Thyroid UK
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Hashimotos and Graves


Please can someone help me work out what on earth is going on with me!

I was diagnosed as hypothyroid in June. With a TSH of 8.8 (ref range 0.27-4.5). My TPO antibodies were >600. I started taking 50mg levothyroxine and my next blood tests showed a TSH of 0.27.

More bloods were done and I have just found out I have tested high for Thyroid Stimulating Immunoglobulin (TSI Ab), which is indicative of graves.

I feel dreadful.

Could I have graves and hashimotos?

4 Replies

JanVanderhoven, some people do have Hashimoto's and Graves antibodies. Usually only one prevails, Hashimoto's in your case, which has made you hypothyroid. It can be helpful to adopt 100% gluten-free diet to manage Hashimoto's and reduce Hashimoto's and Graves antibodies.

Have FT4 and FT3 been tested?

Vitamins and minerals can be trashed in thyroid patients. Ask your GP to test ferritin, vitamin D, B12 and folate. Low/deficient levels cause musculoskeletal pain, fatigue and low mood similar to hypothyroid symptoms.


I have had all those tested and they are 'normal'..

my TSH was 0.27 and T4 was 18.7. My Vitamin D, ferritin and folate were all normal.

I have been to see an endocrinologist who did the further bloods and found the high level of hyroid stimulating hormone receptor antibodies as well as high TPO antibodies.

My question was could I have both hashimotos and graves disease and my symptoms often swing between hypo and hyper.

My GP says he doesn't understand enough about the thryoid to comment and I have to wait to see the endocrinologist again, which is in 8 weeks. However, with the way I feel at the moment I simply can't function. I have a 9 month old daughter to care for and am currently having to pay someone else too as I cannot. It is very distressing.


Jen, normal is an opinion, not a result. Being anywhere within range is normal, and while that may be okay for healthy people, unwell people need their levels to be optimal. You can feel very unwell with ferritin, vitD, B12 and folate at the bottom of the normal range, supplementing to optimise levels is usually very positive. Post the results if you have them or ask for printouts with ranges from your GP receptionist or practice manager.

Your antibody tests confirm you have Hashimoto's and Graves. See the antibodies link I posted above.

TSH 8.8 means you were hypothyroid in June. 50mcg Levothyroxine has replaced low thyroid hormone and raised your FT4 to a healthy 18.7 which is why TSH has dropped to 0.27. If you were hyperthyroid your TSH would be undetectable, <0.03 anyway, and FT4 would be elevate over the top of range.

It is likely the Hashimoto's which is causing you to swing between hypo and hyper. When the thyroid gland is attacked cells are damaged and killed off. As the cells die off they dump hormone into the blood which can make you feel hyper. In the early days FT4 &/or FT3 may be elevated (transient thyrotoxicosis) but for the most part bloods don't reflect high FT4 or FT3 but the hyper symptoms are nevertheless experienced.

A lot of people are convinced autoimmune disease is related to poor gut health and gluten is seen as a villain. That's why gluten-free is recommended. Improving gut health can reduce Hashi flare ups and may reduce Hashi and Graves antibodies.


My folate was 15

my ferrtin was 21

my b12 was 441

my vitamin D was 71

sorry i dont kn ow ranges, but was told they were all normal

any suggestions???

The british thyroid foundation gave me this response:

''Dear Jen

There is no reference range for the antibody tests, see: . The GP would look at the TSH result to determine treatment. Your TSH of 0.27 is a little on the high side and shows that you are slightly over medicating ( this does not mean that you have Greaves disease [or over-active thyroid]).

If your GP hasn't altered your dose and you are still feeling very unwell you could see him again for another blood test in a week or so, incase you need your medication decreasing. If he has altered your dose you would need to wait 8-12 weeks before a further blood test.

If you were able to see an Endocrinologist privately, it would speed up the process, but you would again need you go through your GP for referral.''

They suggest antibodies dont mean anything as there are no true ranges. And that the presence of them doesnt even indicate hashimoto's, nevermind graves.

I'm getting so many mixed messages and feel so overwhelmed


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