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Hypothyroidism/Hashimoto Thyroiditis

To make a long story short . Which one comes first Hashimoto or hypothyroid .
I was told 24 years ago I had hypothyroidism and 3 years ago my biopsy came back as hashimoto Thyroiditis . I have been on meds from the beginning . I'm a little confuse at which one comes first I have been reading up on the matter and cant make heads or tail of the matter .
With my research I discovered that I should be on a special diet that none of my Doc's ever told me about so I need to know which diet I should be following . Thanks in advance for those that reply
3 Responses
649848 tn?1534633700
Hashimoto's causes hypothyroidism when antibodies destroy thyroid tissue; however, many of us aren't diagnosed with Hashimoto's until "after" we've been diagnosed with hypothyroidism because that's when most of the tests are actually done.  Some doctors actually refuse to do antibody testing to diagnose Hashimoto's (my doctor did) because Hashimoto's is the # 1 cause of hypothyroidism in developed countries so they simply assume that's the cause.  Some simply call it an "idiopathic" issue, meaning there's no cause, better taken to mean they don't care to look for a cause.  

Sometimes, people are diagnosed with hypothyroidism but don't have antibodies so the cause isn't readily determined.  Hashimoto's can be diagnosed via thyroid ultrasound determined by certain characteristics consistent with Hashimoto's.  

In addition, not all hypothyroidism is caused by Hashimoto's.  Sometimes it's caused by Central, otherwise known as Secondary, hypothyroidism, which is a pituitary or hypothalamus issue not an autoimmune condition.  Other times, it's a sub-clinical problem that resolves itself over time or often turns into an autoimmune condition.

Because of the various possibilities, it would easier for us, if you'd post your thyroid-related blood test results, including Free T4, Free T3, TSH, any antibody testing, etc.  Be sure to include all reference ranges for any results since ranges vary from lab to lab and have to come from your own reports for the best comparison.  

Not everyone needs to be on a special diet, although some of us do better if we eliminate certain foods that can cause problems.  That can be easily determined with an elimination diet; however, eliminating foods you don't need to eliminate can cause deficiencies that can make matters worse.
Thank you for your answer .
I do not have the # that u r asking for . For 24 years i only get blood work done once a year , I didnt know any better I didnt think my conditions was much to worry about and now that I'm looking into it 8 sure wish I knew long ago and was better educated on the matter .
I'm making a Dr app today and I will go from there !
What test should I be asking him to do ?
When you did get blood work done, what test(s) were ordered?  How long ago did you have any testing done?  If you've been feeling okay, all these years, maybe there wasn't much to worry about.  Some people do just fine with "standard" treatment, but many of us don't; that's how we find our way to forums like this.

The blood tests you need are Free T4, Free T3, TSH - those will determine thyroid function (if any) or how well your replacement thyroid hormones are working for you.

You also need antibody testing for Hashimoto's - those tests are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb)... both are markers for Hashimoto's and some of us have one or the other and some have them both, so you should get both of them to avoid being misdiagnosed.

Many of us with Hashimoto's/hypothyroidism are deficient in vitamin B-12, D and iron, plus these vitamins/minerals are necessary for the proper metabolism of thyroid hormones; therefore, you should also ask to get tested for B-12, D and ferritin, which is the storage hormone for iron.

If the doctor you're making the appointment with is the same one that's been treating you all along, maybe you should be prepared to have her/him deny most of these tests... if they haven't been ordered previously, most likely it's because the doctor doesn't feel they're needed; if that's the case, you might have to think about changing doctors as many of us have had to do in order to get adequate testing/treatment.

