Most people, doctors included, think about Hashimoto’s as a disease that results in hypothyroidism or low thyroid function.
And while that is true, it isn’t the whole story.
Can patients with Hashimoto’s thyroiditis also end up with hyperthyroidism?
The answer is yes.
In fact, there are several ways that it can happen and it’s not as rare as you might think.
And this hyperthyroid state can result in a lot of confusion for patients who have Hashimoto’s thyroiditis and are expecting to have low thyroid.
For these reasons, let’s discuss how Hashimoto’s can lead to hyperthyroidism and how patients with Hashimoto’s may end up with an overactive thyroid.
Today you will learn:
- How Hashimoto’s can result in hyperthyroidism
- How and why your thyroid symptoms can fluctuate if you have Hashimoto’s
- More information on the double diagnosis of Hashimoto’s and Graves’ disease
- The role that thyroid medication plays in your thyroid status
- And much more…
DOWNLOAD FREE RESOURCES
Foods to Avoid if you Have Thyroid Problems:
I’ve found that these 10 foods cause the most problems for thyroid patients. Learn which foods you should avoid if you have thyroid disease of any type.
The Complete List of Thyroid Lab tests:
The list includes optimal ranges, normal ranges, and the complete list of tests you need to diagnose and manage thyroid disease correctly!
How Hashimoto’s Can Cause Hyperthyroidism
Let me first start off by saying that most of the time Hashimoto’s does result in hypothyroidism or low thyroid function.
The normal route that most patients with Hashimoto’s take looks something like this:
- Step 1: Something sparks the creation of thyroid antibodies from your immune system which target proteins found inside of the thyroid gland (this could be due to genetics (1), the environment (2), infections, nutrient deficiencies (3), or many other factors).
- Step 2: The antibodies produced by your immune system target your thyroid gland and cause local inflammation.
- Step 3: White blood cells (from the immune system) infiltrate (4) thyroid gland tissue which slowly results in damage.
- Step 4: Over time this infiltration and inflammation result in permanent damage that causes decreased production of thyroid hormone.
- Step 5: This progressively gets worse until the thyroid gland can no longer produce thyroid hormone at all.
This is the normal progression for MOST patients who get Hashimoto’s but, as you probably are well aware, real life is not always this clean.
It’s hard to take a series of steps that should occur based on what has been read in a book and neatly apply it to everyone.
In the real world, the progression of Hashimoto’s isn’t always this clean and tidy.
This progression also doesn’t take into account treatments that patients may undergo to try and prevent their disease from getting worse.
With this in mind, let’s talk about some ways in which this progression changes and how these changes may result in hyperthyroidism.
#1. You May Go Through Hyperthyroid Phases
The first thing you need to understand is that many people with Hashimoto’s will experience fluctuations in thyroid function over time.
And this makes perfect sense if you think about it.
Sometimes your immune system will flare up and you will have more damage and inflammation and other times your body will be relatively under control and you won’t experience the same level of inflammation.
Imagine the ebbs and flows in your life, sometimes you are more stressed than others, sometimes you are getting more sleep than others, sometimes you may find yourself sick more frequently than others, and so on.
“Sleep deprivation makes a living body susceptible to many infectious agents. In the result, immune system of human body is altered by releasing immunomodulators in the response of infections as reported by various researchers.”
– Human Immune system during sleep (5)
Each of these will have an impact on your immune system and, therefore, the progression of your Hashimoto’s.
These fluctuations in immune function can be problematic because they can and do influence thyroid gland function.
Sometimes inflammation can lead to a DECREASE in thyroid hormone production (as mentioned above) and other times it may result in an INCREASE in thyroid hormone production.
Your thyroid gland is a tissue that is designed to create and store (6) thyroid hormones.
When it gets inflamed or damaged it may accidentally release too much thyroid hormone instead of too little.
When this happens you may experience a bout of hyperthyroidism.
“The organ system manifestations of Hashimoto thyroiditis are varied due to the nature of the disease. Initially, patients may have bouts of hyperthyroid symptoms, as the initial destruction of thyroid cells may lead to the increased release of thyroid hormone into the bloodstream.”
– Hashimoto’s Thyroiditis, et al (7)
Is this a rare occurrence?
Not exactly, it’s estimated that up to 10% of patients with Hashimoto’s will experience hyperthyroid episodes either on initial diagnosis or throughout the course of their disease.
When it happens and who will it happen to can be difficult to predict but one thing is for sure:
We know that it can and does occur.
