Thyroid UK
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Hashimoto's & Graves Disease

Hi I am new to this site and looking for some help and advice. I first saw my endocrinologist with a TSH of 9 - I was put on 75mcg thyroxine which has been gradually reduced to 50mcg, 25mcg and stopped 2 weeks. Initially once the thyroxine kicked in after 6-8 weeks I was feeling much better. The reason for the thyroxine being stopped was my T4 which has raised to what I believe is high currently 31.8! So the endocrinologist has diagnosed both ends of spectrum Hashimoto's & Graves. Also have high antibodies! This has significantly impacted my fertility. I'm feeling scared......have all the symptoms of Graves currently toxic. I had a thyroid uptake scan on Friday so waiting for the results. Also been prescribed Propranolol but trying to ride the symptoms out! Treatment options discussed - surgery- not keen on this, further medication which may not work & take along time - this is not an option due to fertility reasons or radioactive iodine - this means fertility being on hold for 6 months! I'm just worried that I have gone from one end to the other since March! Could the thyroxine have pushed me to Graves' disease? Any help would be appreciated.

Thank you.

4 Replies

You very likely have Hashimotos and Graves together as my husband did only the idiots failed to recognise it

Whatever you do don't accept RAI and if you do have both then sooner or later they should cancel each other out but meanwhile you may have to treat yourself on symptoms

What you will not like and must realise is that this will now seriously affect your chances of having a child free of thyroid disease

We have 2 daughters and 6 grandchildren and only 2 of that lot are free of Hashimotos at the moment and 1 has Aspergers which is linked and another is Coeliac and 3 are gluten sensitive


Roxychick, Levothyroxine was appropriate with TSH 9. Although Levothyroxine will overmedicate when entering a hyper phase, it won't have caused Graves, or triggered a hyperthyroid phase. Hashimoto's can cause Hashitoxicosis, a transient thyrotoxicosis (hyperthyroidism) in the early days as it destroys thyroid cells which dump excess hormone into the blood. The thyroid uptake scan should determine whether or not Graves has caused the hyperthyroidism.

Propranolol will not only slow a racing heart and reduce anxiety caused by high FT4 and FT3 but will also reduce thyroid production.

Autoimmune disease is widely thought to start in the gut, triggered by gliadin in gluten. 100% gluten free diet can be helpful in reducing autoimmune flares and antibodies.

I think it will take some time to stabilise thyroid levels with medication, if it is an option, and it will take several months after thyroidectomy or RAI, which will make you hypothyroid, to optimise dose and thyroid levels before conception and pregnancy are likely to be successful.

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Thank you Clutter for your reply! It's so confusing & I just don't know what treatment to have Surgery or RAI! Hopefully my scan results will tell me more!

Very interesting about the gluten free diet, will look into this and will definitely consider eliminating out of my diet. Just find it hard that I have swung from one end to the other. I am wondering if my T4 will reduce if I do nothing for a while?


Roxychick, I wouldn't recommend surgery or RAI yet. You've swung from hypothyroid to hyperthyroid in 6 months. It's possible you will settle in between and be euthyroid for a while. Pregnancy could upset euthyroid status and send you hypo or hyper so you will need to be monitored carefully. Doing nothing is a good option at the moment but you will need anti-thyroid drugs if your T4 continues rising.

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