Hashitoxicosis

Hi everyone! I haven't posted for quite a while so excuse my silence!

I have been off of all medication for 6 months now. Doing ok.

I'm still trying to do as much research as I can on what happened/is happening to me. Just to re-cap - about 6 months after having my daughter I began having my hyper symptoms. TFT confirmed this and I was immediately put on Carbimazole before antibody results returned. Antibody tests confirmed HIGH Anti-TPO but nothing else, no Graves.

Within about a month I was euthyroid. I was then consistently hypo. Then put on block & replace and consistently hypo for months until around March/April 16 when I was euthyroid and taken off of medication.

Two blood tests since (albeit last one in July) showing I am euthyroid although both creeping towards the hyper end of the scale, but not by much. (See other posts if interested in the numbers).

What I am trying to work out is whether I had:

Postnatal Thyroiditis (and just happened to be treated for the transient hyper phase because it was so high)

or

Hashitoxicosis - however I can still find little to support the transient hyper phase of this being treated in the same way as Graves.

Any case studies I find on HashiT report a pretty quick transition from hyper to hypo, however my Endo told me that if I relapse I will likely be hyper again. What factors influence this, if any? Timeline-wise, it is just a case of 'some take months, others years'?

My curiosity is around the fact that, when treated with Carb alone and B&R we really struggled to get me away from hypo. I wonder if I would have transitioned to hypo on my own without treatment? Although I understand the big risks involved in leaving a hyper person to bubble up and I am grateful for the treatment.

The initial letter from Endo to GP said that I had Hashimoto's and was thyrotoxic. When the question is put to the GP's they all refer me back to the Endo. When the question was put to the Endo in regards to why I would relapse to hyper he replied 'Antibodies'.

I understand this but it was not really what I was getting at.

I hope that makes an ounce of sense and if not please ask me to clarify any points.

P.S. Sorry for the essay - knowledge is power is my justification :)

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6 Replies

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  • Chloececilia,

    Hashitoxicosis means you had high FT3. As lymphocytes infiltrate the thyroid gland cells are destroyed and dump hormone into the blood causing transient hyperthyroidism. Continued attacks eventually atrophy the thyroid gland until it is unable to produce sufficient hormone and you become hypothyroid.

  • Hi Clutter and sorry for the delay in responding. Thank you. I have read so many times the following in differing formats:

    'NB: thyrotoxicosis associated with thyroiditis is transient and resolves spontaneously. Anti-thyroid drugs are not effective and should therefore be avoided.' - from patient.com

    If the case is Hashimoto's that is not, for instance, transient postpartum thyroiditis, does that mean I will need anti-thyroid treatment for every 'attack' that occurs? At initial diagnosis my FT4 was 39.1 (9-24) and FT3 was 12 (3.5-6.5) so while my FT3 was also above range I suppose it hadn't skyrocketed like my FT4.

    In my case I would have said that the drugs were obviously effective in reducing my thyroid output but in no time I was sitting with a TSH of 73! (I know TSH isn't completely reliable but I can't find the rest of the results for that test).

    I feel I did transition to hypothyroidism on my own and the anti-thyroid drugs just made it plummet. (Possible?)

  • Chloececilia,

    Were you ever tested for Graves antibodies? FT4 and FT3 levels were hyperthyroid which is why you were treated with Carbimazole. You were over medicated for TSH to rise to 73.

    I very much doubt that a Hashimoto's flare would cause FT4 to rise to 39 or FT3 to 12.

  • Hi Clutter, yes, I was tested for Graves and it was completely negative. I am unsure as to whether postnatal thyroiditis could make my levels that elevated also?

  • Chloececilia,

    Yes they could. Postnatal thyroiditis is a form of hyperthyroidism, usually transient, but often needs treatment with anti-thyroid drugs to regulate the thyroid levels. Good news that you are negative for Graves. There is much more chance of permanent remission in the absence of Graves.

  • Brilliant. Thank you Clutter for all your valued advice once again.