And when it does it can be confusing for patients, especially those who are taking thyroid medication.
Imagine being someone taking thyroid medication like levothyroxine because your thyroid was low, only to experience hyperthyroid symptoms out of the blue because now it’s producing more thyroid hormone than it should.
This will necessitate changes to your thyroid medication and may even prompt a workup for additional autoimmune disease of the thyroid gland.
Understanding that this happens can prepare you for when it does and prevent unnecessary tests or a delay in diagnosis.
#2. You May Have a Double Diagnosis of Both Hashimoto’s and Graves’ Disease
This one is not quite as common as the first or the third but it can happen.
What if you end up with a double diagnosis of both Hashimoto’s thyroiditis and Graves’ disease?
If you aren’t familiar with Graves’ disease let me fill you in.
Graves’ disease is an autoimmune disease of the thyroid gland that results in hyperthyroidism.
Thyroid patients with Graves’ disease produce thyroid-stimulating immunoglobulin which binds to your thyroid gland and results in excess production of thyroid hormone.
The result? Hyperthyroidism.
This is pretty much the exact opposite of Hashimoto’s but these two disease states have a lot in common.
In fact, the same things that trigger Hashimoto’s can trigger Graves’ disease, and the same natural treatments for Hashimoto’s often work for Graves’ disease as well.
You can think of Graves’ disease and Hashimoto’s as two sides of the same coin.
They are slightly different but share a lot of similarities in their causes and treatment.
The main difference, of course, is that one typically results in hyperthyroidism and the other hypothyroidism.
But because they are so similar (8) in what can cause them, they may co-exist (9) together in some patients.
You might think it would be easy to differentiate these disease states based on checking for thyroid antibodies, right?
Unfortunately, it’s not quite that easy.
Patients with Graves’ disease can see elevations in both thyroglobulin antibodies as well as thyroid peroxidase antibodies (10).
*Image key: AITD = autoimmune thyroid disease, GD = Graves’ disease, HT = Hashimoto’s thyroiditis.
This makes the diagnosis difficult to make at times.
Patients who find themselves with both conditions are often at a loss for what to do.
If you experience both autoimmune thyroid conditions then the answer is to always focus on whichever is more dominant.
It’s impossible for the same tissue to be both overstimulated and understimulated simultaneously by thyroid hormone.
You can use this information to figure out your thyroid status and whether or not you are mostly hypothyroid or mostly hyperthyroid.
Both conditions do have some overlap in symptoms, though, so this strategy doesn’t always work but it’s a great place to start.
Finally, if all else fails then the ace up your sleep should be focusing on your immune system.
Remember:
Both Graves’ disease and Hashimoto’s are considered autoimmune diseases which means they are first and foremost a problem with your immune system.
You don’t necessarily need to know what is happening with your thyroid to focus on treatments that balance your immune system and reduce inflammation.
The treatments that work for Hashimoto’s often work for Graves’ disease.
#3. You May Be Overmedicated with Thyroid Medication
Finally, the last way you can become hyperthyroid if you have Hashimoto’s is through the use of thyroid medication.
Thyroid medication, when dosed correctly, is supposed to bring balance to your thyroid function.
But it’s not hard to imagine a scenario where this goes wrong.
For the reasons I’ve already mentioned, your thyroid function can be a moving target based on fluctuations in your immune system and other factors.
Imagine trying to figure out how much thyroid medication you should be taking while your thyroid gland rotates between overproduction and underproduction of thyroid hormone.
Not so easy, right?
This is one of many reasons why patients with Hashimoto’s often do not always feel better even while taking their thyroid medication.
It’s not uncommon for them to either take too much or too little.
If you take too much then you can push yourself over into the realm of hyperthyroidism and if you take too little then your medication will have little if any effect.
And even without the moving target of thyroid function in Hashimoto’s, it turns out that doctors aren’t that great at dosing patients with thyroid medication anyway.
It’s estimated that up to 20% of thyroid patients taking thyroid medication are taking too much (11) at any given time.
And it’s also been estimated that up to 30% of thyroid patients who are taking thyroid medication don’t need to be on it (12).
Those two stats should say a lot.
Doctors are routinely (though accidentally) overdosing patients and giving patients thyroid medication that don’t necessarily need it.
If you are someone with Hashimoto’s who is taking thyroid medication and you aren’t feeling where you want to be then one of the first places to look may be at your thyroid medication dose!
If you are experiencing hyperthyroid symptoms then dropping or lowering your dose may be the fix that you need.
