootersmom; 04-15-2009 at 06:31 PM.
Re: Is there a difference between Hashitoxicosis and Hashimotos?
Hi Alexa,
There are some great minds helping you here, including my hero, MG. (MG has been a great help to me.) I thought I would add the little bit that I was told by my doctor about hashitoxicosis and hashimotos. When I had my first appointment with an endo in December of 2008, I was new to the whole thyroid world. I didn't even know where the thyroid was before November of 2008. Little did I know then, that such a little gland would become a great big part of my life.
I first had pain in my neck, which was truly in my thyroid, I learned. My GP ordered an ultrasound and I was told that I had a multinodular thyroid. I guess that is common with hashimotos. I then had a needle biopsy and did not have cancer but I did have lymphocytes and large cells present (I can't recall the technical name for the large cells right now) Again, both indicative of hashis.
Lastly, I had blood tests. My results were elevated for FT3 and FT4, very low normal TSH. Then I saw the endo. He told me that I have Hashimotos disease, and was now experiencing hashitoxicosis. As MG said, that is when the thyroid is overstimulated and has released too much hormone so you are in the hyper stage. Again, as MG said, the release of too much hormone is due to the death of thyroid cells. Apparently, nodules can burst when overstimulated and I think that was the neck pain that I started with. The endo said that eventually, I would go hypo. I did. Hypo shows in the blood as low FT3 and FT4 and elevated TSH. I am already on 25 mg of a generic Synthroid medication called Levothyroxine. I felt better the first day I took it and have felt better every day since but I am watching it closely. I read that some people can avoid going back to the hyper stage by taking the thyroid pills and I have my fingers crossed.
I guess that the overall disease is called Hashimotos and hashitoxicosis is something that only some sufferers get. Lucky us. I read that it is more rare. Most people with hashis do not go hyper at all, only hypo.
Hope this helps. Good Luck to you! I have learned to shepherd my health because we can be shuffled off unless we make our voices heard. All the best to you in this journey. The boards help a lot....
Re: Is there a difference between Hashitoxicosis and Hashimotos?
I just can't believe that there are so many doctors not paying attention to symptoms, just numbers. I am afraid that it's going to end up with surgery. I get emails from people saying just go ahead and have a TT because it all ends up that way once the Hashimoto's has progressed so much. I am kind of exasperated at this point.
Re: Is there a difference between Hashitoxicosis and Hashimotos?
I noticed that they diagnose us with autoimmune, Hashis or Graves but it seems no one investigates any futher than than. I want to know what CAUSES the autoimmune diseases. I actually have been looking into this, so I can address the root of the problem. I believe mine may stem from chemical toxicity, mercury, candida and possibly some unknown food allergies, perhaps wheat intolerance.....? I want to investigate this further.....
Re: Is there a difference between Hashitoxicosis and Hashimotos?
Alexa, we may never know what causes an autoimmune disorder. Sometimes it is familial. There are a lot of autoimmune disorders out there...rheumatoid arthritis, MS, lupus...causes are not known. I really don't think the medical community cares what causes thyroid autoimmunity if you ask me, but that's just me. BTW, you have described your eye symptoms but have you had the high heart rate and elevated BP associated with Graves along with the multitude of other symptoms like weight loss, anxiety, shakiness, etc.
MKG: Are you freaking serious? As the thyroid dies off it spills T4? Just curious where you found this info because it certainly explains a LOT. It explains why I was in the ER with hyperthyroid symptoms yet an elevated TSH but also high frees and T3 uptake....sheesh. I agree with another poster, you need to go to our appointments with us.
Re: Is there a difference between Hashitoxicosis and Hashimotos?
Yes, I have other Graves symptoms. I lost 10 pounds within 2 weeks, most if it being the first week. I have others, they all came on suddenly. I have to get the to the bottom. I found many causes of autoimmune. In my case I believe it to be from possible chemicals. I plan to embark on a detox of my whole body, I am thinking of finding a naturopathic doctor to help me with it. I don't want to accept that I may be totally hypo without a functioning thyroid at this point.
Re: Is there a difference between Hashitoxicosis and Hashimotos?
Well, since I am a type I diabetic, I was first diagnosed as a type II back when I was 25. At that time, I had elevated antibodies indicating Hashimoto's but they went back down, and it was elevated only a small amount.