Once you get the testing to see what your levels are, you can think about whether or not you want to try an elimination diet.  That's a matter of eliminating certain foods (typically gluten, dairy, sugar and soy) for about 3 weeks, then add them back into your diet, one at at time (except soy - I don't recommend that at all, ever) and see if you have a reaction to any of them or if you feel better without them... If you can't tell a difference without them than you did with, then there's no need to eliminate them permanently, although depending on your diet, I might recommend some other changes.
Here is the result from Sept for TSH 3.74   T4 14.4 , I have been on Iron supplements for years now 5.5
What's the reference range for the T4 and iron?  Ranges vary lab to lab and have to come from your own report for the best comparison.  Also is that Free T4 or Total T4?  If the report doesn't specify, it would be Total T4, which isn't as useful as Free T4.  

Have you ever had vitamin B-12 and D tested?
1756321 tn?1547095325
Hashimoto’s thyroiditis is the most common cause of hypothyroidism in the western world. Infiltration of lymphocytes into thyroid tissue can lead to thyrocyte destruction and
ultimately hypothyroidism. In short, Hashimoto's thyroiditis comes first.

Selenium is essential for the conversion of T4 to T3 and also plays a role in protecting the thyroid gland itself. Studies show selenium decreases thyroid peroxidase antibodies (TPOAb).  The best source of selenium in the diet are Brazil nuts.
I dont understand how the ultrasound that diagnosed me 24 years didnt show that it was hashimoto ! When doing some research people have said that getting an ultra sound will give determin what is wrong .
I cant see how they had it backward when they diagnosed me .
Thanks for responding and helping out in the matter
In prep for any doctor appointment, I suggest clicking on my name and then scroll down to my journal and read at least the one page Overview of a full paper on Diagnosis and Treatment of Hypothyroidism: A Patient's Perspective.   The more you know about the subject the better able you will be to get the tests you need and hopefully the right treatment.  
This is from Radiopaedia's article Hashimoto's thyroiditis....


It is difficult to reliably sonographically differentiate Hashimoto thyroiditis from other thyroid pathology. Ultrasound features can be variable depending on the severity and phase of disease 1,5"
Avatar universal
Thats a good question since I asked my dr. and she told me it was the same thing? What is the difference?
If you're asking the difference between Hypothyroidism and Hashimoto's, this it:

Hypothyroidism is when the thyroid doesn't produce enough of the necessary thyroid hormones to supply the body and keep certain processes going.  Thyroid hormones control several processes such as metabolism, body temperature, and heart rate, as well as others.

Hashimoto's is an autoimmune condition, in which the body erroneously attacks the thyroid and eventually destroys healthy tissue so it can't produce adequate amounts of thyroid hormones.  Hashimoto's is one of several causes of hypothyroidism...

Some doctors automatically believe that if one is hypothyroid, they have Hashimoto's, but that's not correct as there are other causes of hypothyroidism, such as Central or Secondary Hypothyroidism. Central hypothyroidism is not a thyroid problem; it's caused by a malfunction of, either, the pituitary or hypothalamus glands, so there isn't adequate TSH produced.  Without adequate TSH, the thyroid won't be stimulated properly so it won't produce hormones either.  

There are also temporary causes of hypothyroidism, some of which end up becoming permanent...
Thank you are there certain test that a dr can do to figure this out.  I went to a specialist and he didn't find out much that helped me either.  I feel like they are just pushing me aside.  
There are 2 antibody tests to determine if one has Hashimoto's... Those are Thyroid Perxoidase Antibodies (TPOab), sometimes known as microsomal antibodies.  The other one is Thyroglobulin Antibodies (TgAb).  Both tests should be done since some of us have one or the other of the antibodies and some have them both.  If you only get one test done, you could be misdiagnosed.  

There have been some people diagnosed with Hashimoto's, even with negative antibody counts - this is done based on characteristics of the thyroid as shown on ultrasound.

Additionally, thyroid function tests will help as well.  For instance, if TSH is very low, and Free T4 and Free T3 are also very low in the ranges, that's an indication of Central hypothyroidism, as it indicates that there isn't enough TSH to stimulate the thyroid to produce its hormones.  In this case, pituitary tests would be advisable.

Do you have hypothyroidism?  Are you on replacement medication?  
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649848 tn?1534633700
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