Is there a possibility of both Hypo and hyper thyroid

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Hi,

Three years back I was found that I had hyperthyroid due to grave disease, I was given 10mci of Radio Iodine , after two months of that I became hypothyroid .

after that I am continuously having my blood test for every 5 to 6 months, my blood results shows my thyroid is never balanced , from last two  results shows I am both hypo and hyper, I mean my FT4 is high 2.5  and low TSH 6.5 , so my doctor thought that may be due to pituitary gland and suggested to undergo MRI scan for pituitary gland, I had mri scan my MRI shows its normal.

so now Doctor has given blockage treatment , I mean he asked to take medicine for both hypo and hyper .

he prescribed 175mg thyronorm and 50mg PTU, I am totally confused , after my 10mci of ROI I was thinking that my thyroid is completely dead  and now I should take only hypo thyroid medicine but now doctor is telling I need to take both, I dont know this is a special case or really something wrong with me. 

Please help me to understand, I am thinking that my situation may become worst . 

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9 Replies

  • Posted

    Hi, did you talk to your radio surgeon prior to taking I-131? I am asking because 10 mci is not a very high dose and the aim could have been to render you euthyroid or slightly hypothyroid (and not necessarily to completely destroy your thyroid). 

    What was your daily thyroxine dose after you recovered from your thyroid ablation?  

    It is difficult to comment on the FT4 value since you did not include the units or the normal range. Are the units ng/dl? In that case, the value is high.  (In the UK the normal range for FT4 is usually 9.0 - 25 pmol/L.).

    Your TSH at 6.5 seems high assuming it is measured in mU/L. That is consistent with a hypothyroid state.  

    Your endocrinologist might use a method called block and replace. It is sometimes used to treat Graves' disease. 

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    • Posted

      Hi dan, thank you very much for your reply .

      During giving radio iodine my surgeon told it may cure the current thyroid condition and if it works out well I dont need any other supplement. after 2 months  taking the radio iodine, I started with 100mcg of thyronorm  

      Here with I have attached my blood report , ultrasound scan for thyroid and also the report of  Radio Iodine update study which was done before giving 10mci of radio Iodine 2 1/2 years back.

      Please help me to understand my condition , currently I doctor suggested 175mcg of thyronorm for hypo

      and 50mg of PTU(Propylthiouracil) for hypo . 

       

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    • Posted

      currently my doctor suggested 175mcg of thyronorm for hypo and 50mg of PTU(Propylthiouracil) for hyper . 
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    • Posted

      The ultrasound shows that your thyroid has shrunk considerably after the RAI treatment. The size of each lobe is now approx. 4mm whereas a normal thyroid lobe would be around 40 - 60 mm long. 

      The uptake scan you had before RAI shows that your thyroid was in fact enlarged and the Iodine uptake is higher than normal and homogeneous across the thyroid (that is your scan did not show any nodules). 

      Your blood test shows that your FT4 and TSH are both above range whereas your FT3 is within range. 

      You did not mention how you feel or if you have any symptoms that would indicate that something is wrong.  

       

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    • Posted

      Hi,

      Was that going for Radio Iodine for Grave disease  was right choice ?

       

      my symptoms are , I feel tired, especially in the morning , and I get frequent headache , and always feel that I have little headache at back side of head, especially when bend my body or get up .. 

      I had all BP checked and done MRI for brain and pituitary gland, everything is fine, so my mine symptoms are headache and tiredness. 

      based on my report do you think I need to take both hyper and hypo medicine ?

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    • Posted

      Regarding your medication, I think you should follow the instructions of your endocrinologist. You have to remember that on this forum you will mostly get advice from fellow patients and not from medically trained professionals. Do you take your medication early in the morning on an empty stomach? 

      Regarding your headache, this might not be necessarily directly linked to your thyroid problems. Some people can have bad tension headaches that can be improved with gentle stretches and massages. One such exercise is to stretch your neck by pressing your chin against your chest (and slightly moving your head sideways). 

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    • Posted

      Yes, I take hypo medicines 10 min before breakfast .... 

      Was that going for Radio Iodine for Grave disease  was right choice ?

      headache,  I had all kind of treatment(Migrane , tension etc), but still not able to get the exact reason for headache, I always feel there is headache and headweight back side of head(just above ears ) and feel pressure inside eyes and some times eye pain ... 

       

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  • Posted

    From what I have read the Radioiodine treatment was ineffective and you may have to go through it again. Unfortunately you will end up having hypothyroidism as a final result and will need to take thyroid hormones from then on. 

    If tgey gave you a calculated amount of iodine and not the fixed amount it can be ineffective sometimes. There is a small risk of thyroid storm so make sure you know the symptoms to look out for. 

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    • Posted

      Hi, I have given with fixed amount of radio iodine and and immediately after 2 months of that treatment I became hypothyroid , since that I am taking thyroid supplement .. first started with 100mcg of thyronorm and now taking 150mcg but in the recent blood test docotor told I am both hypo and hyper and asked to take 175mcg of thyronorm for hypo and 50mg of PTU(Propylthiouracil) for hyper . 
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