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Forum Name: Endocrinology Topics

Question: Thyroid disorder / hashimoto


 mousebandit - Wed Apr 27, 2005 2:15 am

Hi. I was diagnosed in 2003 with Hashimoto's disease. I initially went to the doctor with many symptoms of hypothroid, and she ordered a TSH expecting to confirm that. The result came back 0.015 TSH, and she had the lab re-check, with the same result.

She immediately referred me to an endocrinologist, who did more tests. TSH came back 0.20, Free T4 1.05, Total T3 1.1, TBG 20, and ATA 125.06 with ATG 292.84.

This makes no sense to me. How can my TSH be practically not there, and have such low Total T3? Based on the antibodies, he diagnosed me with Hashimoto's. I was unhappy with his treatment suggestions, and my lack of ability to communicate with him, so I declined his suggestions.

I returned to my primary care physician, and she ordered another round of thyroid tests. By this time 8 weeks had passed since the endocrinologists diagnosis of Hashimoto. I had been on no medication. This time: TSH 26.031, Free T4 0.50, T3 99. I had now swung to firmly hypothyroid in 8 weeks time. In light of the wildly varying test results, she suggested we wait another 8 weeks and then repeat the panel.

Two months later, we repeated. This time: TSH 0.32, Free T4 0.97, T3 uptake 30. Another complete turnaround. During this 5 month time period, I was consistently experiencing symptoms of hypothyroidism. I requested treatment for hypothyroid which was refused, as my blood tests indicated hyperthyroid! I sought treatment elsewhere.

I found a naturopath who agreed to prescribe me a trial of Armour Thyroid, which appeared to improve my symptoms. However, before we could run more blood tests, I ended up moving, and it's now been just about a year since I've been on medication, and a little over a year since my last bloodwork. I have consistently been experiencing many hypothyroid symptoms, and will soon be having a tubal reversal. I know that I need to resolve these thyroid issues before I become pregnant.

I intend to find a doctor in the Reno area within the next couple of weeks, and begin testing and treatment again, but I am still so confused by the pendulum action with my TSH and other thyroid bloodwork. Can anyone help explain this to me??

--Tracey R.
 Dr. Tamer Fouad - Mon May 02, 2005 1:45 pm

User avatar Hello mousebandit
Please have a look at our Hashimoto's thyroiditis page
You will notice that there may be a period of hyperthyroidism associated with the early phase of this disease.

The disease is characterized by destruction of the thyroid cells by various cell- and antibody-mediated immune processes. Antibodies binding to and blocking the thyroid-stimulating hormone (TSH) receptor have also been described and may contribute to further impairment in thyroid function. The result is inadequate thyroid hormone production and secretion, although, initially, both preformed thyroxine (T4) and triiodothyronine (T3) may "leak" into the circulation from damaged cells.

The presence of anti-TPO and anti-Tg deliniates the diagnosis. Please consult an endocrinologist as soon as possible in order to start taking the proper medication.

Best regards,

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