Re: got the word on my biopsy -

[Guest guest]

Hi ,

Well, it appears that I am in good company at any rate with the Graves &

Hashi balancing act. :-) I'm wondering though....if you have both, is it

possible

to still achieve remission? I certainly hope so, though I guess there are

worse things in life than having to take a medication of some sort or the other

for the rest of my days. Thanks for the helpful info and have a great night!

[Guest guest]

At 01:25 PM 7/16/2003 -0400, you wrote:

>So if you go hypo, you say you do thryoid horomone replacement. Would that be

>in conjunction with continuing to take the ATD drug?

I may be speaking beyond my knowledge here, but that said, I will try to

clarify my thoughts. I was referring to a person who is hypO without the

use of ATDs. That would be Hashi's being expressed, from what I understand.

So, in that instance, one would logically need thyroid replacement hormone

in order to get into the normal range. But there is also Hashitoxicosis

(Hash's and Graves'), so this can get confusing. Here's an article by Elaine:

http://www.suite101.com/article.cfm/graves_disease/71806

Here is some simple information on Hashimoto's Thyroiditis:

http://www.methodisthealth.com/endocrin/hashim.htm

I'm sure there is a lot more info you can find, such as from Shomon,

the About.com Guide:

http://thyroid.about.com/cs/hypothyroidism/

also has a book on living with hypothyroidism, but I haven't checked

it out, as I'm hyperT, at least now.

And the standard recommendation is to see Elaine 's Suite 101

articles, as well as her book Graves' Disease, A Practical Guide.

Hope I didn't cause more confusion!

If one is hyperT, then treating that condition is what's done. So it's not

a matter of treating the label (Hashi's or Graves'), but treating the

symptoms that predominate (as in the state you are at without medication,

not if your ATD is too high -- in that case you would reduce the ATD). I

don't think you " treat " Hashi's when you are in a Graves' process. Indeed,

there seems to be no specific treatment for Hashi's, but just adding

replacement hormone. But like I said, I've seen it suggested that selenium

could help in reducing the inflammation. I wouldn't go wild with it,

because it can be toxic; so getting the amount from your multi should be

fine, along with dietary sources. I think a brazil nut or two a day sounds

good to me, because it almost says " nature's natural vitamin " on it

(perhaps my imagination is getting the better of me here!). I love brazil

nuts, but I know a lot of people dislike them. Never understood why -- an

acquired taste? ;-)

>Is that the block and

>replace therapy I've seen mentioned on the board?

That was not what I had in mind. B & R is typically a protocol that is used

for hyperT, which is to start someone on the ATD, and then instead of

titrating down, adding thyroid replacement to the regimen. There is

controversy regarding this method, and it is doubtful whether doctors in

the U.S. ever practice it " correctly " (they may throw in a little extra

synthroid, but not do exactly what the a group of Japanese docs did, who

apparently yielded impressive results in terms of high remission rates, but

this study has yet to be replicated).

>Oh my.....I feel like Alice

>thru the looking glass....curiouser and curiouser! Hopefully once I get

>out of

>hyper and into the " zone " of normal for me, I won't swing the other way.

I think you just need to do the best you can as you go along. Keep on top

of the FT3 and FT4 (most reflective of where you are at right now), not

just the TSH (which lags).

> I

>don't much like how the hyper is making me feel and from what I've seen

>shared

>hypo is even worse for some so I'd just as soon pass on that, thank you very

>much! LOL

Same here. Since I've only been treated for a month, I have limited

personal experience.

Head on over to mediboard.com -- though it's mostly Graves'-focused, I'm

sure there are people who have knowledge of Hashi's.

>My multi is really good I tell ya!

What is it?

>I appreciate your taking the time to share your thoughts with me .

>Have you heard back from the doctor yet with your lab results?

