[Ghadeer]

#1060491

Hi everyone,

I’m a 21 yrs old female. five years ago I was diagnosed with graves disease, but since then I’ve been switching between hyper and hypothyroidism for like 6 times! my doctor is advising me to have a radioactive iodine. I really need advice on what to do. anyone have had the same problem?

Thanks in advance

[Kimberly]

#1182931

Hello and welcome – There are several scenarios where Graves’ patients can swing from hyper to hypo. Being on too high of a dose of anti-thyroid drugs like Methimazole can push patients into hypo territory. If your doctor is only looking at TSH in making dosing decisions, this can cause hyper/hypo swings as well. Free T3 and T4 are better benchmarks for making dosing decisions for a Graves’ patient who is early in the treatment process.. In other cases, the antibodies that cause Graves’ can start *blocking* thyroid hormone production instead of stimulating too much thyroid hormone production. Finally, there are some patients that actually have both Graves’ disease and Hashimoto’s thyroiditis – Hashi’s is another autoimmune condition that causes destruction of the thyroid gland and can lead to hypothyroidism.

For some patients, it might be easier to stabilize levels by using a fixed dose of anti-thyroid medications and then adding a small amount of replacement hormone. This is fairly commonly used in children, but is sometimes used in adults as well.

It’s definitely important to research your options before making a final decision, as all three (anti-thyroid drugs, RAI, and surgery) have risks and benefits. The “Treatment Options” thread in the announcements section of this forum has a couple of nice links that go through the pros and cons of each.

Take care – and please keep us posted!

[JEH]

#1182932

I am decades older than you and was diagnosed with Graves in 1998. I went on anti-thyroid meds and hormone supplements that year and kept to that regimen for at least 7 yrs. I noticed almost immediately upon treatment that a substantial change happened that felt like I could be flipping over into hypo, but my doc told me to stay the course, which I did.

A new doc took me off all the meds in about 2006, and the most dangerous symptoms remained in normal range. However, I have been steadily gaining weight over the years since I began treatment and so recently I decided to return to the first doc to see what he thinks may be going on. I was middle-aged when diagnosed but now am considered elderly. So the levels of T3/T4 that I show in testing now are interpreted differently than they would have been in 1998. So I am back on a small dose of T4 in the hopes that I can dig myself out of the T4 hole I am in and perhaps lose some of this extra weight.

The point is that I doubt it is all that unusual to flip back and forth between hypo and hyper as long as your vital signs stay within normal range. I have a sister with Hashimoto’s (hypo) and she has flipped to hyper at least once. I would just get a good bp monitor so you can keep track of your bp and heart rate. I understand those to be the critical points to keep track of between doc visits. Any extremes in those readings can damage your heart over time, as I understand it, and should be reported to your doc immediately.

[sarawebberdurnell]

#1182933

HI I bounce back and forth frequently. I was diagnosed with Graves and Hashimoto’s about a year ago. My symptoms were from both ends of the spectrum and difficult to handle. RAI wasn’t an option for me, so I opted for a Total thyroidectomy, which happened in Feb. I feel tons better and my symptoms are a lot less drastic. I am still trying to find my “sweet spot” with the right dose of medication, but is easy to see if I’m running hypo or hyper. My blood pressure gets high and I break out like crazy (hoping the racing pulse doesn’t return too), when I’m hyper. When I’m hypo, I have joint pain and am super tired. Doing the research is the best option as it was hard to come to my decision of surgery. I am really glad I did it though and wouldn’t change it. Nothing is an easy answer when it comes to the thyroid. Best wishes.

Sara

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