Thyroid UK
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Can I have both antibodies

Morning all. I’m hoping someone can give me some links on having both graves and hashimotoes antibodies circulating at the same time. Latest tests showed both antibodies which is more than puzzling as I was told my thyroid had died years ago. I have had hashimotoes for over 25 yrs. I am currently on 125 mg thyroxine with frees in upper range but tsh at 0.005 . I’m feeling fine but a bit worried as to meds. Many thanks

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It has been reported that those with Graves antibodies (TRAB/TSI) quite often have Hashimoto's antibodies (Thyroglobulin and/or thyroid Peroxidase).

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I have TED and have been tested before but nothing showed up. New endo was puzzled by my plummeting tsh while on same dose as a previous reading of 3.20. I have been under 1.00 since November 17 but no where near this

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I should also say that after having hashies for 25yrs it’s only recently I’ve had graves. I am aware that people with graves often go on to develop hashies but I cannot find anything to guide me the other way around as this is apparently rare.

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It seems people with Graves’ do often become hypo, even without RAI or TT, but it’s less clear whether this is because having had one autoimmune disease makes it more likely you will get others, or that Hashi’s and Graves’ are two ends of a spectrum, or simply that the thyroid gets worn out after regularly being forced to overwork itself due to the Graves’ antibodies. It’s pretty rare to get Graves’ after Hashi’s - or perhaps it usually only gets picked up if people suffer from TED, as if you’ve had Hashi’s for any great length of time, presumably your thyroid would struggle to produce sufficient natural hormone to make you well over-range ?

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Thank you for your reply. My thyroid is supposedly atrophied and has been for at least ten years. No scan has ever been done however. This is my second round of Ted and my antibodies were tested when it first started but no graves detected its only the last year that it showed up. I'm just at a lose regarding the way forward.

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Perhaps the thyroid wasn't as atrophied as they thought - have they suggested a scan? - in which case, this begins to look like a Graves' relapse. By the way, when did you have the RAI ?

They will obviously need to monitor/treat the TED anyway, but it will be interesting to see what they do about your thyroid levels. They might balance out, in which case, for a while at least, you might be able to remain within range without either levo or carbimazole - deep joy :) However, the endo may not be happy if your TSH remains persistently low, although reducing the levo a bit might do the trick with that.

Hopefully they will offer regular testing, and perhaps a scan. It would be interesting to see what your FT3 is doing, although they probably won't test this until/unless FT4 is actually over range.

If you google something like 'graves relapse after RAI', there are some articles etc - some people appear to have relapsed after a lot more than ten years.

Just realised you posted this monhs ago - not sure how I picked it up today, hope it's still relevant !

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No rai. What’s left after the hashies is still there. Looking through lots of links and I appear to be ords. No scan at the moment only a dexa lined up for next month. I’m taking 162 of levo per day and there is no way I could live without it. The treatment is what I want to know about as I don’t think they know what to do with me at the moment.I am being treated for the eye disease and thankfully it looks like it’s working but unless something can be done about the antibodies then I could be going through this as soon as I come off the cyclosporine .in 12 months time.Quite frankly it terrifies me

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Tsh not particularly low either . Apart from the odd results of the last few months it’s always been around 0.86 with ft3 past middle and ft4 top quarter. If tsh rises above 1 I know immediately as I feel so ill.

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Is there a name for this, helvella? And, what effects would that cause, I wonder? TIA.

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Hi there Dee i have both, hashis and graves but you cant have them at the same time-you can have a hashi flare and then a graves flare, not great i know!!

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Thanks Rmichelle that’s interesting to know. I will be seeing endo again beginning of July so hopefully find out more then. How do you manage with meds if you don’t mind me asking and would having thyroid removed stop the graves antibodies. So many questions sorry😐

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Providing there is no thyroid left, having the thyroid removed (or ablated with RAI) stops the Graves’ antibodies from causing excess production of thyroid hormone, however there is still a risk of Thyroid Eye Disease; this seems to be greater if you have RAI, which is why people with TED may be steered towards a TT rather than RAI.

btf-thyroid.org/information...

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If you mean TPO and TRAb, although 90% of those with Hashi’s have elevated levels of TPO, according to Thyroid U.K., the Mayo Clinic and various other sources, so do 65% of those with Graves’.

mayomedicallaboratories.com...

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

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Thank you. Will take a look.

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