Do I have Graves' or Hashimoto's or both?

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Hi. I was diagnosed with an overactive thyroid last November. I was booked in for a thyroidectomy but I cancelled it to give myself a chance to try and control my metabolism naturally, which I've managed to do. My latest results are better than they were but they're not perfect: my TSH is 0.14, T3 is 4.51, RT3 0.07, T4 is 15.11, Anti TPO is 116, TRAb anti-receptor TSH is 2.3. Along my journey I've been told by some doctors that I have Graves and others that I have Hashimoto's but I'm not sure which one I really do have... I'd be grateful for any help and guidance as to what the above results mean.

Thanks. P

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  • Posted

    Hi p27565, it would be helpful if you can add the normal range for the test results mentioned above. Labs use different units so it's difficult for me to tell if the values you listed are low, normal, or high. 

    There is some overlap between Hashimoto's thyroiditis (HT)  and Graves' disease (GD), that's why your doctors might have come to different conclusions. Both diseases are of autoimmune nature.

    Most  HT patients have elevated Anti TPO levels causing an inflammation of the thyroid (these antibodies attack the thyroid). The initial phase of HT is characterised by oscillating thyroid hormone levels with phases of hyperthyroidism (thyroxine can leak from the inflamed gland to the blood stream) followed by phases of hypothyroidism. In the long term, HT typically leads to an underactive thyroid and patients tend to become hypothyroid (and need thyroxine supplementation).

    GD is characterised by raised TSH receptor antibodies. These bind to the TSH receptors of the thyroid. There are three kind of these antibodies (blocking, neutral, and stimulating). The stimulating TSH receptor antibodies cause GD patients to become hyperthyroid. (Stimulating TSH receptor antibodies mimic the action of TSH.) In the long term, GD patients tend to have recurring phases of hyperthyroidism and some may develop Graves' ophthalmopathy. 

    The confusion comes from the fact that some GD patients also have raised Anti TPO levels while some HT patients have raised TSH receptor antibodies. 

       

     

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    • Posted

      Thanks Dan and Linda. I've inserted the ranges below along with my calcium and magnesium levels.

      Magnesium 4.42 (4.40-5.80)

      Vitamin D 53.2 (30-60)

      TSH 0.14 (0.3-4.5) (I'm up from 0.01 just 3 months ago)

      Free T3 4.51 (3.23-6.47)

      Reverse T3 0.07 (0.14-0.54)

      Free T4 15.11 (9.03-23.22)

      Anti TPO 116 (<60neg)

      TRAb anti-receptor TSH 2.3 (0-1)

      The goiter on my neck which I had last year has almost disappeared now as have all my symptoms ie sweating, hot flushes, shaking, anxiety. My T4 level was 65 nmol/L (same range as above) a year ago so it has all improved. I'm worried that I'm now on my way to becoming hypo.

      I find it all quite confusing!

      Thanks so much.

      P

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    • Posted

      Even though your thyroxine levels are now within normal range your TSH is still suppressed. As Linda mentioned earlier that is considered hyperthyroid.

      The positive thing is that your levels seems to be normalising and your symptoms of hyperthyroidism have reduced. You will need monitoring of your thyroid levels. Should you ever become hypothyroid you will need to supplement your thyroxine.

      The pro-active thing that you can do is to generate a list of your thyroxine levels that includes a column with your symptoms and something like a well-being score.  It will help you find out your optimal TSH level and (if necessary in the future) the optimal thyroxine dose.

       

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    • Posted

      I think one of the first things I would want if I were you is an accurate diagnosis.  You must find out if you have Hashimoto's along with your Graves diagnosis.  As I said, the antibody that diagnoses this is TGAb. Your TRAb antibody level confirms you have Graves, you just need to know if you have Hashi's as well.  My experience with Hashi patients who have posted to this and other Boards is that they do well with natural protocol treatments but have difficulty keeping their levels stable with prescribed meds because in Hashi's, the thyroid gland itself is being attacked rather than the TSH receptors.  I would add a Magnesium supplement because although your Magnesium is at the bottom of the normal range, it could be raised slightly by taking a Magnesium supplement at a low dose like 50 or 100 mg a day. Your Ferritin level will be very important as well.  For all our thyroid diseases, whether Graves or Hashi's, it is important to reduce stress so stress reduction techniques like Mindfulness, Yoga etc will also help.  I will send you some information privately about the Reverse T3 and what it means so you can learn more about it.  The other thing that I found helpful for me was taking anti-inflammatory supplements like Omega 3 and Curcumin to reduce the inflammation. 

