Aa
Had Hashi's for 17 years, now hyperthyroid postpartum?
Hello all. I have had hashimotos thyroiditis since i was 9 (17 years). I have only been on Synthroid since 19 (7 years) and started at 100ug then. After my daughter was born, i was put on 150 ug and was on that until March 09 when my dose was increased to 175 ug. I had been dieting and exercising before that (1500 cal a day and running about 9 miles a week) and had been unable to lose weight, and after the dose change was able to drop 24 lbs in 6 mos. After i lost my weight, i got pregnant again and my OBGYN monitored my thyroid ( not as often as i would have liked) and said it was fine. I stayed on 175 throughout my preg.
My baby is now 7 weeks old and I am nursing. I am eating 2100 cal and running about 6 miles a week and am not dropping weight. I also have a goiter again for the first time since i've been on 175 and i'm exhausted (baby sleeps through the night- not the baby!!) and i have numbness/tingling in my hands and feet. I had my OBGYN redraw my blood (can't get into the endo for a while) and she came back and said all my levels are normal but my TSH is low, meaning i'm hyperthyroid. What gives? If I'm hyper, then why am i not losing any weight and exhausted? My Hashi's is fairly severe and have been told i have very little thyroid "left" and that it is mostly "scar tissue". They suspected a nodule last year, but it turned out to just be a lumpy thyroid when they did the ultrasound.
Help!! am i hyper? Is this a postpartum symptom that will go away once my hormones regulate??
My baby is now 7 weeks old and I am nursing. I am eating 2100 cal and running about 6 miles a week and am not dropping weight. I also have a goiter again for the first time since i've been on 175 and i'm exhausted (baby sleeps through the night- not the baby!!) and i have numbness/tingling in my hands and feet. I had my OBGYN redraw my blood (can't get into the endo for a while) and she came back and said all my levels are normal but my TSH is low, meaning i'm hyperthyroid. What gives? If I'm hyper, then why am i not losing any weight and exhausted? My Hashi's is fairly severe and have been told i have very little thyroid "left" and that it is mostly "scar tissue". They suspected a nodule last year, but it turned out to just be a lumpy thyroid when they did the ultrasound.
Help!! am i hyper? Is this a postpartum symptom that will go away once my hormones regulate??
If you blood tests were indicating hypothyroidism the symptoms of both diseases can mock each other confusing the patient even more.
Labs + symptoms can indicate alot if you are getting consistant sensitive testing. Basing the TSH on the Hashi's condition is almost pointless for many sufferers. You must maging the Hashi disease in a 2 step process.
Trying to supress the antibodies and making positively sure you are getting the FREE T3 and FREE T4 tests to best determine if you are HIGH or LOW on the Free T3 test to see if hyper or hypo is indicated.
The very sensitive Free T3 ( lab) or the direct T3 hormone ( in the body) is very destinctive on a lab telling the doctor and you where your function is at. If the FT3 is >low you should be hypothyroid but symptoms can mock hyperthyroid. If the FT3 is <high - then you are clasically hyperthyroid but those symptoms can mock some hypOthyroidism too.
Did you have the Free testing during your period of hyperthyroidism to see where your FT3 numbers were at?
Clay, I mentioned above that a post from you would be great but for the last 2 days this statement of always going to a sonagram is something I'd like to understand.
The "sonagram" you feel - indicates everything there is to relate to hyperthyroidism and the autoimmune issues of the disease.. You have lots of research indicating your feelings and maybe you could be correct on that.
My question is, let's say a patients gets this sensitive sonogram you write, and does find some thyroid issues again that you talk about.
What protacol is used after this sonagram is done to monitor the patient with medication?
Do you do a sonagram everytime you are rechecking the thyroid ( as done with labs 6-8 weeks regularly) and base increases or decreases of thyroid medication off those follow up scans? Is that even possible to not look at blood and only look at a scan to best determine what a hormone is actually doing in the body?
Let's open up a new post on this and really discuss what you have researched. I do have many questions that would like to have here discussed.
