General Medicine

» Papo1 - Hashimoto's Thyroiditis verses Grave’s Disease

I am trying to understand my diagnosis: Hashimoto's Thyroiditis verses Grave’s Disease

I have had hyperthyroidism with most of the typical symptoms over 4 years. My family practice doctor say’s I have Hashimoto's Thyroiditis and not Grave’s Disease? Why is this so? I thought individuals with Hashimoto’s may have a SHORT period of being hyperthyroid and then eventually become hypothyroid? But over 5 years does not seem like a short period to me.

I looked over my labs for clarification but I get confused when trying to understand the antibodies which are abbreviated and different from the 2002 and 2004.

Could you please look at the following lab results and tell me if the diagnosis is correct or wrong and why it is so.

Many thanks!
Papo

On June 5, 2002, I had a physical that showed the following Endocrinology results that indicated hyperthyroidism:

June 12, 2002 In Range Out of Range Reference Range Units
T4 Free 1.8 0.71-1.85 ng/dL
TSH 0.06 0.40-4.70 uIU/mL

June 26, 2002 In Range Out of Range Reference Range Units
TSH 0.06 0.40-4.70 uIU/mL

Then on July 16, 2002, I had to undergo a Thyroid Scan and Uptake. The results of the scan showed “No abnormalities…Thyroid uptake at six and twenty-four hours is within the range of normal.” “Thyroid scan shows no focal areas of increased or decreased activity within either lobe of the thyroid gland.”

July 16, 2002 In Range Out of Range Reference Range Units
6hr RAI 14.7 5-15 %
24hr RAI 25.6 15-30 %

On July 18, 2002 further blood tests where conducted to check for the presence of thyroid auto-antibodies (x 2) for Hashimoto and thyroid stimulating antibody for Graves to determine etiology of hyperthyroidism, Graves verses Hashimoto. The results are as follows:

July 18, 2002 In Range Out of Range Reference Range Units
TSH 0.06 0.40-4.70 uIU/mL
Anti-TPO 2.23 0.00-0.90 Index
Thyglob Ab (EIA) 57.3 1.0 IU/mL
Thyroglobulin 0.1 3.2-56.7 ng/mL

The diagnoses I was given was Hashimoto's Thyroiditis.

I was prescribed methimazole 10mg, but I did not take the medicine as prescribed and was on and off it from 2002 to 2006 and worse I did not follow up. I am now taking a proactive approach to my health and since then got back on the methimazole 10mg after a follow-up the results were:

Off medicine for 2 years
August 4, 2006 In Range Out of Range Reference Range Units
Thyroglobu, QN 0.20 0.73-55.00 ng/mL
Thyroglobu Ab 243.0 40.0 IU/mL

On Medicine for month
Sept 8, 2006 In Range Out of Range Reference Range Units
Thyroglobu, QN 0.20 0.73-55.00 ng/mL
Thyroglobu Ab 213.0 40.0 IU/mL

Recommendation is to increase my methimazole to 15mg.

-- posted by Papo1