greygoose in reply to Veejay17

You're welcome.

SlowDragonAdministrator in reply to Veejay17

SeasideSusie

greygoose

Can you look at this

Can you explain why levothyroxine prescribed?

SeasideSusieAdministrator in reply to SlowDragon

I'm puzzled. When thyroiditis was diagnosed in September FT4 was normal at 57% through range. No reason to start Levo.

Obviously latest July results look. Like a hyper phase of Hashi's.

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greygoose in reply to SlowDragon

Pressumably because of the antibodies.

Veejay, can you tell us what your blood test results were when you were diagnosed? Are they the September results above?

TSH 0.23 (0.3-4.20)

FT4 14.7 (9-19)

Did you ever have any results with a high TSH and low FT4?

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Veejay17 in reply to greygoose

Yes would have been September, I started on 50mg then upped to 75mg that’s all results I have above.

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greygoose in reply to Veejay17

No, you weren't given the wrong medication. It's just that SlowDragon doubted you needed medication at all. But, your symptoms do sound hypo. And, if the levo made you feel better, then that's the main thing.

The reason you started to feel unwell recently, are these results here:

free t3 15 (2.6 -5.7)

free t4 31.5 (9-19)

And, these result are why they're now saying you're hyper, because they don't understand how Hashi's works. But, you had a Hashi's 'hyper' swing. Which is perfectly normal. And just needs you to stop taking the levo for a while. The levels will come down by themselves and you will start to feel hypo again. Here's a brief run-down of how Hashi's works:

OK, so Hashi's is an autoimmune disease, where the immune system attacks and slowly destroys the thyroid. It is diagnosed by testing Thyroid Peroxidase (TPO) antibodies and Thyroglobulin (Tg) antibodies.

Contrary to popular belief, it is not the TPO/Tg antibodies themselves that attack the thyroid:

"When lymphocytes infiltrate the thyroid gland, mistakenly taking it for a foreign bacteria invader, they damage the thyroid gland and release thyroid peroxidase &/or thyroglobulin into the blood stream. These don't belong outside of the thyroid gland so antibodies are developed to mop them up.

The antibodies are a result of the attack on the thyroid gland, the antibodies don't cause the attack."

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

After every immune system attack on the thyroid, the dying cells release their stock of thyroid hormone into the blood stream, causing the levels of the Frees to shoot up - FT4 to around 30 something, FT3 around 11/12 - and the TSH therefore drops to suppressed.

There is no knowing how long these high levels will persist, but eventually, they will drop by themselves as the excess hormone is used up or excreted, and not only will you become hypo again, but slightly more hypo than before, because there is now less thyroid to make hormone.

(NB: A Hashi's 'hyper' swing is not true hyperthyroidism in that your thyroid is over-producing thyroid hormone. It's physically impossible to 'go hyper' if you are basically hypo. The thyroid cannot regenerate itself to the point of over production of hormones - or even normal production. Very few doctors appear to know that.)

Therefore, it's very important that your doctor does not reduce your prescription, because you’re going to need it again! If you start to feel over-medicated at that point - some do, some don't - the best thing is to stop levo for a few days, then, when you feel hypo again, start taking it again. It's very important to know one's body, and how it reacts.

There is no cure for Hashi's - which is probably one of the reasons that doctors ignore it - apart from the fact that they know nothing about it, of course!

However, between the 'hyper' swing, and the descent back into hypothyroidism, there can be a phase - quite a long one, sometimes - of normality, where the person is neither hypo nor 'hyper'. This is where people sometimes start talking of having 'cured' their Hashi's, by whatever means. But, it doesn't last. Eventually, you will go hypo again.

But, there are things the patient can try for him/herself to help them feel a bit better:

a) adopt a 100% gluten-free diet. Hashi's people are often sensitive to gluten, even if they don't have Coeliac disease, so stopping it can make them feel much better. Worth a try. Some say that going gluten-free will reduce antibodies – I’ve never seen conclusive proof of that, but, you should be aware that even if you were to get rid of the antibodies completely, you would still have Hashi's, because the antibodies are not the disease. It is not the TPO/Tg antibodies that do the attacking.

b) take selenium. This is not only reputed to reduce antibodies, but can also help with conversion of T4 to T3 - something that Hashi's people often find difficult.

c) the best way to even out the swings from hypo to 'hyper' (often called Hashi's Flares, but that doesn't really sum up the way it works) is to keep the TSH suppressed. This is difficult because doctors are terrified of a suppressed TSH, for various false reasons, and because they don't understand the workings of Hashi's. But, TSH - Thyroid Stimulating Hormone (a pituitary hormone) - tries to stimulate the thyroid to make more hormone, which also stimulates the immune system to attack. So, the less gland activity there is, the less immune system activity there will be, meaning less attacks, gland destruction slowed down and less swinging from hypo to hyper and back.

greygoose in reply to greygoose

Apologies for the lack of spacing. Gremins are at work on HU tonight!

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Veejay17 in reply to greygoose

Morning Greygoose, cheers for this explanation, I really appreciate it and it’s understandable

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greygoose in reply to Veejay17

You're welcome.

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greygoose in reply to Veejay17

Yes, that's the thyroiditis part, which just means: swollen thyroid. Glad to hear it's gone down.