Hashi flare up

[flo-jo100]

Hi, I’m a bit confused! When you have a Hashi flare can you be hypo or hyper?

[greygoose]

Hyper.

I don't like the word 'flare', it gives the wrong impression. I think it's much clearer to call it a Hashi's 'hyper' swing. Because that's exactly what it is. It happens when the immune system releases lymphocytes to attack the thyroid, and the dying cells dump all their stock of hormone into the blood at once, causing levels of FT4 and FT3 to shoot up suddenly. It's not true 'hyper', because it's not the gland being over-active, but you can still get the same symptoms as being hyper. Although not everyone does. And, eventually, the levels go down by themselves as the excess hormone is used up or excreted. So, you swing back to hypo, but more slowly. And, sometimes you can stay in a euthyroid state for quite a long time before going hypo again.

[flo-jo100 in reply to greygoose]

Ah ok. Well I’m definitely not hyper my temperature and pulse slow. I feel awful! My Endo raised my ndt dose to 2.5 grains 3 weeks ago but I could feel this coming a few days ago. Feel more hypo than before raise

[greygoose in reply to flo-jo100]

Which is why it's not a good idea to call it a Hashi's 'flare', because people confuse it with a 'flare up', when symptoms get worse.

By how much did your endo raise your NDT? What were you taking before? How are your nutrients - vit D, vit B12, folate, ferritin?

[flo-jo100 in reply to greygoose]

Vitamins all good. He raised me from 2 1/4 to 2 1/2

[greygoose in reply to flo-jo100]

Good, that's not too much. When are you getting your next tests done?

Being stressed for a week won't make you feel any better, that's for sure, but might not be the sole cause of your symptoms. Did your doctor test you before raising the NDT?

[flo-jo100 in reply to greygoose]

Yes he did my t3 was near top of the range but my t4 was still quite low. I just had enough room for a 1/4 grain raise but I am keeping an eye on bp and temperature. Thanks for your help Greygoose

[greygoose in reply to flo-jo100]

If your FT3 was near the top of the range, you could now be over-medicated. Raising NDT because the FT4 was low is the wrong way to go about things. The FT4 is more than likely going to be low when taking NDT, because the T3 lowers it. And, for most people, that's ok. If you do need to raise the FT4, it's more usual to add in some levo, because increasing the NDT is going to raise the FT3 more than the FT4.

July is nearly 3 months away. That's too long. Retests should be done 6 to 8 weeks after a change of dose.

[flo-jo100 in reply to greygoose]

He did talk about adding Levo to the mix. I’m going to retest myself at 6 weeks and see where I am. Wouldn’t my bp be higher and my temperature if over medicated?

[greygoose in reply to flo-jo100]

Not necessarily, no. Good job you're going to retest yourself. A lot can happen in 3 months.

[flo-jo100 in reply to greygoose]

Yes that’s what I thought

[flo-jo100 in reply to greygoose]

Oh forgot to say he doesn’t want to see me till July

[flo-jo100 in reply to greygoose]

I have been quite stressed the last week work related wonder if that’s the cause.