Hashimotos advice - fluctuating between hyper / hypo

Dear All

I have posted on here a number of times before. I'm a male, 29, diagnosed hashimotos back in December 2014.

Currently on 112.5mcg Levothyroxine. (Have been at this dose for a few months).

Last bloods -

TSH - 2.33 (0.30 - 5.00)

T4 - 14.1 (9.00 19.00)

T3 - 4.90 (3.25 - 6.21)

For the past couple of months I have been experiencing what feels like a fluctuation between hyper and hypo symptoms.

I'll experience a few days of feeling extremely tired, body will ache, and generally feel pretty lousy. Followed by a number of days of feeling hyper - so more foggy, slightly irritable / uncomfortable, feel hot and will have a bit of a head ache.

And then I'll have a couple days where I'll feel normal in between.

I know hyper and hypo symptoms are similar but for me these two states feel very different. I think fluctuating between hyper and hypo state with hashimotos is fairly common. Anyone else experience this? Is there anything I can do to prevent this from happening? Any thoughts / advice welcome.



15 Replies

Hello Joe86,

You have answered your own question...you are going from hypo to hyper as antibodies attack your thyroid gland and stored hormone is suddenly "dumped" into the blood stream. These attacks will continue until your thyroid gland is atrophied and hormones are depleted....some people months ..some people years... depending on the level of thyroid antibodies.

You can dampen the aggressiveness of the attacks by reducing the level of your antibodies. Many members ( myself included) have found going gluten free to be beneficial. I also supplement theraputic doses of Curcumin which I feel has calmed the immune response further.

Your test results show there is still room for improvement. Many function at their best with a TSH of around 1.0 and T4 & T3 in the upper quadrant of range. Being optimally medicated would suppress TSH and reduce Hashi attacks further.

I hope you feel better soon.




Hi Flower,

Thanks for this.

For a while I was being treated by my GP who had me on 150mcg levothyroxine. My TSH was suppressed at around 0.5. I read(probably on here) that often people with hashis do better with a suppressed TSH so auto immune attacks on the thyroid have less of an affect. Unfortunately I still didn't feel well at that dose(150mcg) so I went to see a private endo who recommended I reduce my dose to 112.5(based on my body weight). I definitely feel better at this dose but I now have to put up with this constant fluctuation between hypo and hyper. Such a nightmare!

Anyhow, will definitely give gluten free a go and will look into the curcumin thing. Thanks for your help.


Oh sorry, I missed the bottom of your note. Yes, I think I could definitely do with a small increase of t4 to reduce TSH a bit. I will take that up with the my NSH endo next time I see him. thanks.

Selenium 200mgs daily, is shown to lower antibodies. Dairy free, is also as important as Gluten Free. But diet is only a part of this, but you could be lucky and this could stop your hashi's. You can do GF for a few weeks and keep note of symptoms, same with dairy, then adding it back in to see if you get worse. For some diet makes no difference.

Joe, your TSH 2.33 is too high for comfort for most people. Many will be comfortable with TSH just above or below 1.0. Read Treatment Options in thyroiduk.org.uk/tuk/about_... A 25mcg dose increase is likely to be sufficient. The lower TSH is, the lower your thyroid activity and this is good for suppressing Hashi attacks which are making you feel hyper and hypo. Overtime Hashi attacks reduce thyroid function so upward dose adjustments become necessary. Gluten-free diet has been helpful in managing Hashi attacks and reducing antibodies for many patient..


Hi Clutter,

Thanks for the info.

Always such a nightmare getting ones GP / endo to agree to changes in dose when you are within 'normal range'... as I'm sure you know. But I will go to my next appointment armed with relevant info.... The trials and tribulations! Thanks again, most helpful.


Joe, email louise.warvill@thyroiduk.org.uk for a copy of the pulse article to show your GP or endo.

Hi joe in exactly the same position as urself it's not nice ive got to the stage I dont know whether I'm hypo or hyper but this is the best place for advice 😁. Hope u get sorted soon with ur dose

thanks. Hope you do too.

Joe I am the same as you at the moment, drives me crazy. it feels that I am my own endo/doctor. There are a lot gps and specialists are unsympathetic or not knowledgeable. We end up suffer further more. Cut the story short, you have definitely to try gluten free. It will help the reduce the inflammation in your body. Certainly my gut issue is less severe and is recovering since I started gluten free and dairy free 9 months ago. Nobody has told me this, only by reading in this site has helped me to find ways to cope with the illness. I wish somebody told me 10 years ago about this. Look after yourself.

Such a nightmare isn't it! Thanks for your message. I've done the weekly shop and I think I'm covered on the gluten free front...

thanks again.

For many, Joe, like me, meds aren't enough to stop symptoms. Hashi's is autoimmune, which means the problem is with you immune system and not your thyroid gland. People are actually going into remission, by diet changes and other methods. Maybe time to look into that. I am.

is that a free t4 and free t3? I hope so! Total shows even less about dosing than free's.

Yes thats free t4 / t3. Well I definitely watch what I eat but I do slip up on the old guten free front every now and then. I need to be more on it! Actually to be honest, going gluten free is good from a health point of view but I find you have to also make more of an effort with your meals(think outside the box a bit, i.e less pasta!), so you end up eating tastier / more interesting food. Thanks the Selenium tip. Will give it a go!

Gluten Free hasn't helped me. I don't think it's healthier not to eat it, if it doesn't cause problems. GF people, become low in b vitamins and get other deficiencies.

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