Graves or Hashimotos, confused and depresses

[Mstiles]

Hello again everyone,

Please see my previous post with thyroid panel numbers, Thanks you

Here are my antibody and vitamin levels:

Antibody ranges are the same

AUGUST 2: TSI: 267 (122%), TPO: 16.2 (0.0 9.0 iu/ mL) Thyroglobulin 4.2 (0.0 - 4.0 iu/mL)

OCT. 6: TSI: 154 TPO: 26.5

NOV. 5: TSI: 251 TPO: 19.80

[Clutter]

Mstiles,

There's really not much point in retesting thyroid antibodies. You have a confirmed diagnosis of Graves and that isn't going to change even if your hyperthyroidism eventually goes into remission.

TPO and thyroglobulin antibodies are also positive and denote Hashimoto's. It is not uncommon to have Graves and Hashimoto's in tandem.

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

[Mstiles in reply to Clutter]

Thank you Clutter. So how in the world is this treated if you have both and confusing symptoms that seem to fluctuate?

[Clutter in reply to Mstiles]

Mstiles,

Although you have antibodies for both you are hyperthyroid and it is the hyperthyroidism which is being treated with Carbimazole. Thyroid levels determine treatment, not symptoms.

[Mstiles in reply to Clutter]

So to get the levels that are recommended here to feel good, (I.e TSH near 1.0, T4 and T3 near the top of the range) it is done by tweaking my Methimazole dosage? My endo says TSH 4 “is a good number”. She’s not helpful, but I’ve found a new integrative MD who will be better I think. Thanks for explaining Clutter.

[Clutter in reply to Mstiles]

Mstiles,

I think most people will feel very hypothyroid with TSH 4 because FT4 and FT3 will usually be low.

Although hypothyroid patients taking Levothyroxine generally aim for TSH 1.0 or lower with FT4 and FT3 in the upper range I think you, as a hyperthyroid patient and >70, are likely to feel well with TSH 1-2 and FT4 and FT3 mid range to upper third of range. The thyroid levels should only be used as a guide, not a target, balanced with improvement or disimprovement in symptoms.

[Mstiles in reply to Clutter]

Thank you Clutter for helping me understand. As I’ve learned on here a lot of endos are clueless. I had to ask to reduce it to 5 mg, and then on my own I went to 2.5.