Labs + symptoms can indicate alot if you are getting consistant sensitive testing. Basing the TSH on the Hashi's condition is almost pointless for many sufferers. You must maging the Hashi disease in a 2 step process.
Trying to supress the antibodies and making positively sure you are getting the FREE T3 and FREE T4 tests to best determine if you are HIGH or LOW on the Free T3 test to see if hyper or hypo is indicated.
The very sensitive Free T3 ( lab) or the direct T3 hormone ( in the body) is very destinctive on a lab telling the doctor and you where your function is at. If the FT3 is >low you should be hypothyroid but symptoms can mock hyperthyroid. If the FT3 is <high - then you are clasically hyperthyroid but those symptoms can mock some hypOthyroidism too.
Did you have the Free testing during your period of hyperthyroidism to see where your FT3 numbers were at?
Clay, I mentioned above that a post from you would be great but for the last 2 days this statement of always going to a sonagram is something I'd like to understand.
The "sonagram" you feel - indicates everything there is to relate to hyperthyroidism and the autoimmune issues of the disease.. You have lots of research indicating your feelings and maybe you could be correct on that.
My question is, let's say a patients gets this sensitive sonogram you write, and does find some thyroid issues again that you talk about.
What protacol is used after this sonagram is done to monitor the patient with medication?
Do you do a sonagram everytime you are rechecking the thyroid ( as done with labs 6-8 weeks regularly) and base increases or decreases of thyroid medication off those follow up scans? Is that even possible to not look at blood and only look at a scan to best determine what a hormone is actually doing in the body?
Let's open up a new post on this and really discuss what you have researched. I do have many questions that would like to have here discussed.
Honestly I also feel there is way too little info relating to hyperthyroid in Hashimoto's and alot of people like myself get very confused and scared when they are severely hyper from Hashi's. I was for a year but all blood tests indicated hypo. I thought I was dieing when no doctor was able to explain to me why I was having every hyper symptom in the book when I was hypo on paper. This did alot of damage psychologically.
BTW - thanks for the well wishes.
I know we want to stay on the original post with kpeters1984 but I do have a few questions. Would you mind bring up a history post on yourself? Your case may sound like something and would be a great feedback source to have on here.
a few questions I would bring up is Hashitoxicosis? - TSI readings? US scans on the hyper nodules? and deficiencies?
a few questions I would bring up is Hashitoxicosis? - TSI readings? US scans on the hyper nodules? and deficiencies?
We are sure that multiple diseases have and are occuring now. I am fighting to keep my gland for several reasons, but the latest tests have my gland growing about 12cm a month, and both tumors growing at a relative pace, so my time with the gland is getting very short.
Graves has been ruled out, but not Plummers. The Docs believe the leaking of the cyst has been a big culprit in most of the Vitamin A disorders (skin), and the weight swings but they are not sure. 14 docs are not sure, so I doubt we'll ever know. I better start focusing on kpeters1984 questions and needs. My case mirrors few I feel.
Graves has been ruled out, but not Plummers. The Docs believe the leaking of the cyst has been a big culprit in most of the Vitamin A disorders (skin), and the weight swings but they are not sure. 14 docs are not sure, so I doubt we'll ever know. I better start focusing on kpeters1984 questions and needs. My case mirrors few I feel.
Hashi's affects different people in many different ways. Sometimes there is an initial hyper phase, which is typically quite short. More often, as thyroid function diminishes, it does so in fits and starts (some days not putting out enough T4, others too much). This can cause a "rollercoaster" effect of hypo to hyper and back again.
I sounds like you might have had more than just Hashi's going on...a toxic nodule (toxic adenoma) perhaps? Hashi's can take years or even decades to damage thyroid function enough to make you hypo, or it can go like gangbusters. However, I think 53 years might just get you into Guinness. Hashi's is classically associated with hypo, not hyper, and your esoteric case might cause a lot of confusion amongst those new to the disease.
You also do not follow the typical pattern of Hashi's, which is instability between hypo and hyper in initial stages, stabilizing into "permanent" hypo in later stages. If you are experiencing more and wilder swings as you get older, I'd be exploring other possibilities. Have you been tested gor Graves"? Plummers? Multiple thyroid diseases might be at work in your case.
