Hello. I was been diagnosed with having Graves when I was 3 months pregnant with my daughter 4.5 years ago. I was on meds for a few months and went into remission (where I was off meds and feeling great until last May). I gained 25 lbs in 2 months.
My current symptoms are as follows: weight gain, soar throat, extra dry skin on my legs, constipation, and I feel extra hot all the time.
I recently had blood work that showed the following results, with normal ranges in ():
TSH : <0.01 (0.32-4.00)
T3: 6.2 (3.1-6.2)
T4: 22 (9-19)
Thyroglobulin: 179.4 (<60)
TPO Ab: >600 (<35)
I understand that I have hyperthyroidism, but why are my symptoms that of someone with hypo? If anyone can help, that would be wonderful. Thanks.
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Reign7
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Raised Thyroid Peroxidase and Thyroglobulin antibodies actually confirm autoimmune thyroiditis, aka Hashimoto's disease, not Graves Disease.
Were TSI and TRab antibodies tested when you were originally diagnosed with Graves? If not then it's not possible to confirm that diagnosis.
With Hashi's, this is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results. When the antibodies attack, the dying cells dump a load of thyroid hormone into the blood and this can cause TSH to become suppressed and Free T4 and Free T3 to be very high or over range. These are called 'Hashi's flares' or 'swings'. Unless a GP knows about Hashi's and these hyper type swings, then it's not unknown for a wrong diagnosis of Graves to be given.
The hyper swings are temporary, and eventually things go back to normal. So it sounds very much as though you may have had a Hashi's flare originally and it sent your test results haywire (maybe you had hyper type symptoms).
Having Hashi's means that you can get "hyper" results and hypo symptoms. It doesn't mean you have hyperthyroidism, that's just the nature of Hashi's.
TSH : <0.01 (0.32-4.00)
T3: 6.2 (3.1-6.2)
T4: 22 (9-19)
These results look very much like another hyper-swing.
If I were you, I would be asking for the Graves antibodies to be tested to find out for definite whether or not Graves disease is involved. Some people do have Graves and Hashi's running in tandem.
I think you should ask to be referred to a thyroid specialist - not just an endo who specialises in diabetes (which most of them do), but a proper thyroid specialist because a diabetes specialist doesn't know enough about the thyroid and I doubt will understand what's happening in your case.
Thank you so much for your response. I did blood work 9 months ago, and the results were as follows:
TSH: <0.01 (0.32-4.00)
T3: 4.8 (3.1-6.2)
T4: 15 (9-19)
I saw 2 different endocrinologists concerning my hypo symptoms, and my concerns were brushed of both times. They did not test my antibodies. I have never had them test until I did my own research and insisted that my family doctor test them. I agree, I need a doctor that specializes in thyroid treatment, NOT an endo. After reading up on it, I was so sure that my TSH, T3 and T4 would show that I was hypo....so imagine my confusion in seeing hyper levels. Hhmmmm, Hashi storm....something to research. I feel like I have had to self-diagnose. Thanks so much.
I thought I'd reply as I have had a very similar set of symptoms as you.
I have been suffering from hypo symptoms on and off for many years and I also have a very strong family history of hypothyroidism, but I have been unable to convince a doctor that the symptoms were down to hypothyroidism because all my blood tests came back just within the normals ranges.
Earlier this year I had particularly severe symptoms and rapid weight gain which resulted in me visiting a new doctor at a new practice, I took a list of the symptoms I had been suffering from and she agreed that it did seem to point to hypothyroidism.
I had some bloods taken the next day but as I had waited to see the doctor for three weeks I noticed a change in the symptoms, I had a racing heart, muscle cramps ( and many other symptoms I now realise of hyperthyroidism). As I had waited to see the doctor I had the blood tests anyway.
I was convinced I would be very hypo, but when the results came back they showed the complete opposite, the emergency Dr I saw freaked out a bit and repeated the tests which came back the same, however as I had a private blood test kit at Home I repeated the tests again and within a week the Free T's had come back down into the normal range. The original GP sent further bloods off a week or two later and I was showing signs of hypothyroidism again so I now know that what I had was probably a Hashi's flare. This great GP put me on Levothyroxine and I am now increasing my doses until I feel well and my TSH is around 1.
Had I gone back to the emergency Dr I feel sure that I would have been diagnosed Hyperthyroid based on the blood results and started on hyperthyroid medication pretty swiftly, which would have been the completely wrong medication for me.
I hope you are able to convince your doctor that your symptoms, which you have had for some time are the ones that need addressing and that the blood test results may be result of a Hashi flare, which seem to be quite common.
Seaside susie and others on here are great for helping you to understand what is going on, it always pays to be pro-active about your own condition as many doctors, not all as I have found out, tend to be clueless when it comes to understanding thyroid problems particularly when they are so reliant on blood tests including ones that do not even measure all the thyroid hormones.
As you have posted an exact copy of this post in a new thread, I have deleted the new post as it will be too confusing having both running at the same time.
You can have high TPO and high TG antibodies with a Graves' disease....but if extremely high (as your TPO antibodies are) more likely suggests Hashimoto's
Insist on TSI or TRab antibodies are tested....or order your own testing privately
Thank you. This has been so frustrating. I have been told to go on walks...told that my earlier blood work suggested improvement with my graves...my age was even brought up as a source for my weight increase (I’m in my 30’s). Even after mentioning that my eyebrows were falling out! These comments all from 2 endos. I was diagnosed as having Graves without my antibodies checked!
I will have my GP test for TSI TR ab and those others. What is typically the course of action once diagnosed with hashimoto’s? I just don’t want anything to be overlooked like before. I can’t say just how much I appreciate your comments/help with this.
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