In order to get this information, though, you will need to get a full thyroid lab panel.
It’s never a good idea to make changes to your thyroid medication without first checking these lab tests.
Symptoms of Hashimoto’s Hyperthyroidism
I mentioned above that one of the best ways to assess whether or not you are hyperthyroid is based on your symptoms.
And while this is a great way to qualitatively assess thyroid function, it’s not perfect.
It’s a great tool for thyroid patients that can help you determine if you need to see your doctor, though, which is why we still should talk about it.
The symptoms of hyperthyroidism are typically the exact opposite of those seen in hypothyroidism (with a few exceptions).
But in addition to these symptoms, patients with Hashimoto’s who also have hyperthyroidism may experience some immune-related symptoms as well.
Symptoms of hyperthyroidism in patients with Hashimoto’s may include:
- Weight loss
- Fatigue (also seen in hypothyroidism)
- Dry brittle hair (hair loss is also seen in hypothyroidism)
- Diarrhea
- Tremors
- Rapid heart rate
- Hot flashes
- Anxiety or panic attacks
- Warm sensation in the body
- Heat intolerance
- Insomnia
Immune-related symptoms may include:
- Headaches
- Feeling achy or flu-like
- Rashes (dermatitis or eczema)
- Enlargement of the thyroid gland or swelling of the neck
- Joint pain or muscle aches
- New allergies to foods or other products/chemicals
The immune-related symptoms are tied to thyroid function insofar as they impact inflammation in the thyroid gland but they are often completely different from the symptoms of hyperthyroidism or hypothyroidism.
The addition of these symptoms can often help you understand if your hyperthyroidism is caused by your own body or by thyroid medication.
If you experience hyperthyroid symptoms without immune-related symptoms then there’s a good chance your symptoms are related to your thyroid medication.
If you experience hyperthyroid symptoms with immune-related symptoms then there’s a good chance your symptoms are related to your own body causing a flush of thyroid hormone.
Again, these aren’t perfect but they can be used as a rough guideline.
Treating Hashimoto’s Hyperthyroidism
What can you do if you experience hyperthyroid symptoms and you have Hashimoto’s?
The first step is to try to figure out what caused the hyperthyroid state.
If you can nail down the cause then it will make treating the problem a lot easier.
For instance:
- If your hyperthyroidism is caused by your thyroid medication dose then reducing your dose is your next best step.
- If your hyperthyroidism is caused by fluctuations in thyroid function then focusing on reducing inflammation and reducing your thyroid medication dose temporarily (if you are taking any) is your next best step.
- If you have a combination of both Hashimoto’s and Graves’ disease then using natural therapies to cool down inflammation or medications like LDN is your next best step.
No matter what you do, though, make sure you get tested before you make any changes to your treatments or medication!
It may seem counterintuitive but there are plenty of times that your thyroid lab tests don’t always correlate with your clinical symptoms.
If that is the case then you need to do some more investigative work to figure out what is going on.
You might ultimately find that something like menopause is causing hyperthyroid-like symptoms which you are incorrectly attributing to your thyroid.
Believe me when I say that this sort of thing happens often!
You can prevent barking up the wrong tree by always checking your thyroid lab tests.
Wrapping it Up
Even though we think about Hashimoto’s as a disease that primarily causes hypothyroidism that isn’t always the case.
There are at least three different situations in which patients with Hashimoto’s can end up with hyperthyroid symptoms.
If you have Hashimoto’s then understanding how this occurs is important as it can help you get on the right treatment and avoid unnecessary delays in diagnosis.
Now I want to hear from you:
Do you have Hashimoto’s thyroiditis?
Have you experienced hyperthyroid symptoms before?
If so, do you know why?
Are you someone with a double diagnosis of Graves’ and Hashimoto’s?
Do you think your thyroid medication could be contributing to your hyperthyroid status?
Leave your questions or comments below!
Scientific References
#1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3271310/
#2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2935336/
#3. https://pubmed.ncbi.nlm.nih.gov/28290237/
#4. https://pubmed.ncbi.nlm.nih.gov/35140214/
#5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5768894/
#6. https://www.ncbi.nlm.nih.gov/books/NBK500006/
#7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5053048/
#8. https://pubmed.ncbi.nlm.nih.gov/17823263/
#9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3603068/
#10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5422478/
#11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4560848/
#12. https://pubmed.ncbi.nlm.nih.gov/33161885/
Hi Dr. Childs,
I just found your site and I am thankful. I had my thyroid removed in 2012. I recently had to change doctors due to my health insurance. My latest results on my TSH is 31.7, T3 is 2.4 and T4 is 1.0. The doctor questioned if I had been taking my medicine? I take 137mg. She is now increasing it to 175. I have been gaining weight and loosing lots of hair. My nose, feet, and hands are always cold. Any thoughts to help me?
