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  • diagnosing graves/hashimotos thyroid, thyroiditis

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    Old 02-09-2009, 02:23 PM   #1
    tired47
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    diagnosing graves/hashimotos thyroid, thyroiditis

    Hi A!
    ??? for all experts-
    What are the conclusive tests for graves? Can you have normal TSH,T3,T4? What symptom and what tests are definitive for a positive diagnosis?
    And for hashimotos or just thyroiditis??
    Can all your lab tests be negative but a FNA be the only thing that shows Graves, hashitmotos or thyroiditis??

     
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    Old 02-09-2009, 02:29 PM   #2
    Reece
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    Re: diagnosing graves/hashimotos thyroid, thyroiditis

    I think for graves there are tests such as TSI, uptake scans, as well as the usual tsh (very low) free T4, free T3 etc.

     
    Old 02-09-2009, 06:08 PM   #3
    tired47
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    Re: diagnosing graves/hashimotos thyroid, thyroiditis

    can you be hypothyroid, and have both hashimotos and graves( god forbid)??

     
    Old 02-10-2009, 10:17 AM   #4
    mkgb
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    Re: diagnosing graves/hashimotos thyroid, thyroiditis

    can you be hypothyroid, and have both hashimotos and graves( god forbid)??

    YES, I am hypothyroid and hypoadrenal.. but I have Graves and Hashimoto's! Hashimoto's will win out over Graves every time. If you have both in the end you will go hypothyroid. Why? Well Graves works by tricking the thyroid tissue to work overtime in its T4 and T3 production. Now Hashimoto's is different.. it is a bunch of attack squads that wait and watch for thyroid tissue to be activated.. when this occurs, the thyroid tissue is attacked and destroyed resulting in temporary hyperthyroid flares early on. In patients with both Hashi's and Graves the hyperT flares can be excessive. However as more and more thyroid tissue is destroy there is less natural production of T4 and T3 and thus the Graves antibodies become less and less effective.

    My mother and Aunt B1 and I all have Graves and Hashimoto's. Diagnosis of Graves came about through the blood serum tests and iodine uptake scans.. which we proved allergic too..
    I have positive TSI and TRAb.. these are the Graves antibodies. I also have positive TPOAb and TGAb the Hashimoto's blood serum tests. Now the blood tests do give false negatives in some. There is a 30 and 40% Graves tests and a 20 and 40% Hashimoto's tests chance of a false negatives respectively. The only 100 % identifier for Graves is catching an RAI Uptake scan during an active period to coincide with low TSH and High Ft3 and Ft4 levels. The 100% identifier of Hashimoto's comes from the characteristic tissue destruction of the thyroid tissue. Thyroid tissue biopsies are not 100% for Graves identification.

    MG
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    Last edited by mkgb; 02-10-2009 at 10:19 AM.

     
    Old 02-10-2009, 12:14 PM   #5
    tired47
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    Re: diagnosing graves/hashimotos thyroid, thyroiditis

    Mgmbrook,
    Thank you - you are a wealth of information.
    One more question-
    How would your lab values look???

    For Graves, and for hashimotos??
    High T3, High T4, low T3, low T4, with normal or high TSH???
    Thanks again all.

     
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    Old 02-11-2009, 10:25 AM   #6
    mkgb
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    Re: diagnosing graves/hashimotos thyroid, thyroiditis

    tired47;

    Thank you - you are a wealth of information.

    Your welcome.

    One more question-
    How would your lab values look???
    What a question... well it depends on the individuals body chemistry and if the pituitary is functioning properly.. meds and a lot more factors.

    So I will speak of my blood results and those of the females with Graves and Hashimoto's in my family.

    TSH wise we have always been LOW or Normal in range. We never jump above 3 EVEN after a thyroidectomy has been performed. Highest TSH in our family was 2.877 six weeks POST TT. Free T values.. in the tank LOW.. but the pituitary gland doesn't seem to catch on.


    For Graves, and for hashimotos??
    EARLY ON:
    TSH Low/Normal - FTs Normal to High in range.

    As Hashimoto's dominates:
    TSH Low - FTs Low to Low Normal

    When thyroid is 80-100% obliterated:
    TSH Low/Normal - Fts Low

    When you have a hyperT flare due to Graves or Hashimoto's destruction and T4 dumping you tend to get the low/low normal TSH reading and High Normal/High Ft values.

    Note that blood work may not correspond directly to HOW you feel. It takes about 2 weeks for your symptoms to manifest with a change in hormone levels. As a result a steady testing regime is necessary to catch the thyroid hormone fluctuations. When my thyroid destruction was in over drive I was oscillating from hypoT to hyperT on a one-two week basis. It was literally the insane thyroid roller coaster from HADES. Catching the TAIDs early on can be difficult. Your MD has to be willing to test you frequently and THOROUGHLY. In many cases they have to RULE them out. This means blood work alone is often insufficient.

    Good luck in your quest for answers and a solution. I hope that you truly get the care you deserve.

    MG
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    Old 02-11-2009, 10:54 AM   #7
    mkgb
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    Re: diagnosing graves/hashimotos thyroid, thyroiditis

    You kidding?! I am in the last car on the coaster, so I can enjoy getting jerked around. I am glad i don't get motion sick on roller coasters.. Buses on the other hand.. DANG IT! I just trigger the "WHEELS ON THE BUS" Chorus in my head. *sigh* My son will be happy to sing it with me on the way home.

    MG
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    Last edited by mkgb; 02-11-2009 at 10:55 AM.

     
    Old 02-11-2009, 02:57 PM   #8
    queenofbaird
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    Re: diagnosing graves/hashimotos thyroid, thyroiditis

    When you are speaking of Graves or Hashimoto's you are speaking
    of an autoimmune situation. If you suspect this, then the most
    definitive tests will be antibody tests. The doctor can run TPO,
    TBG, and TSH antibody tests. If these are high they indicate
    that you have an autoimmune reaction against the thyroid
    gland.

    There is a video on one of the major internet video sites that explains some things about
    hashimotos disease. A doctor out of Fresno. Go to you the video site
    and search "hashimotos disease", I learned a lot.

    Quote:
    Originally Posted by tired47 View Post
    Hi A!
    ??? for all experts-
    What are the conclusive tests for graves? Can you have normal TSH,T3,T4? What symptom and what tests are definitive for a positive diagnosis?
    And for hashimotos or just thyroiditis??
    Can all your lab tests be negative but a FNA be the only thing that shows Graves, hashitmotos or thyroiditis??

    Last edited by queenofbaird; 02-11-2009 at 02:58 PM.

     
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