Hashimoto spike

[CapnM]

I have seen reference on this forum to a Hashimotos spike, perhaps obvious but can anyone describe this a bit more? Naturally symptoms will vary but are there any common characteristics?

[SlowDragon Administrator]

On your profile you say you are on 25mg Levothyroxine for last 2 years

Do you mean 25mcg (half standard starter dose)

Or 250mcg?

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Have you had thyroid antibodies tested?

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Is this how you do your tests?

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

[CapnM in reply to SlowDragon]

thanks, my wording was probably a bit vague.

Its the 'spike' bit of that sentence I am interested in. Is such a spike a 'thing' or just the way people taking about re-occurring symptoms.

e.g.

Is there a way that Hashimoto progresses that it does so through spikes,

Or are these spikes more likely to be result of deteriorating co-factors e.g. vitmanins.

I may be reading too much into the language it but had seen a few posts use the 'spike' language so thought I would seek more information.

The main objective here is I have started to notice and diarise (sp!) early warning of re-occurring symptoms, obviously symptoms are quite diverse amongst people so I just wondered if there were general characteristics to a 'spike'

yes your right it should be 25mcg - Ill update my profile

thank you

Michael.

[SlowDragon Administrator in reply to CapnM]

Hashimoto's flares are common, especially in early stage as thyroid cells break down suddenly releasing loads of thyroid hormones. This can cause temporary hyper symptoms.... weightloss, rapid heart rate, etc etc

During a particularly bad flare, some patients need to temporarily stop or reduce Levothyroxine, retesting frequently until levels drop. Then often may need increase in dose after as more of thyroid has been destroyed

25mcg is a tiny dose ....reserved for frail, elderly, heart patients or child

But even if starting on 25mcg the aim is the same to slowly increase Levothyroxine in 25mcg steps upwards, until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 in top third of range and FT3 at least half way in range

Retesting bloods 6-8 weeks after each dose increase

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

NICE guidelines

cks.nice.org.uk/hypothyroid...

The initial recommended dose is:

For most people: 50–100 micrograms once daily, preferably taken at least 30 minutes before breakfast, caffeine-containing liquids (such as coffee or tea), or other drugs.

This should be adjusted in increments of 25–50 micrograms every 3–4 weeks according to response. The usual maintenance dose is 100–200 micrograms once daily.

Low vitamins are extremely common with Hashimoto's and especially if left on too small a dose

[greygoose in reply to CapnM]

I've never heard of a 'spike' in terms of Hashi's. People talk about a 'Hashi's flare', which isn't really a very good way of describing what happens. I prefer to call it a 'Hashi's 'hyper' swing', because that's what it is. But I cannot imagine what a 'spike' would be.

People talk about 'spikes' when discussing what time to have a blood test done. About two hours after taking your levo, the blood level 'spikes' - i.e. rises sharply, and then goes down again. So, you don't want to have the blood draw near that. But, that's the only 'spike' I know of in the thyroid vocabulary.

[Mary-intussuception in reply to greygoose]

Thank you

[greygoose in reply to Mary-intussuception]

You're welcome.

[CapnM in reply to greygoose]

I'm thinking of flare! I wasn't sure spike was right but couldn't remember the word.

Thanks that helps me. I'm not getting hyper symptoms except very early on but will look out for it

[greygoose in reply to CapnM]

OK, well, a Hashi's flare - or 'hyper' swing - is when the immune system launches an attack on the thyroid, and the dying cells dump their store of hormone into the blood, causing Free levels to rise sharply, and therefore the TSH to drop.

Some people do get hyper symptoms, some don't. Personally, I just felt incredibly well, and it made a nice change after the hypo symptoms! I lost weight, my hair grew, and I had loads of energy.

But, it doesn't last. Eventually, the excess hormone will be used up or excreted, and the levels will drop and you will become hypo again. How long that takes varies from person to person. As does the frequency of the swings. And you can't predict them. Going gluten-free might reduce them - then again, it might not. Suppressing your TSH might also reduce them, but there's no guarantee. Mainly, we just have to put up with them, I'm afraid.

[Cooper27]

I also think you might be thinking of a hashi's flare. It's probably most simplistically described as a burst of hyperthyroid-like symptoms, as the thyroid floods the system with thyroid hormones. It can last a few weeks to a few months.

[CapnM in reply to Cooper27]

Your right it was flare I had seen. Thanks for taking time to reply