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  • Hashimotos to Graves???

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    Old 12-02-2007, 06:21 PM   #1
    AnnMarie36
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    Hashimotos to Graves???

    I'm new here and am desperately looking for some help.

    4 years ago I was diagnosed with Hypothyroid (hashimotos). I had some problems in the beginning and was put on Synthroid but the dose was too high so it caused high and irregular heart rate, tightness in the throat etc. My Dr told me to stop the Synthroid for a day and the symptoms went away. After trying it again and another medicine My Dr finally put me on Armour Thyroid which has worked great for me. I am on the lowest dose and another Dr (Endo Dr) told me I could try going off the med to see if I was ok off it. I've been off it for almost 2 months and I've been fine.

    Here's the problem...

    I started feeling that feeling I had in the beginning like I was getting too much thyroid med but I'm not on it anymore. Does this mean Im going graves? I was at the ER most of the day today and they found nothing wrong. My THC is on the VERY LOW end of normal (.54) which is too low for my body. Again, this is without being on any thyroid medication. I feel awful and they just sent me home telling me it was normal. Even my oxygen level drops when I'm active. Someone who doesnt have this doesnt understand how awful this feels. I feel like someone is holding their hand around my throat. I can't even walk down my stairs without losing my breath. Any suggestions would be appreciated.

    Thank you, Ann

     
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    Old 12-02-2007, 06:49 PM   #2
    mkgb
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    Re: Hashimotos to Graves???

    My mother and her oldest sister have had Hashitoxicosis from the beginning. It is not unusual for this to happen. Hashi's will win in the end, it has the complete obliteration tactic that works in its favor there... it is not uncommon as long as you have any thyroid activity to have hyper/hypo wars. In the case of my aunt they RAI'd it because the Hashi/Graves conflict was causing uncontrollable symptoms and then had to RAI again.. and when it came for a third RAI.. my aunt said something I will not type and told them to hack it out. So now it is gone and she is stabilized on synthroid.

    My mother had to have a partial thyroidectomy to remove the dead growing half.. they left the hyper half and her at the mercy of Graves and Hashi's.. now her partial thyroid has collapsed and she is trying to get treated for her hypothyroidism. Having Hashitoxicosis and getting both diagnosed is rare, because most MDs target the one in dominance or wait until Hashi's has beaten the Graves back by thyroid destruction.

    My old Endo said that it is just Graves which collapses eventually from thyroid over use.. that you can not have both. I had to laugh and say if you have all the Antibodies both Graves and Hashi's how can you refuse to acknowledge both.. this had her back peddling, but she did't change her mind set there.

    The only way to know if it is Graves for sure..
    you have to have the TSI and TRAb antibody run.
    you also need an iodine uptake scan.

    There is a 25% chance that the antibodies will give you a false negative.. but if you have Graves hot zones will be obvious.

    Sincerely,
    MG
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    Last edited by mkgb; 12-02-2007 at 06:51 PM.

     
    Old 12-03-2007, 03:22 PM   #3
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    Re: Hashimotos to Graves???

    I have antibodies for both Graves' and Hashimoto's - and have had episodes of both. It's very hard to keep my thyroid medication regulated because of it. I sometimes need dosage changes 3 times in a year to compensate.

     
    Old 12-04-2007, 05:31 PM   #4
    AnnMarie36
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    Re: Hashimotos to Graves???

    Thank you so much, this is a huge help. I saw my Dr yesterday and when I mentioned "Hashitoxicosis" he looked at me funny like he had never heard of it. He's not a specialist (waiting to hear back about getting in sooner with him). He started asking if I had a sore throat, cough etc. Its very frustrating getting them to understand what this is I guess. He's running a blood test to see how much hormone is running through my blood. I'm sorry I cant remember the name of it. My question is, will that give him the answer to what I'm feeling? Also, when this happens to any of you do you feel a tightening around your throat? I'm feeling it up the sides of my neck and a little under my chin. Its driving me crazy.

    One more question: I know a lot about Hypo but nothing about hyper. Is there a medication they can give me that will increase my TSH level?

    Thank you

     
    Old 12-04-2007, 07:47 PM   #5
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    Re: Hashimotos to Graves???

