Hyperthyroidism to hypothyroidism

Looks like you have Hashimoto's Thyroiditis disease, hence the high TPO antibodies and your ultrasound results.  It is an autoimmune disease in which your immune system goes haywire and attacks your thyroid and destroys it, as it mistakes it for something foreign.  If your thyroid is destroyed enough, Hashimoto's causes hypothyroidism.  It is actually normal in the beginning stages of Hashimoto's for your thyroid to bounce from hyperthyroidism to hypothyroidism before settling to hypo.  The most common medication that it is used to treat hypothyroidism is Levothyroxine.  It provides the T4 your body needs to help maintain your thyroid levels. This will most likely need to be taken for life.  Only the hypothyroidism is treated and not the autoimmune disease itself.  This is because medication such as presnidone used for lupus and other autoimmune diseases causes does more harm to the body then the Hashimoto's itself.   But.. there are ways to help calm down the immune system yourself, to help slow down the attack on your thyroid.  This includes cutting out all processed foods, sugars and gluten.  Also, stay away from pesticides and herbicides, ect.. Stress is also a big trigger and also make sure your getting enough sleep and excercise too.  Hypothyroidism is actually very common these days and is easily treatable.  You will be able to lead a healthy, normal life.  Did you doctor give you medication yet?  If you are symptomatic, then it is time to start the medication.  You should asked to be referred an endocrinologist, which are doctors who specialize in thyroid disorders, as it seems that regular family doctors are not the most reliable in treating hypothyroidism.  Symptoms from hypothyroidism include.. dry skin, dry and breaking hair, weight gain, feeling cold all the time, constipation, brittle nails, digestive issues, irritability, depression, anxiety, slow heart rate, low libido, high cholesterol, muscle aches and/or weakness, impaired memory..ect.  If you are not symptomatic yet, most doctors will wait to treat you for the hypothyroidism, but if you are symptomatic, then, like I mentioned earlier, it's time to start medication.   Best wishes...

Hi Youkon, a few things that may shed some light on things for you.

As thyroid disease progresses, the thyroid gland can "sputter", as it tries to regulate. This results in alternating between hyper and hypothyroidism. This sputtering usually occurs as thyroid disease becomes more advanced, and can be followed by severe hypothyroidism.

Keep an eye in your symptoms, because as thyroid disease advances, symptoms may increase in a  disproportionately larger amount compared to decrease in blood levels. That is, you may be experiencing advanced hypothyroid symptoms long before your blood tests show hypothyroid.

Radioactive iodine uptake tests are said to have minimal risks, and are compared to the amount of radioactive exposure from an xray. It is believed that the radioactive iodine 123 is excreted through urine in 24-48 hours following testing. However, radioactive iodine is known to cause damage to the thyroid gland, so the more radioactive iodine that's absorbed, the more damage it can do. This is why the uptake test is not always the best choice for hypothyroid, but is of less concern for hyper patients. I would also be wary of radioactive testing because the radio isotope goes through the entire body, kidneys, etc before it's released. And radioactivity does have a half life, meaning it takes time to become inert.  I have worked with radioactive isotopes, gone to radiation safety training, etc. The information I've found about this test does not reflect the properties of radioactive isotopes. So I can only guess that all these medical sites explaining radioactive testing are dumbing it down while also minimizing the potential risks. My feeling is that if you're at risk for thyroid disease of any sort, DONT make it worse by radiation exposure, which is known to cause thyroid disease!

My point us that the exposure to radioactive iodine for testing or other purposes can actually damage your thyroid gland and worsen hypothyroid disease. As the cells die off over time, you would see this in decreased thyroid function.