[Anonymous]

#1052329

First, I posted these replies about Grave’s and being hypo because someone asked if it was possible to have Grave’s and be hypothyroid without being hyperthyroid in the past. This is not denying that Grave’s leads to hypothyroidism in the future, but it is denying that Grave’s starts as a hypothyroid condition. Pumkin, If you are defending that you are hypo, but you were hyper in the past, then being hypo now is not rare at all, but is considered the typical course of the disease.

Pumkin, (this is just a little friendly debate, not something to get upset about)

How did you have thyroid tissue removed from your eyelid?

I’ve encountered this a number of times. I have had several people (including my mother, who I got this disease from – probably) before I ever came down with this disease tell me that they went to the doctor and were found hypo, and that they were told that it was Grave’s disease in it’s early stages. I knew this to be incorrect. We actually studied alittle about Grave’s when I was in the military because of the President and Barbara Bush thing. I then found out that my mother had this disease, and so I began a quest. Well, two of the people had Hashimoto’s thyroiditis, and one had ‘painless’ thyroidistis. My mother and a couple others went to other doctors and found out that they did have Grave’s, and that they had been hyperthyroid in the past, and that this was a residual condition. About four months ago, a little after I started my own treatment I talked to another women who I had known who had just recently been diagnosed with Grave’s disease by a podiatrist! (crazy?!?!) But she was hypothyroid. He told her that was the condition throughout the course of the disease. He said she was wrong when she said that she read that Grave’s was hyperthyroidism. He said that it is both. He prescribed for her a prescription of 20 mg of antithyroid medication (because that is something that doctors prescribe for people with an onset of Grave’s), and she almost died (because she was hypo, not hyper!). He was wrong. She was suffering from Hashimoto’s thyroiditis! Nevertheless, she was represented by the state, and he was fined for malpractice by the state. They declared in court that Grave’s cannot be hypothyroid at onset (beginning of the disease), based on a lot of the information that I have below.

Well, I would like those phone numbers. It would be interesting. And I stand my ground on this one. I’ve put my foot in my mouth before, but now I’m in an area where I do have experience…diagnosis. The info I am about to write is taken out of a text book that I used while in the military. It is called “A Physician and Medic’s Guide to Clinical Diagnoses.” When a disease is given a name, whether it be Grave’s or diabetes, there are a list of characteristics that must accompany the disease, otherwise it is not that disease. I’m not referring to symptoms here, but actual characteristics that distinguish the disease from other diseases. When a condition is encountered that presents itself in a way that never has been presented, but does not qualify under any other characteristic reference, than this condition is a new finding and subject to all new finding rules and regulations as governed by the medical community of authority. This means that if something does not meet all required characteristics, and if it does not match any other set of characteristics, then this is a new disease. If someone does not have problems with insulin production or insensitivity, then they do not have diabetes. This is a required characteristic of diabetes. Someone (I don’t know who) discovered a disease where people had problems with insulin production or a cell-insensitivity to insulin, and this disease was named diabetes. The disease is not the entity, but it is the presence of the required characteristics that compromises the disease. The name means nothing in diagnosis; it is the characteristics that define the disease, not the name. The name is merely a symbol (a verbal tool) that relates to the disease, and gives it verbal structure.