    You are talking about anti thyroid medication like Tapazol to raise the TSH and lower the T3 and T4 levels in your blood. L-Carnitine is an OTC substance that my Graves Aunt uses to help regulate her hyper symptoms. Palps and rapid heart beat you can get scripts for a beta-blocker... Yes there are medications.

    You can also eat a high fiber, soy, brocolli and cabbage diet. Go low iodine and salt. Hummm.. what else? Bad thing about this diet is the potential to develop groiters. I must admit raising my TSH is something I do not have much experience in forcing however I am trying right now so that my TSH matches my T4 and T3 blood levels. I have just succeeded in making the right side of my thyroid swell and do the annoying lump in my throat thing.

    But yes I have a constant soreness or swelling right at the base of my neck. When it is tight and sore.. I am hoarse and everything feels like it catches down there on the swallow.

    Keep your fingers crossed that my cardiologist can give me a physician to physician referral to the MD of choice for thyroid issues in Chattanooga tomorrow. If not.... I will settle for his IM practice partner. I am curious what my FT3 and Ft4 levels are now, but I am only supposed to check quarterly.. which means wait until January. I am interested to see what the adrenalline study will show me tomorrow.

    Good luck on your thyroid care hunt as well.

    For your MD and his education in Hashitoxicosis.. my MD SIL gave me this definition explaination from her medical references.

    There is a phenomena that also happens quit commonly in hypothyroid patients with Hashimoto’s and it is referred to by the medical term “Hashitoxicosis”. This is an intermittent condition that takes place as the antibodies cause the thyroid gland to slowly die off. As previously mentioned, these thyroid antibodies, the main ones being the “anti-Thyroglobulin and anti-ThyroidPeroxidase antibodies” (abbreviated TG and TPO), are relentless in attacking and eradicating the enemy they have wrongly identified. During this process, thyroid cells do indeed die off and as they do, the thyroid hormone that is stored in these cells, is released into the bloodstream.

    Normally the thyroid releases these stored hormones, into the blood stream, at a rate that is regulated by the pituitary gland, another master gland, that is found in the brain and the pituitary does so, by means of a regulating hormone called ‘TSH”, which stands for “thyroid Stimulating Hormone”. With Hashitoxicosis however, hormone is released at a sporadic rate that is not regulated and as a result, the patient experiencing this, will have spells of mild to severe Hashitoxicosis, despite the fact they are actually hypothyroid.

    These two paragraphs sum up to my war analogy.

    Some patients with Hashimoto’s Thyroiditis, also have co-existing Grave’s Disease (hyperthyroidism), due to also having “TSI” antibodies, standing for “Thyroid Stimulating Immunoglobulins”, which are the antibodies that contribute to Grave’s Disease, the majority of these patients have only one disease or the other active at one time. When a patient does have Grave’s antibodies co-existing with Hashimoto’s antibodies, they may eventually develop into overt hyperthyroidism periodically only to have violent swings or thyroid storms as a result of TPOAb and TGAb flares and attacks. However, if it is a patient with only the antibodies (TPO and TG) causing Hashimoto’s, their intermittent spells of hyperthyroidism, are likely caused by Hashitoxicosis response in dying cells and not by co-existing Grave‘s Disease.

    Basically from what I am reading if you are hypoT and have hyper symptoms be it destruction of the thyroid or co-Graves it is a form of thyroid toxicosis.

    The official med text definition of Hashitoxicosis:
    A form of Graves disease that is easily misdiagnosed.
    Hashitoxicosis is an autoimmune thyroid disorder, in which individuals with autoimmune hypothyrodism, usually Hashimoto's thyroiditis (HT), experience intermittent or sporadic periods where they also have symptoms of hyperthyrodism. In some ways, these patients can be described as having both HT and Graves' disease since the antibodies associated with both diseases are present.


    Sincerely,
    MG
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    Last edited by mkgb; 12-04-2007 at 07:49 PM.

     
    Old 12-05-2007, 02:33 PM   #6
    AnnMarie36
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    Re: Hashimotos to Graves???

    I know all about goiters, I have 4. The racing heart has gone away. The only thing thats really bothering me is this tightness around me throat. I was up at the ER again last night feeling like my throat was closing. I was having acid reflux which I think the hyper is causing because I've never had it before. So that combined with an enlarged thyroid is very uncomfortable and scary. Is L-Carnitine the viatamine I take for my TSH to rise again? I feel that once my level increases a little bit I will feel normal again. I'm sorry for all the questions I just dont understand the hyper side of things and my Dr is doing nothing to help me. I even called the specialist again and no one is getting back to me.
    Thanks for all your help. Ann

     
    Old 12-05-2007, 04:13 PM   #7
    AnnMarie36
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    Re: Hashimotos to Graves???

