Hypo to Hyper treatment : Talking to friend, in... - Thyroid UK

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Hypo to Hyper treatment

Airmed profile image
11 Replies

Talking to friend, in his early 70s, over the weekend who suffers with Sarcoidosis. A couple of years ago I advised him to get his thyroid checked out. The medics advising that his fatigue and other symptoms were sarcoid or age related, I wasn’t convinced. However, last year he was given levothyroxine, he can’t remember the dosage. He took them for a year then the GP took him off levo and put him on carbimazole 60mcg. I have no clue as to why he would swing from hypo to hyper with a hefty dose of carbimazole to boot. He also tells me that his voice is gravelly. Would once again appreciate any help

11 Replies
SlowDragon profile image

Hashimoto’s frequently starts with transient hyperthyroid results and symptoms….swinging from hypo to (temporary) hyperthyroid type symptoms

He should have had thyroid levels retested 5-6 weeks after stopping levothyroxine/starting Carbimazole

Strongly recommend getting FULL thyroid and vitamin testing including thyroid antibodies for Hashimoto’s

Recommended on here that all thyroid blood tests early morning, ideally before 9am

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes


Medichecks Thyroid plus antibodies and vitamins


Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins


Link about thyroid blood tests


Link about Hashimoto’s


Symptoms of hypothyroidism


Graves Disease antibodies test


Airmed profile image
Airmed in reply to SlowDragon

Thank you so much. I have left him with a bunch of questions for his GP. Why levo = hypothyroidism

Then Carbimazole = hyperthyroidism

Ask them to test Antibodies for Hashimotos.

This site is truly amazing. I seem to remember members posting about hashis swinging from hypo to hyper but wanted confirmation.

SlowDragon profile image
SlowDragonAdministrator in reply to Airmed

So often Medics just freak out as soon as they see very low/suppressed TSH

With Hashimoto’s, especially as a “senior “ it’s highly likely he has low vitamin levels

Low vitamins tend to lower TSH as well

Lalatoot profile image

Airmed this is the pattern for autoimmune thyroiditis otherwise known as hashis. The person is hypothyroid. The autoimmune system attacks the thyroid. The damage to the thyroid results in additional hormones in the blood so the person temporarily has a high level of hormones. Once things settle again they go back to being hypo.If this is the case carbimazole is the wrong treatment. The hypo patient should lower or stop levothyroxine until their hypo symptoms return. Carbimazole is designed to stop the thyroid producing too much by way of hormones but with hashis the thyroid is not overproducing. Carbimazole will not lower the additional thyroid hormones that have been released into the blood stream.

The way to find out if it is hashis is to test for antibodies. Antibodies are present to clean up the mess left by an autoimmune attack. If you search on here for hashimotos or look in the topics section you will find plenty of info.

It is not uncommon for doctors to know very little about the thyroid and its workings. That is why we are on here as we had to find help for our condition elsewhere.

Airmed profile image
Airmed in reply to Lalatoot

Thank you. Will pass info to his daughter who is overseeing his welfare

tattybogle profile image

it is unusual, but occasionally possible to go from hypo to 'properly' hyper see here :healthunlocked.com/thyroidu...

However we do often see cases on here where a hyper phase has been misdiagnosed and treated as Graves hyperthyroidism , when really it's just a transient phase of hyperthyroid which can happen in the early stages of hashimoto's hypothyroidism......so it's important to make sure the diagnosis is confirmed properly with the right antibody tests.

tattybogle profile image
tattybogle in reply to tattybogle

Specific antibodies which confirm Graves (autoimmune hyperthyroidism) are TRab (Thyroid Stimulating Hormone Receptor antibodies)or sometimes written as TSI ( thyroid stimulating immunoglobulins)

TPOab (Thyroid Peroxidase antibodies) can be present in both Hashimoto's (utoimmune hypothyroidism) and Graves ... so finding these does not prove it's Graves

Airmed profile image
Airmed in reply to tattybogle

Thank you have passed all replies to his daughter who is overseeing his welfare. Advised to join HealthUnlocked 😀

tattybogle profile image
tattybogle in reply to Airmed

usually it is endocinologist who orders the TRab /TSI test that confirms Graves. GP's seem unable/ unwilling to order it. GP's can test TPOab. which usually mean hashi's ... but

be aware .... if TPOab are positive it could be Hashi's or Graves , as Graves patients often have some TPOab as well as their TRab

SlowDragon profile image

Sarcoidosis Linked to autoimmune thyroid disease (hashimoto’s)


DoeStewart profile image
DoeStewart in reply to SlowDragon

Hi SlowDragon, the link you have provided made very interesting reading for me. I was diagnosed with sarcoidosis at the age of 31, I wouldnt say I had any of the symptoms that normally occur, I had swollen lymph glands under my jaw, was told it was glandular fever but the swellings didnt go down at all. It was by pure chance that I was going into hospital for a minor procedure, 1 night stay. My husband suggested I mention the swellings under my jaw which I did. Well, I was kept in for 3 weeks, had a biopsy of one of the swellings and then the diagnosis, first case they had seen at this Wirral hospital for 30 years. It was 5 years later after the birth of my first child that my thyroid problens started . Thank you for providing the link.

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