Typically, the initial hyper stage of Hashi's is so fleeting that most of us don't notice it (except perhaps in retrospect) since few of us have been diagnosed at that point, and we are not attuned to thyroid symptoms.
So, while I agree that Hashi's can make you hyper at times and you can definitely spend years euthyroid with Hashi's, the emphasis should be on the hypo phase of the disease to avoid confusion.
I sounds like you might have had more than just Hashi's going on...a toxic nodule (toxic adenoma) perhaps? Hashi's can take years or even decades to damage thyroid function enough to make you hypo, or it can go like gangbusters. However, I think 53 years might just get you into Guinness. Hashi's is classically associated with hypo, not hyper, and your esoteric case might cause a lot of confusion amongst those new to the disease.
You also do not follow the typical pattern of Hashi's, which is instability between hypo and hyper in initial stages, stabilizing into "permanent" hypo in later stages. If you are experiencing more and wilder swings as you get older, I'd be exploring other possibilities. Have you been tested gor Graves"? Plummers? Multiple thyroid diseases might be at work in your case.
Typically, the initial hyper stage of Hashi's is so fleeting that most of us don't notice it (except perhaps in retrospect) since few of us have been diagnosed at that point, and we are not attuned to thyroid symptoms.
So, while I agree that Hashi's can make you hyper at times and you can definitely spend years euthyroid with Hashi's, the emphasis should be on the hypo phase of the disease to avoid confusion.
Hashimoto's thyroditis, my condition, is intially "HYPERthyroidic", usually due to enlarged nodes or tumors/cysts as my case was, from time of birth it is believed due to radiological reports. You then roll over, which I am doing now, to HYPThyroidic. This takes different amounts of time in different people. I have gone from TSH readings of .05 during my storm, to my current reading of 9.7 in just over 2 years. This is occuring because my gland is dying, but had been hyperthyroid due to thyroiditis in activity for 53 years.
Hashimoto's hypothyroidism is where all go, eventually, if they have the actual Hashimoto's disease. But they do not have to be hypothyroidic to have it. At least for some period of time. In my case, there were distinct periods of time when my body shifted from hyperthyroidic behavior, to hypothryodic, as the gland was attacked anytime I caught a cold or infection. As I got older the swings have been much wilder in nature and more often in occurance.
I just want to clear the air the having the thyroid disease Hashimotos, does not 100% of the time mean hypothyroidism. Ask any endo or gp.
Stella hope you get to feeling better, best to you all.
Hashimoto's hypothyroidism is where all go, eventually, if they have the actual Hashimoto's disease. But they do not have to be hypothyroidic to have it. At least for some period of time. In my case, there were distinct periods of time when my body shifted from hyperthyroidic behavior, to hypothryodic, as the gland was attacked anytime I caught a cold or infection. As I got older the swings have been much wilder in nature and more often in occurance.
I just want to clear the air the having the thyroid disease Hashimotos, does not 100% of the time mean hypothyroidism. Ask any endo or gp.
Stella hope you get to feeling better, best to you all.
I am not saying weight gain cannot be something with hyperthyroidism. The stats are there.
Where I saw a possible typo was how you related to Hashimoto as something related to hyperthyroid with Hoashimoto is only linked to hypothyroidism.
Where I saw a possible typo was how you related to Hashimoto as something related to hyperthyroid with Hoashimoto is only linked to hypothyroidism.
COMMUNITY LEADER
I think the "typo" Stella referred to was that Hashimoto's is related to hypERthyroidism; it's not, it's related to hypOthyroidism. Graves Disease is the autoimmune that's related to hypERthyroidism.
Nope, not a typo at all. 47%+ of all HYPERthyroidics gain weight, and also show wide weight swings. During research for my book, my doc studied 100 confirmed men with hyperthyroidism of on type or another. 47 had gained more than 20 pounds in the last year. It is like saying that if you don't lose hair, you don't have thryoid disease! Hair loss is not statistically significant in thyroid disease or disorder, neither is weight loss with hyperthyroidism.
