Hashis 'flares'?

[Zadock]

Can anyone explain just what's meant by a Hashis flare? I think I know (and also think I get them!). But what can be done to manage them and better still can we do anything to prevent them.

I was diagnosed 6 years ago and take 75mg levo daily. I'm still symptomatic some of the time and getting fed up with the amount of time when it's affecting my lifestyle. Vitamin levels are all good.

[SlowDragon Administrator]

Looking at previous post you had terrible Ft3

You were working on vitamins and going to be more strict about sticking on gluten free diet

healthunlocked.com/thyroidu.......

TSH (0.27 - 4.2) 0.26 mlU/L

Free T3 (3.1-6.8) 3.3 pmol/L

Free Thyroxine (12-22) 19.1 pmol/l

Folate serum (>2.9) 11.5ug/L

Ferritin (13-150) 61ug/L

Vit B12 - active (25.1-165) 186 pmol/L

Vit D (50-200) 94 nmol/L

CRP HS (0-5) 3.5 mg/L

Thyroglobulin antibodies (0-115) 30.2 IU/mL

Thyroid Peroxidase Antibodies (0-34) 189.0 IU/mL

FT4: 19.9 pmol/l (Range 12 - 22) 79.00%

FT3: 3.3 pmol/l (Range 3.1 - 6.8) 5.41%

Most people when adequately treated will have Ft3 at least 50% through range

Helpful calculator for working out percentage through range

thyroid.dopiaza.org

Have you seen endocrinologist to discuss getting T3 prescribed alongside levothyroxine

Email Thyroid U.K. for list of recommended thyroid specialist endocrinologist and doctors who will prescribe T3

[e-mail]

[Zadock in reply to SlowDragon]

Thanks for this. Yes you are right and I have chosen an endo with thyroid expertise thanks to your list and this forum. I now need the referral from my GP.

In the meantime I'm having what I think is a Hashis flare after having Covid (albeit with only mild symptoms). Perhaps I shouldn't be surprised.

[greygoose]

A Hashi's 'flare' - not a very good name for it, because people confuse it with 'flare-up' - is when the immune system attacks the thyroid, and the dying cells release their store of hormone into the blood, causing FT4 and FT3 to suddenly rise sharply, causing hyper-like symptoms. I, therefore, prefer to call it a Hashi's 'hyper' swing, becaquse that's exactly what it is: you swing 'hyper', then swing back down to hypo again, sometimes staying euthyroid on the way down for quite a while. But, eventually becoming hypo again.

Hope that helps.

[Zadock in reply to greygoose]

Yes thank you. What I'm wondering though is what triggers these. -Are they more likely to happen after having a virus (in this case Covid), and should we just accept them, or perhaps adjust medication when it's happening? I've never done that.

[greygoose in reply to Zadock]

I don't think anyone really knows what triggers them. Could be all manner of things. I never knew what triggered mine. Except that I had one after each pregnancy with a boy, but not with my daughter - coincidence? I don't know.

And, I really don't think there's much you can do about them. Yes, reduce your thyroid hormone replacement if you feel 'hyper'. But, do it on your own. Don't involve your doctor, because they really do not understand these swings, and if they reduce your prescription, you might have terrible trouble getting them increased again when your T4/3 levels go down again.