What is a Hashimoto's Flare?

[bessygo]

I keep reading about a Hashimoto Flare? What is that?

My levels on 75 mcg Synthroid, 2.5 mcg T3

TSH 1.04 (.40-4.5)

Free T4 1.3 (.8-1.8)

Free T3 3.1 (2.3-4.2)

Total T3 95 (76-181)

TPA Antibodies (Hashimoto) : 78

[greygoose]

A Hashi's flare is what happens when the immune system launches an attack on the thyroid gland.

As the cells of the gland die off, they dump their store of hormone into the blood, causing levels of FT4 and FT3 to rise steeply - FT4 to somewhere like 30 - 40 and FT3 to around 12 - and the TSH therefore drops to unreadable.

This causes your doctor to announce that you've 'gone hyper' - or even that you've 'abused' your meds! - but it's not true hyper, because the gland isn't over-active, quite the contrary. Once the excess hormone has been used up or been excreted, levels will fall to hypo again, only more hypo than they were before, because there's now less gland to make hormone.

This swinging backwards and forwards to 'hyper' then hypo - with sometimes a long euthyroid period in between - will continue until the thyroid is totally destroyed and can no-longer make any hormone at all. Which is why I prefer to call it a Hashi's 'hyper' swing, because that's more descriptive of what happens. If you call it a 'flare', people tend to confuse it with a 'flare up', like you might have with arthritis, where the symptoms get worse. Whereas with a Hashi's 'flare', hypo symptoms go away and aren't always replaced by hyper symptoms. Some people actually feel better.