    Just got my test results
    T4 .53 (.34-5.60)
    T4Free 1.1 (.6-1.3)

    Now I'm really confused. The Dr just called and is convinced its something else but I know its not. I tried telling him I'm too low for ME!! So frustrating.

     
    Old 12-11-2007, 03:42 PM   #8
    AnnMarie36
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    Unhappy Re: Hashimotos to Graves???

    PLEASE someone help me. Since my last post I went to another Emergency room and the Dr there saw a nodule (which I knew I had) and said it was inflamed. My TSH has dropped to .43. I know thats considered normal but for me its too low. My calcium is 10.3, Albumin is 4.8. I've been to the ER 3 times. Seen 2 endo's and none of them are getting it. Im still having this squeezing feeling around my throat that I get every time my TSH is too low.

    Does someone know of something I can take to increase my TSH level.

    I would really appreciate some advice. Thank you

    PS I tried L Carnitine and it didnt make me feel any better.

    Last edited by AnnMarie36; 12-11-2007 at 03:43 PM. Reason: forgot something

     
    Old 12-11-2007, 03:50 PM   #9
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    Re: Hashimotos to Graves???

    You need to get someone to prescribe an anti thyroid drug like Tapazole. The A T Ds are the only thing that just raises the TSH without causing increased chance of groiter growth and such. Cut your iodine intake.. an that will dial back a key ingredient need in the conversion process. What symptoms forced you to go to the E-room. It might be possible to treat the symptom til you drop again. My mother and aunt kept flip flopping until nodes and groiters and general bad behavior of the thyroid resulted in surgical removal of the bad parts.

    I wish I had a better answer for you.
    MG
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    Old 12-12-2007, 06:13 AM   #10
    AnnMarie36
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    Re: Hashimotos to Graves???

    I have had goiters for 4 years. I just found out my PTH is 9.4 (14-72). I cant find ANYONE to help me. They all say Im normal. IM NOT!!!! I just dont know what to do anymore. Thank you so much for all your help.

     
    Old 12-12-2007, 06:49 AM   #11
    mkgb
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    Re: Hashimotos to Graves???

    I just found out my PTH is 9.4 (14-72).

    First there are two factors to consider that can affect the PTH test. Medications that you are on and the time the test was done.
    Drug interactions
    Some prescription drugs affect the results of PTH tests. Drugs that increase PTH levels include phosphates, anticonvulsants, steroids, isoniazid, lithium, and rifampin. Drugs that decrease PTH include cimetidine and propranolol.

    Timing
    PTH levels are subject to daily variation, ranging from a peak around 2:00 A.M. to a low point around 2:00 P.M. Specimens are usually drawn at 8:00 A.M.

    Now what does a low PTH mean? Abnormal results
    When measured with serum calcium levels, abnormally high PTH values may indicate primary, secondary, or tertiary hyperparathyroidism, chronic renal failure, malabsorption syndrome, and vitamin D deficiency. Abnormally low PTH levels may indicate hypoparathyroidism, hypercalcemia, and certain malignancies (normally a benign tumor on the parathyroid - you have groiters in your thyroid.. it stands to reason you may develop one in/on the parathyroid).

    Have they done a targeted scan of the parathyroid yet? Or have they only scanned and looked at the thyroid. Are your nodes hot or cold? I may have given you more questions than answers.. but my knowledge of the hyper side of things is low as well.

    MG
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    Old 12-12-2007, 06:55 AM   #12
    mkgb
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    Re: Hashimotos to Graves???

    Here is an MD that is with in 10 mi of your location that prescribes Armour and thus may be a bit more receptive to open minded thyroid treatment.

    Jehangir Vazifdar, MD - Family Medicine - Meredith

    You can use the Armour physician finder to dig up registered MDs that prescribe Armour. Those that prescribe Armour are a bit more open in practice.. because there was a ten your MD school period where it was taught only synthroid was needed. So those that prescribe Armour think outside of the box.

    MG
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