After I had my first child, I went from type II to type I. The antibodies, coincidently, were on the rise again, but absolutely euthyroid (normal TSH) and absolutely no symptoms.
I went on like this for years until I moved into a new house that we eventually found out had a mold problem. We found out it had a mold problems because I broke out in chronic hives (urticaria) and my thyroid antibodies went through the roof. I believe that either the stress from the mold toxins on the body (physically) or just the toxin itself ACCELERATED the Hashimoto's.
So in my humble opinion, I believe we are genetically predisposed to autoimmune and it is often something environmental that triggers it. Also, there is the age/time-bomb problem because as we age, our thymus (which plays a part in typing antibodies) shrinks. We have the most protection during childhood. That is why adult-onset diabetes which is triggered by antibodies attacking the isles of langerhans are commonly found in the 20's and 30's (me) and Hashimoto's is commonly found (30's and 40's).
Re: Is there a difference between Hashitoxicosis and Hashimotos?
Quote:
Originally Posted by juner50
MG,
I'm assuming you've had an ultrasound of your thyroid. Out of curiosity, is your thyroid shrunken? What I mean is, were you told you had a very small thyroid?
I have one lobe that is smaller than normal and showing signs of atrophy. The other lobe is inflammed and enlarged and possesses a single nodule.
MG
__________________
If we learn by our mistakes, I am working on one hell of an education.
Re: Is there a difference between Hashitoxicosis and Hashimotos?
Quote:
Originally Posted by Hashihelp
Instead of this hyper to hypo, hives/swelling/, I am opting to have the thyroid removed, but all the endos/specialists want to wait. This would be a publishable case study because of the tie in between urticaria and thyroid. Am I nuts for wanting it out?
No you are not nuts. I went through the hives, swelling and more before getting on T4 supplementation. Now things are manageable. I did take steroids proactively to stave off anaph.. instances. I have hypocortisol output in addition to the hashimoto's. When my adrenal and hashimoto's treatment were both implemented many of the lingering symptoms were fixed. Now even though most of my symptoms are in check now.. if an MD offered to remove my thyroid I would jump at the chance. I have seen how much better my Mom and Aunts got when their MDs finally sanctioned removal of their thyroids. Now I am waiting my turn.
MG
__________________
If we learn by our mistakes, I am working on one hell of an education.
Re: Is there a difference between Hashitoxicosis and Hashimotos?
Quote:
Originally Posted by AlexaIn2006
I noticed that they diagnose us with autoimmune, Hashis or Graves but it seems no one investigates any futher than than. I want to know what CAUSES the autoimmune diseases. I actually have been looking into this, so I can address the root of the problem. I believe mine may stem from chemical toxicity, mercury, candida and possibly some unknown food allergies, perhaps wheat intolerance.....? I want to investigate this further.....
Alexa,
I have Hashi's. My doctor put me on a gluten free diet. She thinks a lot of autoimmune diseases stems from gluten intolerance. I am to stay on the gluten free diet for 3 months. After this time your stomach and intestine linings regenerate themselves and become healthy. Then she says we can reintroduce wheat and see what happens.
Re: Is there a difference between Hashitoxicosis and Hashimotos?
Quote:
Originally Posted by sparkie
Alexa, we may never know what causes an autoimmune disorder. Sometimes it is familial. There are a lot of autoimmune disorders out there...rheumatoid arthritis, MS, lupus...causes are not known. I really don't think the medical community cares what causes thyroid autoimmunity if you ask me, but that's just me. BTW, you have described your eye symptoms but have you had the high heart rate and elevated BP associated with Graves along with the multitude of other symptoms like weight loss, anxiety, shakiness, etc.
MKG: Are you freaking serious? As the thyroid dies off it spills T4? Just curious where you found this info because it certainly explains a LOT. It explains why I was in the ER with hyperthyroid symptoms yet an elevated TSH but also high frees and T3 uptake....sheesh. I agree with another poster, you need to go to our appointments with us.
I am always serious! Even when i am tripping in the land of Oz. Yes destruction of a thyroid tissue cell results in the release of any stored and retained T4 and T3. Normally in a 80:20 respective ratio.
