Subclinical Hyperthyroidism???

[Lovemyboys56]

I was experiencing hyper symptoms and my tests indicated subclinical hyperthyroidism. Normal T3 and T4 but very low TSH at .01.   I got more blood work done and now my TSH is within range .38.  The crazy part was my TPO AB result. Normal range is <=5.5 and mine was at 1999.4! My TSI results aren't in yet. I'm not sure what to make of this! HELP!

[Lovemyboys56]

Hi. Just met with my endo. AND...you were right! I have both graves and hashis. I will be tested every 3 months to see if one will dominate the other long term. My only other option was surgery. I'm feeling better and will just go by what my body tells me!

[Barb135]

While it's somewhat rare, it's possible to have, both, Hashimoto's and Graves Disease at the same time.  It's also possible to have elevated TSI and not have Graves Disease; that's determined on a percentage basis.  

Also ask why FT3 was not tested.  And remind them that Hashimoto's can be characterized by periods of hyperthyroidism.

Be sure to get a copy of the report.  Will definitely stay tuned.  

[Lovemyboys56]

I will see my endo on July 10th and question that! Stay tuned!

[Barb135]

Nothing about the low FT4 and T3?  I'd certainly question them on that, because those are not consistent with Graves Disease..

[Lovemyboys56]

So I got the phone call today. They told me my TSI was elevated and that my uptake scans were consistent with Graves Disease.  They won't put me on meds but will continue to monitor me since my TSH level rose within range on its own. Hmmm.

[Barb135]

Yes, I know the wait, alone can make one crazy, but wait we must.

Fortunately, you don't have anything life threatening, but of course, you don't feel well and are concerned; we're here to respond to questions or concerns, or just chat, while you wait.  

[Lovemyboys56]

Again, thank you so much for your responses.  The wait itself is exhausting! I will keep you posted! Hopefully early this coming week!

[Barb135]

Okay, good to know that you aren't on thyroid med... those can often suppress TSH.  

Unfortunately, some of the symptoms of hyper can also apply to hypo, such as the fatigue and rapid heart rate.  

While many doctors only go by TSH to test thyroid function, that's really not the only indication.  When you look at your actual thyroid levels as I mentioned above you can see that they aren't high at all and it's unlikely that your levels would cause the symptoms you're having.

Rarely, one can have both Graves and Hashimoto's and symptoms can change with whichever is dominant at the time.  

I will be interested in hearing about the results.

[Lovemyboys56]

TSH range is .35 to 4.
Mine went from .02 to .01 and currently is .38

[Lovemyboys56]

Thank you for your detailed answer!

No, I am not on any meds. Never was.

And my symptoms are fatigue, fast heartbeat, hand tremors, moody.  I haven't noticed anything difference with weight. I have an increased appetite but I haven't gained weight. I'm 5'5 and 115 lbs.
I first went to my obgyn because I was bleeding between periods which very heavy and painful. That's when they ordered blood tests to check for other possibilities and saw how low my TSH was. So they turned it me over to the endo.

I thought it would be Graves' disease. They did an uptake scan but results aren't in til this week. And they won't let my know anything about my results so far until my TSI results are also in.

[Barb135]

Your FT4 is at the very bottom of its range, which certainly suggests hypothyroidism, not hyperthyroidism.  Unfortunately, if the T3 doesn't specify that it's Free, then it's Total and is considered obsolete and of little value.  Even at that, though, ti's quite low in its range, which suggests that Free T3 would also be very low.

The elevated antibodies would be the basis for a diagnosis of Hashimoto's.  

I should first have asked if you are currently on a thyroid replacement hormone.  If so, it's not unusual for TSH to be very low in the range or even suppressed.

Otherwise, the low TSH may indicate a problem with pituitary function that is preventing from it producing the TSH that would, typically, stimulate the thyroid to produce the thyroid hormones T3 and T4.

What if, any symptoms, do you have?  Common symptoms of hypothyroidism would be weight gain, constipation, dry skin/hair, hair loss, brain fog, fatigue, depression, muscle/joint aches/pain, etc.  Common symptoms of hyperthyroidism would be weight loss, diarrhea, hair loss, fatigue moodiness, tremors, etc.  

[Lovemyboys56]

Thanks for replying. My T3 is 86 (range 58-159). Free T4 is 0.8 (range 0.8-1.5)

[Barb135]

What are the actual results of your T3 and T4?  Are they Free T3 and Free T4 or are they Total T3 and Total T4?  They aren't the same things.  Be sure to post reference ranges with the T3 and T4 results, as ranges vary lab to lab and have to come from your own report and be sure to specify Free or not.

A TPOab of 1999.4 indicates Hashimoto's Thyroiditis.  While Hashimoto's is, typically, associated with hypothyroidism, it's often characterized by periods of hyperthyroidism in the beginning stages.