The same analogy is true with Grave’s. Grave’s disease (it wasn’t called grave’s yet) was first discovered by Caleb Parry back in 1786. He recorded patients with a ‘diffuse goiter’ and ‘hyperthyroidism.’ This was the first published records (circa 1823-1826) of what was soon to be called Grave’s disease. Robert Graves also recorded several hyperthryroid patients. Medical representatives from the United States and other countries met in England and recorded his findings. They named it four things- Grave’s disease and Basedow’s disease (laymens terms), diffuse thyrotoxic (or toxic) goiter, and thyrotoxicosis. The latter two are worldwide terms, and mean that all of the gland is affected (diffuse), that the condition renders physical manifestations of fever and hot flashes (toxic), and that the thyroid is enlarged (goiter). Grave’s disease was the name given to this form of hyperthyroidism.
These terms establish certain requirements of the disease from the start. Next, the two ‘characteristic’ requirements were hyperthyroidism (over-activity, i.e. increased levels of hormones) and goiter. Goiter is a relative term as that most patients that are seen have never had a thyrodiameter (measurement), so it is difficult to tell goiter. Goiter is assumed to be present when ever the thyroid is stimulated to overproduce, because the thyroid must enlarge and “grow” new production cells to assist in the over-activity. Even though the gland may not reflect an enlargement because it is difficult to measure and already pretty small, the gland does enlarge, however slightly. No patients before the creation of Grave’s disease ever were hypothyroid to start, therefore hypothyroidism as an initial diagnosis of Grave’s disease does not meet the requirements of diagnosis. Also, hyperthyroidism must be present at onset of disease for the condition to be labeled Grave’s disease. Grave’s disease can (and usually does) lead to hypothyroidism, but only after its hyperthyroid state. As technology progressed, another “unwritten” requirement entered the scene. It was the presence of “thyroid stimulating antibodies,” which is a general name for several types of antibodies that are found with Grave’s. These antibodies must be present in Grave’s disease, because they are the reason the thyroid is overactive. These little critters sometimes go away, but sometimes they never do. They just usually stop trying to stimulate the thyroid gland, and you may go hypo. The presence of these whether you are hyper or hypo later is a definite indication of Grave’s.
        Another little bit of logic. People with Grave’s disease have been around for a long time. Doctors have diagnosed people with Grave’s disease for a very long time. If 2% of the Grave’s population are hypothyroid at onset, than that is enough for there to be at least one indication of a clinical university or top medical institute reporting this condition. But there are none. Why? Because first of all they wouldn’t make the diagnosis. And second, if they did they would most definitely reap some type of ridicule. The Kent State University Library Medical Link Database has no ‘Grave’s disease with hypothyroid onset without history of hyperthyroidism’ records out of the some 130,000 Grave’s disease records. When I asked my doctors about what happed to my women friend, he said that couldn’t have been Grave’s if she never was hyperthyroid in the past. My bud at John’s Hopkins U. said that wasn’t right. He said that a Doctor there said that he has never seen such a thing, because it doesn’t exist. He said that you had to have been hyperthyroid at some point before hypothyroid for it to be Grave’s.

        I’m just wondering something. Ask your doctors one question. Ask them if they think you have ever been hyperthyroid in the past. They may already be thinking that, but never told you. The thing is that there are so many levels of Grave’s and so many people who are never diagnosed, or diagnosed wrong. With people out there that have Grave’s and never been diagnosed, this poses a problem with people coming back to the doctor later in life with problems associated with past Grave’s. It is possible for someone to never know they are hyperthyroid (say it is very low) with Grave’s, but later in life they become hypothyroid. But doctors can tell if hypothyroidism is brought about by Grave’s, and perhaps that is how your doctors came about their diagnosis. But for it to be Grave’s, the hypothyroidism must have been brought about by hyperthyroidism in your past.

Just for info, here is a list of different thyroid disorders:
silent thyroiditis
thyroid cancer
congenital goiter
anaplastic carcinoma (thyroid)
chronic thyroiditis (Hashimoto’s disease)
hyperthyroidism
primary hyperparathyroidism
subacute thyroiditis
hypoparathyroidism
hypopituitarism
hypothyroidism; primary
hypothyroidism; secondary
medullary thyroid carcinoma
papillary carcinoma of the thyroid

        I am in no way trying to be argumentative. For most doctors, they don’t need a book, but there are books that the doctors use to use when they didn’t know everything yet. These books are available at any medical library or on databases at Universities. Typically you can find a number that corresponds to the weight that the endocrine community has assigned to it. The higher the value, the better the guide. This is essentially the Godfather of all diagnosis guides. In these guides you will find all the above information.

Email me and we can continue this discussion. I don’t want new people to think that this is a big debate and argument BB.

Ron
“Sleepless in Kent”

PS- this was also written at 4:00 in the morning, so it is pretty blunt and to the point. It is not meant that way. It is meant nicely.

[Anonymous]

#1153738

Six years before I was diagnosed with GD at age ten, I had been hypothyroid
at age 4 (found through lack of growth since age 2 1/2) and put on thyroid replacement
therapy. If you are saying there are no cases of hyperthyroid people that
were hypo before GD, there have been several people who posted on this
bb that that was true in there case. They were then LATER diagnosed with
GD when in a hyperthyroid state. So it is evidently possible to swing
back and forth. I have personally met a couple of GD patients who started
out with their thyroid journey in a hypothyroid state.
I’ve read about a case of identical twins where one had GD and the other
Hashimoto’s.
Who can explain it???? Who can tell me why? Wise men never try.
Apologies to Rodgers and Hammerstein.

[Author]

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