Alexn,
There are many sources of AI development the MAJOR cause in thyroid AI triggers are hormone fluxes. There have been many academic studies on this as well. Conclusions they can not say what is the main trigger, but statistically the dominant triggers for thyroid AI activation in females are puberty, pregnancy, and menopause. Some suspect BCS can have an effect because these simulate a psuedo pregnancy state in the body to fool you into not ovulating, but this has not been confirmed yet... Next major trigger set irradiation. Third on the list MONO.. your good old kissing disease... this is the virus cause of choice. There are some rarer cases of chemical exposure.. normally of the radioactive variety, and bacterial infections that may have activated TAIDs.. but these are inconclusive when family history is taken into account.
One well known fact is thyroid AIs have a strong family dominance ESPECIALLY in the females. You have an 80% chance of passage of a thyroid AI from mom to daughter.. mother to son there is a 20% chance of passage. Why? Supposition is that males experience fewer triggers hormonally. They have puberty and.. humm.. well no pregnancy or meno.. so you are left with environment and viral triggers. In many cases Mono...
So what was your trigger you have to case back 2-5 years prior to your onset of symptoms and see what was about. My family pregnancy is the trigger. The first may not get you, but the second one is a guarantee home run. I had Mono 3 years before my pregnancy.. so I can not say for sure which activated my Hashimoto's/Graves BUT my pregnancy sure as HECK woke it up and shook me like my dogs old chew toy. Felt about like that ratty thing too.
So I try not to fixate on the source.. because I can always blame my mom and dad.. and their mom's and their mom's mom's.. but then you start accusing dead people and that gets touchy. So I blame my genes and focus on living with it to the best of my ability and making sure that my son and any future children I may pass my defective genes to are aware and followed closely.
MG
__________________
If we learn by our mistakes, I am working on one hell of an education.
Re: Is there a difference between Hashitoxicosis and Hashimotos?
MG,
Thanks for the response. I was curious about the size of your thyroid because we share a lot of symptoms though I think mine are more pituitary related. I was wondering if yours was small (atrophied) because the few ultrasounds I've had they ALWAYS remark that it's the smallest stoniest thyroid they've ever seen and I've had the US done at different places!
Re: Is there a difference between Hashitoxicosis and Hashimotos?
Juner,
I know you asked MG this, but I wanted to chime in here about the small thyroid.
The doctor mentioned to me that my thyroid was small, which confused me because everything I had read and seen and heard was about thyroids that enlarged and goiters and such. So, I finally found something about Ord's thyroid disease where the thyroid decreases in size. It is actually more common in Europe than the U.S. I thought I would share that in case you had never heard of Ord's.
Re: Is there a difference between Hashitoxicosis and Hashimotos?
One side of my thyroid is smaller (with cysts) and the other enlarged with one nodule. My first episode of thyroditis was after pregnancy, and then again after bad Mono at 46 years old. Yeah, I guess that is kind of late in life but I teach little kids and probably got it there. Did not know what what wrong. I call it my $2000 Mono from all the tests run when I actually had a $10 case of Mono. At least we found out my liver was OK. On paper I looked like a closet alcoholic.
Miserable today, swollen neck and pain. Ringing ears, very annoying. Woke up with screaming headache. My gland is apparently kicking out T4 because of symptoms and this usually lasts about 2 weeks. I called new endo yesterday, he was out of office but nurse said she would tell him Monday that I am miserable. We will see how he handles this and decide whether or not he is a keeper. I have had an ENT that said he would remove the thing - but thought meds might help, try one more time. Did not get any meds at office visit last month and I don't think this doctor will be open to Armour.
Re: Is there a difference between Hashitoxicosis and Hashimotos?
To those with both Hashimotos and Graves, thyroiditis, Hashitoxicosis (they are all the same thing, right?)
My question is: How long do your flare-ups last?
I am just beginning to identify, but I am hyper all the time, always with the achy/pain in my eyes. I think I had one flare-up/inflammation of a few days and then last night, I had some inflammation. I can tell because that is when my throat feels "sick" and my lymph nodes are inflammed, but I am not sick otherwise. Is this typical of what happens during the periods of flares?
How long does it take for the thyroid to be killed off naturally by Hashitoxicosis?
Is there a difference between Hashitoxicosis and Hashimotos? 
Even when i am tripping in the land of Oz. Yes destruction of a thyroid tissue cell results in the release of any stored and retained T4 and T3. Normally in a 80:20 respective ratio.
