Thyroid UK
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How quickly can you go to Hyper to Hypo and the related symptoms

I was diagnosed with Hyperthyroidism and put on 20mg of carbi daily . After 5 weeks the dose was halved as I was going slightly hypo and then I was told to stop altogether a week later after a further test showed i was going even more hypo. I`m confused with the symptoms. I still feel a few of my hyper symptoms returning since halving the dose , yet my consultant is concerned with some of my hypo symptoms (constipation, fatigue, aches and shortness of breath ) ..Is it possible to have symptoms of both ? and what could be causing the very sudden and rapid change.? Still waiting an anti-body test ( which takes 3 weeks)

7 Replies

I'm in no way a medic but have a look at the various forms of thyroiditis. I had/have subacute thyroiditis. To begin with I was hyper and put on carbimazole like you, then became very hypo (tsh jumped up to 20 odd) and now beginning to get 'normal' results back. This began end May/June to give you an idea of time frame. Antibodies in this case are normally negative as indeed mine were. It's pretty rare but hopefully your doc has given it some attention. Good luck with it. Keep getting regular bloods done - it wasn't until I had them done that I knew I had gone underactive. Like you I still felt hyper a lot of the time...


Hi Jackgood63

Fluctuating dramatically between hyper and hypo symptoms is a classic sign of autoimmune thyroiditis (Hashimoto). It really is very normal and your doctors should be aware of this and explain it to you in detail. Sadly, many patients get told they are bi-polar and get sent to the shrink and put on anti-depressants…

A gist of what’s happening, in non-academic language is this: the immune system has got confused and, rather than set out to attack dangerous foreign invaders who are putting your health at risk, it has chosen to attack your thyroid gland (it thinks it is an enemy, when in fact it isn’t). So it starts to create antibodies which attack your thyroid gland. These antibodies are chewing up your thyroid gland and gradually destroying it. As a consequence, the thyroid gland starts to struggle and to produce less hormones (there you start getting your HYPO symptoms). But whilst there is some life left in the gland, it fights back best it can and continues to produce hormones with great effort. Every now and then, given the antibodies are chewing up thyroid tissue, there is a sudden “rupture” and suddenly there’s like an “explosion” of thyroid hormone dumped into your blood stream (that’s when you suddenly get your HIPPER symptoms)…. So instead of the scenario you get when the thyroid is healthy (it gradually gently releases the right amount of thyroid hormone into your blood stream) what you have is a gland under attack, completely stressed out, unable to produce the right level of hormone and releasing what little it can produce in the form of uncontrolled sudden explosions that overwhelm the system…. So yes, it is normal to feel generally HYPO and have moments of complete sudden HYPER outbreaks… The more frequently you fluctuate between one state and the opposite, the more violent the battle is taking place (the wilder the autoimmune process is taking place). In the end, generally the antibodies win the battle (sadly) and the disease stabilises in the form of constant HYPOthyroidism, once the thyroid stops to produce thyroid hormone altogether.

If your doctors haven’t done so already, I would recommend you ask them to do a thyroid antibody test (check both TPO antibodies and anti-thyroglobulin antibodies) to confirm autoimmunity is going on (which it most likely is). Labs in this country don't always agree to test, and when they do, they often only test for one type of antibodes (TPO) which is wrong... Generally doctors don’t bother with this test as they do not have a clue on how to address autoimmunity, so why test for something you cannot treat? If at all, all they care about is providing hormone replacement... Obviously in the above scenario, it is very difficult to get the treatment to work well until the thyroid gland completely dies and the “explosions” disappear (how do you medicate someone who is hypo in the morning and hyper in the afternoon?)... or unless something is done to stop the autoimmunity.

Alternative approaches to medicine DO know what to do about autoimmunity, there is a lot of information on the internet, such as and It is all in the gut!

I wish you all the very best!

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I have been diagnosed hyper and put on 10mg Carbimazole daily since 5th November. This is for the second time and I also have symptoms of hypo thyroid, such as weight gain and feeling the cold, extreme tiredness and lethargy. Everything is a big effort for me just now! I had a blood test yesterday so await results and I will be monitored regularly with blood tests and have my medication adjusted accordingly. Its hard to remember what "normal" was for me anymore so I take each day as it comes. It does help to read other postings and know I am not suffering on my own.

I hope that you will begin to feel a little better before very long. Good luck. xx


Thanks for the advise everybody . I will wait the results of my antibody test ( This is the one he sent to a special lab , so i`m guessing it's the most accurate one ) I have blood tests every 2 weeks and my hospital consultant phones me after each one and see's me every 4-6 weeks . I think he's thinking along the lines now of subcute thyroiditis and not Graves which he originally thought . Hashimoto's has not been mentioned to me yet - so best thing is too wait and see and will let you know the results . Thanks again .


I'll be interested to hear how it pans out! Haven't bumped into many people with subacute thyroiditis!


Yes my Endo's diagnosis is Dr Quavain's thyroiditis ( subacute ) !! so happy it's not Graves as first suggested :-)


Relieved for you that it isn't Graves or hashis :D Hopefully you'll be on regular blood testing. Are you on any thyroxine for the hypo? Feel free to message me at any point but hopefully it'll pan out smoothly for you. Make sure you keep dosed up on vit c/fruit etc - my immune system has been a complete waste of space since the thyroiditis...


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