Thyroid UK
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Tested positive for Graves & Hashimotos

Hi, I'm new to thyroid problems, diagnosed 3mths ago, age 48, British, living in America. I would really appreciate hearing your perspective as I'm not sure what out anything i should be asking my doctor/endocrinologist.

My iodine uptake test shows suggests i have a hyperactive thyroid, but symptoms are mild, maybe because I tested positive for hashimotos antibodies too? Endo thinks they are keeping each other in check. In June this year they also found a few nodules on the right lobe which are >1cm so a second scan will happen in a couple of weeks, maybe resulting in biopsy if there have been changes. I have not been prescribed any medication but i am concerned about these nodules. What experiences have others had??

My blood results are;

Thyroid peroxidase antibody 401 (std range <35)

Free T3 5.08 (std range 2.3-4.2)

TSH <0.01 (std range 0.34-4.82)

TSI, thyroglobulin antibody & Free T4 are within std range

The only other anomaly was increased platelet count in my Complete Blood Cell Count

Should i be requesting other tests or just be grateful that for now i can continue life as normal?

Thank you in advance!

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Cerys14,

TSH 0.01 with FT3 5.08 means you are mildly hyperthyroid. Was Thyroid Receptor antibody body testing done? If not, your TSI is negative for Graves so it is more likely you have transient hyperthyroidism caused by Hashimoto's.

As the lymphocytes infiltrate the thyroid gland cells are destroyed and dump hormone into the blood stream. The hyperactivity doesn't usually last beyond 3-4 months because repeated cell destruction atrophies the thyroid gland which reduces thyroid hormone output.

Hashimoto's causes 90% of hypothyroidism but it may be years before your thyroid levels drop low enough for you to become hypothyroid. Levothyroxine treatment is for the low thyroid levels it eventually causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

chriskresser.com/the-gluten...

thyroiduk.org.uk/tuk/about_...

Most adults have one or two thyroid nodules. It is rare that someone dies without thyroid nodules. They mostly don't affect thyroid levels and 95% of nodules are benign. Nodules are usually slow growing so it may not be necessary to have ultrasound scans more than once or twice a year.

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Thank you Clutter, this was very reassuring feedback and I saved this links to share with my mum who has an underactive thyroid and has been taking levothyroxine for 10years.

I don't think I have had the thyroid receptor antibody test, unless it is known by another name..?

I did ask my Endo on Monday if there could be any other cause of the hyperactivity and she showed me the scan pictures and explained that it was definitely Graves due to the spread of shading due to the iodine uptake. I will ask again at my next appt. I will also be asking her why the summary of my visit online doesn't mention this new diagnosis of Hashi's when it was definitely discussed.

Tbh I am finding this all extremely confusing and her speedy explanations seem to make sense at the time, it is only afterwards I start wondering why I still don't seem to understand!

Thank you again for taking the time to reply.

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Cerys,

I knew that the iodine uptake test determined hyperthyroidism but I didn't know it can determine the hyperthyroidism is due to Graves. I thought antibodies were confirmed by TSI or Thyroid Receptor Antibody tests.

Hashimoto's is incidental if you have confirmed Graves.

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Hi again Clutter,

I went to have my nodules biopsied today and was told they are pseudo- nodules, basically scar tissue and inflammation, due to my hashimotos. I have never been formally diagnosed with hashimotos previously, only graves with the suspicion of hashis. They explained from the ultrasound that my thyroid looks typical of a hashis thyroid and he suspects subclinical hypothyroidism, which is i think what you suspected 2 months ago?! I am due to have blood tests next week, i will ask if they are testing for thyroid receptor antibodies, is there anything else i should ask for? And should i avoid multi-vits before hand too avoid skewing the results?

Once again, THANK YOU for your advice, it is most appreciated.

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