Hi Dee,
You will need to get your TSH under control. If your TSH doesn’t go down with your medication then it means you are probably not absorbing it and you may want to look into gut issues that could be interfering.
Hi Doctor.Childs
I’m Halima (29) from India
My T3 is 119.50
T4 is 6.56
TSH is 7.860
Anti TPO 914.87
TG 14.27
What should I do now
I can’t focus on anything
I’m gaining weight every month
Lossing memory
Sometimes I feel like my brain is not working anymore
Pls suggest me anything
(Note :I’m a feeding mother)
Hi Halima,
I would recommend checking out the natural treatments listed below:
https://www.restartmed.com/natural-thyroid-remedies/
https://www.restartmed.com/tpo-antibodies/
You might also consider getting on thyroid medication: https://www.restartmed.com/thyroid-medication/
Hi Dr Childs,
I appreciate your articles very much, although I’m confused as to what to think of my blood test results, and so are the specialists. 38 yr old female, mother to 6. There is a growth/cold spot on my thyroid.
Not getting the best sleep with littles ones 🙂 but not struggling with insomnia either. Might even get 8 hours now and then, with a few quick interruptions.
TSH <0.01 for the past two years,
total T4 ranging between 104-147; Free T4 100-130
total T3 ranging between 1.5 – 2.4
I am not taking any medication.
As for symptoms, I only experience slight heat intolerance, fatigue and allergies. (But these are not new).
Your suggestions for where to start will be highly valued.
Kind regards,
Elrike
Hi Elrike,
Have you been tested for thyroid antibodies like TSI, thyroglobulin, and thyroid peroxidase antibody?
I was diagnosed with Hisamoto Thyroiditis in 1996 & had my left thyroid surgically removed in 1996, I was never put on medication & now I have been diagnosed with Hyper thyroid, I have a bad digestive system, I can’t sleep, I was diagnosed with Fibromyalgia, my hair came out, I have a lot of belly fat, I am in full blown menopause & my test came back that I have a lot of Inflammation I am now going to a Naturopathic Dr. & she has sense put me on 25 billion Probiotics 1 time a day, which is not working for me & she has also put me on Vitamin E, omega 3 fatty acids & a product with Guggul, Rosemary, Vitamin D ,Selenium, Zinc Vitamin A & Ashwaganda i have also have problems with my Gallbladder, what would You Recommend. when my hair fell out my Hair Grayed a lot & I’m always in Pain everyday
Hi D,
I think it really depends on what your most major/pressing symptom/issue is. If that’s pain then I would recommend starting here: https://www.restartmed.com/hypothyroidism-chronic-pain/
Hello Dr. Childs,
I am concerned with the diagnosis of the Hyperthyroid & the Digestive Issues I am having I was also diagnosed with H-Pylori; my Thyroid lab work keeps coming back as Hyperthyroid, but I am also in full blown Menopause.
I can’t tolerate heat at all & I am having really bad Muscle Spams
I was diagnosed as hyperthyroid (tsh 0.005) about 15 months ago, put on methimazole, a beta blocker, and anxiety meds for the tremors. Even though I was hyper, I still was and am obese. About 5 months into the methimazole treatment, the doctor stopped the meds after my tsh went up to 8.8. At that point I was diagnosed with Hashimotos Toxicosis, which was the doctors suspicion but hadn’t yet tested for antibodies until the tsh shot up so high. Since December 2021, my tsh has gradually come back down and today it was 1.03….about half a point away from going hyper again. I’ve also gained 13 lbs in the last 3 months even though I have been eating a healthy keto diet and exercising 5 days a week. I am at my wits end with this because none of it makes sense. My labs have been all over the place since this started. I quit eating gluten a year ago, take probiotics,, selenium, zinc, Vit d3, E, never eat anything with soy, the only dairy I consume is kefir and rarely cheese. My doctor told me that in over 30 years of practice he has only seen one other patient like me. I just don’t get how I could be so close to hyper again but gaining weight when I’m not overeating, exercising, and also focusing on gut health. I’m trying to do everything right and all the suggestions but I’m still gaining weight. IT DOESN’T MAKE SENSE!