See the posts from thyroid.about.com, and thyroid.org to confirm this - but weight gain with hyperthyroidism of all kinds happens all the time. I've had it several times in my life.
See the posts from thyroid.about.com, and thyroid.org to confirm this - but weight gain with hyperthyroidism of all kinds happens all the time. I've had it several times in my life.
COMMUNITY LEADER
I agree that having a low TSH does not necessarily mean you are hyper. Mine typically runs < 0.01 and we don't even look at it, so long as my Free T3 and Free T4 are at a point that's good for me.
TSH is a pituitary hormone and is not indicative of thyroid hormone levels. You need the actual thyroid hormones, FT3 and FT4, tested to know where you are with everything.
Many of us with Hashi's produce very little hormone and eventually will produce none.
While the various parts of the endocrine system are very closely related, and must work together, it's important to note that the thyroid regulates "only" thyroid hormones, T3 and T4 not adrenal hormones, such as adrenaline or cortisol.
TSH is a pituitary hormone and is not indicative of thyroid hormone levels. You need the actual thyroid hormones, FT3 and FT4, tested to know where you are with everything.
Many of us with Hashi's produce very little hormone and eventually will produce none.
While the various parts of the endocrine system are very closely related, and must work together, it's important to note that the thyroid regulates "only" thyroid hormones, T3 and T4 not adrenal hormones, such as adrenaline or cortisol.
Opps - I think you had a typo there...
Hashi's is not related to HypERthyroidism - its the autoimmune disease of HypOthyroidism.
And in the majority of the cases with a hyperactive thyroid function the weight gain is not as common ( actually loss happens more) .
Hypothyroidism in most cases will have an increased weight index and this poster probably is hypothyroid in her treatment right now.
I have to agree with Goolaara on the importance of looking at the entire endocrine system with any of the thyroid disorders - along with an importance on seeing where the immune system response is and how strong it is to repair some of these issues that can trigger a hormonal imbalance.
Lets just take the brief history we heard here on your post and see where this goes:
You have been clincally low thyroid for almost your entire life and recently you had a birth which is a huge stress on the body. My guess even prior to this birth was that you were still low on your thyroid therapy but muddled through the years OK and had been monitored only by the TSH for these years with your treatment.
Now that you have been pregnant and had a birth - you have aged since treatment started - and other things the Hashimotos may be in more of a destruction mode now and throwing off your entire system with your other hormones all due to the lack of low immune system probably from the beginning.
The ultra sound could be a good indicator of the condition right now with your gland and to see the destruction limits it has done. With Hashiomotos it may not hurt to have a scan done to see more.
Here is a few things to consider in your stage of your disease:
Right now you are most likely estrogen dominant.
You are extremely low on the needed T3 hormone ( measured ONLY by a base Free T3 blood lab test)
Your ratios of thyroid hormone is off - Measured only on the Free T4 and Free T3 blood lab and ratiod out - ignoring the TSH number entirely - based off symptoms
Your Hashimoto antibodies are raging - Selenium supplements could help
Your liver is blogged...
Your immune system from the birth and the disease is off severly.
Hashi's is not related to HypERthyroidism - its the autoimmune disease of HypOthyroidism.
And in the majority of the cases with a hyperactive thyroid function the weight gain is not as common ( actually loss happens more) .
Hypothyroidism in most cases will have an increased weight index and this poster probably is hypothyroid in her treatment right now.
I have to agree with Goolaara on the importance of looking at the entire endocrine system with any of the thyroid disorders - along with an importance on seeing where the immune system response is and how strong it is to repair some of these issues that can trigger a hormonal imbalance.
Lets just take the brief history we heard here on your post and see where this goes:
You have been clincally low thyroid for almost your entire life and recently you had a birth which is a huge stress on the body. My guess even prior to this birth was that you were still low on your thyroid therapy but muddled through the years OK and had been monitored only by the TSH for these years with your treatment.
Now that you have been pregnant and had a birth - you have aged since treatment started - and other things the Hashimotos may be in more of a destruction mode now and throwing off your entire system with your other hormones all due to the lack of low immune system probably from the beginning.
