Can Hashimotos change into hypothyroidism

[Me1157]

I've been back on Amour thyroid and started to feel like the real me again, in early January this year. At the last check I had in March 2024, my T3 and free T3 were both on the higher end of normal; my T4 was good, but my TSH, as always, stayed around zero. My vitamins are good levels, too, and I'm mostly gluten-free, with no additives or preservatives, etc.

My antibodies have been on the lower end of normal for several years now. My current private endocrinologist is good with my TSH being around zero and happy with the rest of my results. I told her that my TSH had always been around zero since I had RAI treatment in 1979.

An enid ( NHS Dr who was acting as an endo - I later found out she hadn't qualified in endocrinology), a couple of years ago stated that since my antibodies were in normal parameters, I no longer had hashimotos but hyperthyroidism as my TSH was 0.01 on her testings. I was far from hyperthyroid as all my symptoms were hypo. so I fired her and went private again.

My questions are:

Can Hashimotos go away and become hypothyroidism?

Does it become dormant since the antibodies are low and can it flare back up? Or is it still there and she was talking nonsense?

Please share your thoughts, as I have no clue; thank you.

[Angel_of_the_North]

Hashimotos IS hypothyroidism, but, owing to the destruction of cells which dump hormone into the bloodstream, it often starts with a hyper phase. The antibodies are just there to clean up the debris, they don't cause the damage. If you have no thyroid because of RAI, of course, you are hypo.

[pennyannie]

Hello Me1157 :

After having RAI thyroid ablation back in 1979 for presumed Graves disease I very much doubt you have much, if any thyroid function of your own and any other antibodies such as Hashimoto's not enough to cause much in the way of symptoms.

Hashimoto's Auto Immune exists to attack the thyroid and would guess ceases when there is no thyroid there left to attack and why some Hashimoto's patients can't tolerate Natural Desiccated Thyroid as introducing natural thyroid triggers their immune system to go on the attack again.

Some symptoms of hyperthyroid are also symptoms of hypothyroid - and over medication and under medication once on any form of thyroid hormone replacement can be confusing.

Once on any form of thyroid hormone replacement the TSH is the least important reading and tracking on T3 and T4 the logical solution to balancing both these vital thyroid hormones.

On NDT your TSH will likely be low suppressed and you track on the Free T3 which should be proportionately much higher than when on T4 monotherapy and your T4 may be much lower than when on T4 monotherapy and this is ok if you feel relief of symptoms and back to being the best version of your ' you ' :

No thyroid hormones work well until the core strength vitamins and minerals are up and maintained at optimal levels - I now aim for ferritin at around 100 - folate 20 - B12 125 ( serum B12 500 ++ ) and vitamin D around 125.

[Me1157 in reply to pennyannie]

Hi, Pennyanne; thank you for your reply. At first (in 1979), they thought I had Graves disease, but when they tested my blood two months later, they found I was hypoactive. They repeated the tests in case anything went wrong at the lab, and it was the same. So they were testing me every six weeks after that, and I was flip-flopping from hyper to hypo, so Hashimotos was diagnosed, and my antibodies were in the hundreds. Later that year, they gave me RAI ( which was a new treatment that the endos at Scott and White Hospital in Temple, Texas, were pioneers of this treatment).

I was only 21 then and was brought up to trust doctors. I wanted to return to the UK, but they said my heart rate was too fast to fly at 140/160 resting, and the heart medication slowed it down to the 80s. They said the CT scan of my thyroid showed half of my thyroid was hyper and the other half hypo, and the RAI would target the hyper part of the gland. They could do surgery, but it was expensive. Four months after I drank the poison I was deemed safe to fly. I'm not sure if they tested the antibodies in the UK regularly. In 2003/2004, back in Florida, my antibodies were in the hundreds again, and the endo there said they were the highest he'd ever seen. That's when I was switched to amour and advised what vitamins to take and to go gluten-free etc. In those days I didn't ask many questions as I thought they all knew what they was doing. That's why I asked the question and wondered if Hashimotos goes away and becomes hypoactive and does flair up again as mine seemed to. But since then, I've tested the antibodies at least twice a year in case they go high again.

[pennyannie in reply to Me1157]

I don't believe RAI knows to target part of the gland - though it might be the ' thinking ' - it's a toxic substance that slowly burns out the thyroid in situ :

The gland may regenerate - though likely damaged - I just wish mainstream medical would rethink this treatment option and remove it from what we perceive as a health care setting.

pubmed.ncbi.nlm.nih.gov/338...

ncbi.nlm.nih.gov/pubmed/306...

[Me1157 in reply to pennyannie]

Totally agree thx

[SlowDragon Administrator]

An enid ( NHS Dr who was acting as an endo - I later found out she hadn't qualified in endocrinology), a couple of years ago stated that since my antibodies were in normal parameters, I no longer had hashimotos but hyperthyroidism as my TSH was 0.01 on her testings.

Showing her ignorance

If you ever had high TPO and/or high TG antibodies this confirms cause of your hypothyroidism is autoimmune thyroid disease (hashimoto’s)

Even if now your antibodies are negative, you still have hashimoto’s, and this has caused your hypothyroidism

[Me1157 in reply to SlowDragon]

Thank you, Slow Dragon; the antibodies were high in 1979 and again in 2003/2004 when they switched me to amour thyroid as it was determined I was a poor converter ( I had a good endo at the time and was living back in the States). I don't recall what tests were done to determine if they were high between those years as I was back in the UK (79/91). I don't think the RAI killed all my thyroid, just part of it. They did some kind of uptake test for it in 1979 and said the RAI would mostly attack the overactive side of my thyroid. My antibodies have been ok since late 2004, and even when I've been unwell since then. How often do you think I should pay for the antibody tests...or are my free T3, T3, and T4 plus essential thyroid vitamins and minerals enough unless I'm worried?

[SlowDragon Administrator in reply to Me1157]

So you had RAI for Graves’ disease

At least annually test TSH, Ft4, Ft3 plus folate, B12 and ferritin

Test vitamin D twice a year when supplementing

Ideally test selenium, zinc, copper once every 3-5 years

[Me1157]

Sorry no they gave me RAI for hashimotos. I will follow your advice on testing thank you.