Hi Cat,
There is a relatively simple explanation for why hyperthyroid patients gain weight which you can read more about here: https://www.restartmed.com/hyperthyroidism-weight-gain/
It can also be caused by anti-thyroid medications as explained here: https://www.restartmed.com/methimazole-weight-gain/
There’s always an explanation for weight gain as long as you know what you are looking for (and ordering the right tests).
Hi,
In New Zealand we can’t get a wide range of blood tests such as reverse T3.
However these are my results to date
Thyroid antibodies were very high
TSH low and sometimes normal.
T3 T4 normal
I have symptoms of both hyper and hypothyroidism but without weight gain (55kg). Because I have leaky gut, and am addressing that, it is quite hard to gain weight when there are so many restricted foods. However I am also losing appetite somewhat lately.
My GP has ordered a natural pig thyroxin and suggested I take it and see if my symptoms improve or reduce so we can see what thyroid condition I have. .
If the symptoms of hyperthyroidism get worse could I induce Thyroid Eye Disease and if so does it come on rapidly.
Hi Diane,
Thyroid eye disease is driven by autoimmunity, not thyroid function. So it’s more about your TSH receptor activity and the sensitivity of your tissues to that instead of your thyroid levels.
Hello Dr.Childs….. I have been diagnosed with hyperthyroid- hasimoto disease. I am a 53 year old male. I’m waiting on my iodine test in a week.I have dry mouth when I wake up and I have unlivable salava watering in my mouth at night. My doctor tried the patch behind my ear but it retained urinating. Is there anything I can do until they can get me on track?
Hi Keith,
There are many things you can get started with including things like diet, stress reduction, ensuring you get enough sleep, taking supplements, etc. I would recommend checking out this article: https://www.restartmed.com/treatments-for-hyperthyroidism/
In regards to your iodine test, please also see this article for more information on why iodine testing is inaccurate and usually unhelpful: https://www.restartmed.com/iodine-testing/
Hi Dr.Childs, I’m v. confused! I now take cytomel 20 mcg/day( split into 4 doses), and feel just fine. For the last year or ss I have taken Armour thyroid, or T4 with cytomel, my TSH has been <0.01, so of course I was told I must be taking too much, even tho’ I have felt horrible and v hypothyroid!!! When I have reduced the Armour or NPT I have still felt bad and my TSH has still been <0.01, or even <0.005. However, when I stop the T4 and continue the T3 alone, I feel 100%, and my TSH has returned, but….. to 4.9 or 5.2! My FT3 is about mid -range and T4 way low-off the bottom of the chart! I thought that T3 or XS T4 would completely suppress TSH, but now it only seems to suppress T4. My Dr. is v confused also, and the endo says I should just take T4 which makes me feel awful and does no good whatsoever! Help please!!!! Thank-you!
Hello,
I’m a 42yr old momma of 4. I have very recently been diagnosed with Graves’ disease AND Hoshimotos. I’m very confused on how that diagnosis was made. I am currently hyperthyroid. All my T3 and T4 are elevated and my TSH is nonexistent. My TSI is 426 and my Thyroglobulin is 4. Looking for advice on what markers show the dual diagnosis.
Hi Jennifer,
It’s possible to have both conditions, but the markers/tests you mentioned here are not sufficient to make that diagnosis. You can learn more here: https://www.restartmed.com/hashimotos-vs-graves/
So very thankful to find your site. I’m a RN and do a lot of research and for the life of me I can’t get my head around all the information and formulate my own plan of care. Finding your site which details the why, how and some suggestions to correct symptoms etc is THE best I have found over the last 1 ⅔. I have done the full AIP, eat low carb appropriate PRO and high fat. I have symptoms of both hypo and hyperthyroidism. Early spring I was taking 50mcg of thyroxine. About 6 weeks into it I started getting palpitations. My resting HR was in the 100s and it jumped to 130s while walking. My other two symptoms which concerned me was profound weakness in my upper legs and both arms. I researched the symptoms of overtreatment with thyroxine and stopped the med. It took another month for those symptoms to resolve. I also have massive lymph swelling throughout my body – have no idea why. But I do compression therapy and my own lymph massage (probably will start seeing someone for this in the new year). My TSH went from 7.11 (Canadian ref ranges) down to 1.07 and my TGAB went from 143 down to 29 as I completed the AIP and started Carnivore, then ketovore and now I am going to just do low carb, higher fat (taking MCT oil). This disease has caused so many symptoms on top of other things I have. The fact that you are dedicating your time to help others is very admirable. Thank you! I am going to start trying a Hashi bundle but currently it is out of stock.
