[James]

#1066258

Hi Kavya,

There may be a number of different reasons that your husband went form Hyper to Hypo. From time to time we hear of patients reporting exactly what your husband has experienced. At the recent Graves’ conference the topic of thyroid burn out came up. I did not receive and definitive answer as to how often this happens and why some people can go for decades and remain and maintain on small doses of antithyroid meds while others become Hypo over time.

You say that you don’t think he has Hashimoto’s or Graves’. There are blood tests available to give him and his Dr. the definitive answer that your husband deserves. TPO antibodies are very destructive to the thyroid gland and those individuals with elevated TPO antibodies can expect to go hypothyroid over time. I have a male relative with Hashimoto’s (elevated TPO) and he has had to adjust his thyroid replacement upward over time as a result. It would be great if your husband asked his Dr. if he has had this testing done. The results may yield some more answers. Not that it would change the current treatment he is receiving, but it may give you some indication of what is to come. As far as the emotional instability is concerned, it is not that uncommon with thyroid imbalance in general. I will let some of the other experienced people who have experience hypo weigh in more specifically on that point.

I can venture some guesses as to why his Dr. would not recommend Surgery or RAI at this point. Generally speaking RAI or Surgery is to get you to Hypo and work your thyroid levels upward from there. He already is Hypo. If your husband starts bouncing back and forth from hypo to hyper, his Dr. may have some different recommendations.

Encourage your husband to sign on here, there are a number of experienced people that have been down a variety of different roads concerning thyroid issues.

Wishing you both well,

James

[kavya]

#1018655

Hi,

My husband was diagnosed with Graves disease in 2003. Since then until 2009 he was on methimazole and for some time on PTU as well. Initially the doctor kept titerating his dosage levels but finally told him he will be hyper life long. Since 2009 he was on 2.5 mg of methimazole. He was stable for a year on that dose and then the doctor told him his disease might have gone into remission and he would not need methimazole. He was taken off metimazole and 2 months later he tested hypo. The doctor did not put him on any meds and again did his blood work after another 2 months. The results came out hypo again. My husband was put on levothyroxin (not sure if I got the spelling right).

We are stumped by the results. How did his thyroid go hypo after methimazole as stopped. Till then it was normal. Now I have a doubt on whether he has Hashismotos or Graves disease. I went through a very bad phase of my marriage because my husband was on a low dosage of methimazole. He become emotionally unstable. What do I watch out for when he is having hypothyroid. In such cases is surgery a better option. The doctor told him RAI is not an option. Please advise.

Regards,
Kavya.

[kavya]

#1066259

Thanks for the insight James. Two of his endocrinologists did conclusively say that he has graves disease. I am not completely sure on what basis they made the diagnosis. But I will point this information to him and ask him to get on the forum.

Thanks,
Lakshmi.

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