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Discussion Starter · #1 ·
Hello

I was put on Armour Thyroid by an ENT 15 yrs ago to shrink nodules. My TSH kept dropping so my PCP finally took me off. He never wanted me on. To make a long story short, after 3 yrs of monumental stress and grief over the illness and loss of my husband, my health took a nosedive. In August 2016 I was diagnosed as hyperthyroid with a TSH of 0.006 and normal T3 & T4. My PCP ran an antibody test:

TSI <140 195

TPO <9 107

I have annual thyroid scans and nodules are stable. One is 3 cm.

PCP had me take a radio iodine thyroid uptake scan. Result: Normal @6 hrs 5.9 % most going to right lobe 3 cm nodule. @24 hrs 20% 5 to left lobe and 15 to right 3 cm lobe. Diagnosis: Hot Nodule.

Saw Endo in January. He did another ultrasound and put me on 10 mg Methimazole. He said after years of ultrasounds and biopsies and stable size cancer wasn't an issue but told me I had 3 options: meds, RAI, surgery. I opted for med. He told me hot or toxic nodules don't remit as graves does.

My question is, could I have Hashi's or Hashitoxicosis? Is that what caused the antibodies or could the hot nodule cause them? My concern is that I'm being treated for the right disorder. My PCP feels the antibodies are a result of thyrotoxicosis from a 3 month case of labrynthitis last Feb and I might have had Hashi's. My Endo has no clue why I have the antibodies.

Can a hot nodule cause TSI and TPO? Does Hashi's produce both TSI and TPO? If so, should I be on anti-thyroid meds?

I am feeling hypo now. Drained, headaches, cold, weak and I lose energy very quickly and have to sit down to recover. This all started last spring with fainting spells and weak legs and low energy. I see and ENT next week for a second opinion but mainly would like your opinion: if the uptake was normal and showed a hot nodule, why would I have antibodies and how can I get rid of them?

I take supplements, D, L Carnitine, Selenium, C, and a host of other vitamins and antioxidants. I recently adjusted my diet to be more nutritious. Oh, I had the antibody test during the end of a bad case of a 3 week flu. Could this have attacked my thyroid and caused both antibodies?

Thank you!

Jaye

195
 

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Likely, you have Hashi's and Graves, so it's probably hashitoxicosis.

Your results are likely caused by BOTH a hot nodule and the antibodies.

It is unlikely that you will be able to stablize on meds with such advanced disease. And, the nodule you have is certainly large enough to warrant surgery. I would strongly advise you to think about surgery.
 
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Discussion Starter · #3 ·
Hi Joplin

Thank you for the reply. When your thyroid is removed, or in my case, maybe just the right lobe with hot nodule, what happens to the antibodies your immune system produces? Or, could my antibodies be a direct result of an inflamed thyroid, and will the antibodies cease after surgery and not be caused by immune system? Do you think the nodule became hot due to the inflammation? I had a nasty virus prior to falling hyper. Wondering if that's the cause.
 

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Hi Joplin

Thank you for the reply. When your thyroid is removed, or in my case, maybe just the right lobe with hot nodule, what happens to the antibodies your immune system produces? Or, could my antibodies be a direct result of an inflamed thyroid, and will the antibodies cease after surgery and not be caused by immune system? Do you think the nodule became hot due to the inflammation? I had a nasty virus prior to falling hyper. Wondering if that's the cause.
I have Graves and Hashi's. Chose the med route for 4.5 years, was kept mostly hypo, monthly lab draws and medication dose changes and one day I spiked hyper 4 years into the medication journey.

My doctor suggested I take a "permanent" route to treatment and I chose surgery.

If you have both TPO and TSI you will likely never be stable. Those are both antibodies - they do not go away. Removing the entire thyroid is your best option. Rarely does having 1/2 provide sufficient thyroid hormone. If you have any thyroid left - it will make it more difficult to stabilize post op.

I would suggest a total vs a partial thyroid removal in your case.
 

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Discussion Starter · #5 ·
Do you feel well now that yours is removed? And you take replacement, right? I took Armour for years for suppression. I'm not against it, I just worry about whether or not antibodies will attack something else (TED) once the thyroid is gone. I understand nodules don't remit and now if I have hashi's too .... What about burnout from antibodies? I'm in a fix because I can't tolerate general anesthesia and Mt. Sinai, who does it under local with sedation, doesn't accept my insurance. I don't want RAI because I read it can cause TED afterward.
 
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