Hi Elly,
Glad you found the information helpful! Also, the Hashimoto’s bundle is now currently back in stock so you should be good to go there.
Your story sounds so much like mine. I had extreme arm weakness to the point that I was taken by ambulance for possible stroke. I went from hypo to hyper in a few months after being overmedicated (which I think was because I did the AIP, lost 20 lbs, cleared my gut, etc.). I was diagnosed with hashi & graves due to antibody testing results & TSH levels. I’m now only on beta blocker, magnesium, vit D, & selenium. As long as I watch my diet, I’m doing great! My graves is now either in remission (or gone!)
Have Hashimoto’s for years. Have been taking Levothyroxine 100 and my dr did some labs then recently cut that to 50 because I just simply do not feel well. Heart palpitations, hair loss, can’t lose weight in my middle. Just generally don’t feel well. I take your function fuel detox. Hoping to feel better soon. The palpitations are an ongoing constant problem.
I have hashimotos thyroiditis and last year has a huge hyper episode. I couldn’t sleep for 3 days as my heart felt like it was going to explode out of my chest. My meds were dropped by half and 2 weeks later it went majorly hypo and I could barely keep awake. Thus year I haven’t had any hyper episodes but I recently have been really ill with lots of viruses. Been worse since I had covid in March. I’m now on levothyroxine 100MG and liothyronine 20mg but I was previously on Armour NDT 2 grains. Don’t know if this change is causing the difference. My tsh is always at 0.01 and doctors try to dose me by that but levels of t4 and t3 aren’t optimal. Usually on the lower level. But still my gp wants to reduce my dose. I’ve never had a thyroid scan so no idea what’s going on inside. Now recovering from a 5 week chest infection. Wish you were my doctor as you understand what most don’t.
Hi Dr. Childs,
Thanks so much for writing this article. I’m kind of lost right now in my diagnosis and you explained it really well here. I recently got taken off my thyroid medication for Hashimoto’s because I am indeed in a hyperthyroid time, as you described I never fully felt better on my medication and I have been getting sicker lately and dropping weight fast, and I have almost all those lovely symptoms you described. My doctor hasn’t been doing the full labs, like I thought, and I honestly think I may have graves’ disease as well or my immune system is going crazy. I’m not sure, finding a solution is going slow for me and my labs my doctor checked for a 3rd time came back higher again and I won’t see him for a month. So I’m going to try to boost my immune system more and sleep. When I was on my meds, I had bad insomnia and my anxiety was so bad, I was getting dizzy and couldn’t sit still, I knew something was wrong, so I took myself off my meds and my doctor called me the same day to tell me to stop. I wish you were my doctor, thanks for writing this article and I will soon follow you 🙂
Hello!
I am hypothyroid in Winter and hyperthyroid in summer. Do you have any advise for me? I am not on any medication.
Thank you.
Hello Dr. Childs
last two months I did thyroid test it. the result was tsh of 4.24 and ft4 of 24 and normal ft3 then last month I checked it my tsh is in the middle normal and 20 ft4. but last week I felt increased heart when I wake up and experienced it for 40hrs straight a doctor give me 40mg of propranolol 2 times and I tested my thyroid again. the result is my tsh is <0.01, ft4 is 25.6 and t3 is 5.4
please help Dr.
This is really interesting. I had no idea Hashimoto’s could cause both hypo and hyper.
I’m wondering about a similar odd situation. I was diagnosed with Grave’s disease (high) about 20 years ago. I elected not to do anything to kill my thyroid, but instead took Methimazole for about 10 years, until everything leveled out and my doctor said I must have gone into “remission” (not sure about that – I think it was just on its way down). Now, 2 years ago, I was diagnosed with Hashimoto’s (low).
My question is whether it was, in reality Hashimoto’s all along? Or did the methimazole do too good of a job reducing T hormone production? But if so, why would what I have be considered Hashi’s and not just low thyroid? But then Grave’s is autoimmune too, so is there a connection between the two somehow?
Hi Meli,
It would be unlikely to have been Hashimoto’s the entire time as hyperthyroidism is fairly rare among those with Hashimoto’s and, typically, short lived.
You can certainly overmedicate on methimazole, though, and that may lead to hypothyroidism. This is fairly common among people taking that medication.