The ultra sound could be a good indicator of the condition right now with your gland and to see the destruction limits it has done. With Hashiomotos it may not hurt to have a scan done to see more.
Here is a few things to consider in your stage of your disease:
Right now you are most likely estrogen dominant.
You are extremely low on the needed T3 hormone ( measured ONLY by a base Free T3 blood lab test)
Your ratios of thyroid hormone is off - Measured only on the Free T4 and Free T3 blood lab and ratiod out - ignoring the TSH number entirely - based off symptoms
Your Hashimoto antibodies are raging - Selenium supplements could help
Your liver is blogged...
Your immune system from the birth and the disease is off severly.
You will need your dose checked again soon. Often it is needed to be lowered after giving birth as the body no longer needs to provide in utero for the baby. Breast feeding will mean you will still need a slightly high dose though. When the baby weans off, you will then need to go down probably back to 100mcgs. It sounds like your dose should have been lowered to probably 150 or even 125mcgs after the birth of your baby.
You aren't technically hyper but the dose you are on is too much for where you are post-partum.
Don't fret that you haven't lost weight when you baby is only 7 weeks old! If you are breast feeding your body will try to keep that weight on as a way to produce milk! The pituitary gland makes prolactin and it needs a certain weight to keep that going.
As I said, I think your dose is a little too high, given the circumstances, and I am sure once you lower it slightly you will feel better. Your body took 9 months to grow a baby and it takes a while for the body to readjust.
Also it is not a good idea to do too much and restrict calories too much when breast feeding, often the pituitary will sense you are in famine and doing too much and will shut down the prolactin which produces milk. The body knows what it is doing, despite the fact we want it to be different!
I have Hashi's. I became extremely hyper after having my 3rd child. My case was undiagnosed for another 15 years.
Weight gain is a symptom of hyperthyroidism, especially Hashimoto's, because we are not metabolizing our food properly. Vitamin supplements, like A, B-6, and Zinc can help both our autoimmune and metabolic issues.
I was born with tumors, and regularly have a large leaking cysts come and go, and doc believes hashimoto's is on it's way to destruction of my gland. This causes a change, from hyper to hypothyroidism as the gland begins to lose it's ability to properly regulate the adrenaline in our systems. Kpeters has a very good point in that the whole endocrine system is inter-related. However, it's a medical fact according to the ATA that more than 15% of hyperthyroidics have few to no symptoms, and blood tests won't diagnose. Ultrasound/sonogram, a full blood panel including minerals might tell a lot. Best.
I was born with tumors, and regularly have a large leaking cysts come and go, and doc believes hashimoto's is on it's way to destruction of my gland. This causes a change, from hyper to hypothyroidism as the gland begins to lose it's ability to properly regulate the adrenaline in our systems. Kpeters has a very good point in that the whole endocrine system is inter-related. However, it's a medical fact according to the ATA that more than 15% of hyperthyroidics have few to no symptoms, and blood tests won't diagnose. Ultrasound/sonogram, a full blood panel including minerals might tell a lot. Best.
A low TSH does not necessarily mean that you are hyper. It only means that you are hyper if you have hyper symptoms, and from what you've said so far, you don't seem to. TSH is a pituitary hormone and unreliable in determing thyroid status because it can be influenced by many factors other than thyroid hormone levels. You have to look at the free T3 and free T4 (the acutal thyroid hormones) levels to determine thyroid status.
The whole endocrine system is interrelated. Reproductive hormones and thyroid hormones are both part of the endocrine system. Upsets in one part are often reflected in other parts. Thyroid imbalances often occur postpartum.
Do you have your FT3 and FT4 results and the reference ranges from your lab report? If so, please post your current results along with as much history as you feel is relevant.
The whole endocrine system is interrelated. Reproductive hormones and thyroid hormones are both part of the endocrine system. Upsets in one part are often reflected in other parts. Thyroid imbalances often occur postpartum.
Do you have your FT3 and FT4 results and the reference ranges from your lab report? If so, please post your current results along with as much history as you feel is relevant.
You are reading content posted in the Thyroid Disorders Community
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
