Do I have Graves' or Hashimoto's or both?
Posted , 6 users are following.
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
1 like, 17 replies
Guest p27565
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.
p27565 Guest
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
Guest p27565
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.
p27565 Guest
Posted
Thanks Dan, Good idea, I'll do as you suggest. P
linda187 p27565
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.
linda187 p27565
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.
rose65668 p27565
Posted
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...
p27565 rose65668
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
linda187 rose65668
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.
rose65668 linda187
Posted
Thanks...
rose65668 p27565
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...
linda187 rose65668
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linda187 rose65668
Posted
rose65668 linda187
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....
joyred1388 p27565
Posted