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  • Posted

    I agree with Dan about the lab tests and posting the ranges for your lab.  However, a TSH of 0.14 is considered hyperthyroid.  They can test the antibody for Hashimotos which is TGAb.  This plus an elevated Anti-TPO indicates Hashi's.  Some people have one or the other and some people have both Graves and Hashi's.  Hashi's is extremely sensitive to antithyroid meds which send a hyper person very hypo very fast and then when given thyroid hormone replacement when hypo, will send them hyper extremely fast.  Are you on any thyroid hormone blocking meds?  People I know who have Hashi's or Graves and Hashi's do much better on natural treatment methods such as Regular L-Carnitine, Vitamin D, Magnesium and Bugleweed as opposed to prescribed meds.  You can get your carnitine, vitamin D and magnesium levels tested.  Most hyper patients are deficient in these values.

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  • Posted

    Hi....I was just wondering what it is you are doing naturally....I have GD...I go up and down... 

    My doctor only does a thyroid panel that consist of T3, T4 and TSH...

    I dont believe or at least Ive not seen any lab results for RT3, Anti TPO, TRAb anti-receptor...  

    Thanks...

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    • Posted

      Hi Rose. I've managed it through diet and supplements supported by a functional doctor. I've given up gluten, dairy, grains and cut down on sugars. It's a different way of living I guess but I feel so much better for it. My GP and endo aren't supportive so I've had to have all my blood results done privately. P

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    • Posted

      Hi Rose

      The TSH, Free T3 and Free T4 are what Endocrinologists usually use to monitor progress of your treatment.  The Anti-TPO, TRAb and RT3 are usually only used at the beginning of a person's treatment to confirm diagnosis and perhaps when the patient becomes euthyroid (meaning all thyroid tests have normalized).  Even though levels have normalized, you want to check your antibody levels because if they have not normalized, you do not want to discontinue meds or you will have a relapse very quickly.  So they are not used routinely in follow up but only at the time of initial consultation and when considering discontinuing meds because of improvement in thyroid levels.

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    • Posted

      Thanks so much....It must be because Im not on medication....mine go normal then up and down and back to normal... 

      Thanks...

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    • Posted

      Thanks....I've been cutting out gluten and sugar...takes awhile to get used to...I know some people us motherworth..lemon balm ..

      My Endo doesnt believe graves/hyper are connected to the stomach...I sure do....

      Thanks...

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    • Posted

      There is an adrenal condition that can cause these kinds of symptoms in your thyroid called pheochromocytoma.  Ask your doc if that is a possibility in your case.
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    • Posted

      I believe that too.  In fact, there is a medical intuitive who says that autoimmune diseases are caused by the Epstein Barr virus which lays dormant in your liver and when it gets actived due to stress, your immune system is trying to fight that.  He says it is a mistaken belief that your immune system is attacking your body, it is actually activated to attack this virus.
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    • Posted

      I believe my grandmother had graves...both of us went gray in our early 20's...I started at 14.... premature grey hair is also connected to autoimmune diseases....my grandmother's looked like a bobble head...she had 2 strokes, pacemaker and then died from a heart attack... 

      Yes..I also believe stress plays a huge part.....I lost my husband and dad 4 days apart in 09...I lost everything from the house to the cat and dog....my son fell out of a tree and broke his neck...then I remarried a guy that drank like a fish...I just didnt see that coming...he's since stopped...thank goodness...but, I believe the stress brought it all on...started with little itchy bumps....

      I'll have to read up on epstein barr....

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  • Posted

    Plesae pass this on to all you know suffrering with this problem! My daughter who is 25 was diagnosed with hyperthyroidism just yesterday! Things didnt add up so I started looking to see if anyone else was having the same problem...extreme weight gain and high liver enzymes and they gave her a host of horrible reasons as to what they thought was going on. After reading this site that many of you posted, many of the things the doctor suspected didnt add up so I ask her to call her doctor back and they had also cecked her estrogen leves and found out it was her birth control that was causing the hyperthyroidism and her high levels of liver enzymes. The doctor told her these are some of the side affects of birth control pills for some women. They advised her to get off the birth control pills and use something else and be checked in three months.
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