Yes, thanks for asking (and praying! That's sweet of you). I'm not sure

what results you're referring to...my FTs? I am toward the low end of the

normal range right now, but I feel fine. My pulse was 60 last night, which

worried me, so I skipped my third dose for the day and called the endo

today and asked if I should reduce (trying to avoid hypO, you know). So he

said, " the medication doesn't work that quickly on the heart rate (or

something like that), so keep on the 150 mg. I tell you, I felt an

immediate difference in my heart sensations from the very start (from

having palpitations on Sunday to having none on Monday, seriously). I have

an appointment with a new endo on Friday. While I know no doctors are

perfect, my instincts tell me that I should at least check out this doc,

who says " most of my patients are on ATDs " (he's from England). Trying not

to get my hopes too high, especially since I will be paying out of pocket

for this one!

Best wishes,

P.S. From what I've read, remission from Graves' is achieved when your TSI

antibodies are less than 2%. Hashi's antibodies lead to destruction of the

thyroid, but I haven't heard anything about remission from

Hashi's...perhaps someone at Mediboard can answer this one!

[Guest guest]

Well all I can say is...... " Halleluiah " ! LOL Guess it may turn out to be a

blessing in disguise for me to have both . I certainly hope so. I'm

very pleased for you that things turned out as well as they did in your case.

May it ever remain and be so for you!

My only concern on swinging into hypo territory would be that it could make

my eye condition worse. But I pray that isn't an automatic conclusion to

things, and if I do see my numbers go that way I think I'd probably insist that

they

treat me with replacement hormones to bring me back around. Still, that would

be a worse case scenario, and though my anal retentive little mind does love

to go there, I shall work very hard about not allowing myself to unpack my

bags and settle into the land of pessimism! :-)

Seems I have something to be thankful for too in that the endo I saw felt I

had both even before he saw the results of the biopsy. Hopefully he will turn

out to be someone I can work with and rely on for my journey. I do have a

backup endo that my chiropractor (who I just adore) recommended to me as well.

It

will make it all so much easier if I don't have to battle my own physician

along the way. Guess change comes hard to a lot of doctors too.....

Thanks again for sharing some uplifting news! I'll be keeping your email

and rereading it often for moral support and encouragement. Have a

great

day!

[Guest guest]

-

Darn right it's still possible to achieve remission! I have seen ancedotal

evidence to suggest that having antibodies for both can even give a person

an increase possibility of remission. I'm one such example. I was diagnosed

with Graves' in 7/01. By 10/01, my thyroid levels had returned to normal and

by 2/02, I had normal TSH levels. I was never on any medication. My doctor

was stupefied (literally). He calls it " spontaneous remission " . After

learning more about it myself and seeing several more doctors, I was found

to have both GD and Hashi's and evidently they are either balancing each

other out or my TSI have gone down enough to where the TPO antibodies are

the predominating ones. I won't pretend to say that life is dandy this way.

My TSH changes up and down sometimes causing me to feel very hypo, yet not

be in official hypo range, so the doctors won't do anything for me. But

overall, I have been lucky so far.

Hopefully, once your production of TSI antibodies decreases, you'll start to

feel better and may likely even swing hypo. It's also not uncommon to shift

back and forth between hypo and hyper during a lifetime. So you do have to

watch out for reoccurrences of one or the other. I currently get my labs

checked every 3 months to see if I haven't slipped back into one or the

other. And there are a bunch of others of us who have both. One doctor I

went to told me it was impossible to have both. You can guess what happened

to him. Turns out it is more common than doctors even suspect.

Take care!

Re: got the word on my biopsy -

> Hi ,

>

> Well, it appears that I am in good company at any rate with the Graves &

> Hashi balancing act. :-) I'm wondering though....if you have both, is it

possible

> to still achieve remission? I certainly hope so, though I guess there are

> worse things in life than having to take a medication of some sort or the

other

> for the rest of my days. Thanks for the helpful info and have a great

night!

>

>

>

>

>

[Guest guest]

--

Glad to hear you do generally well on no medication! And it is a good

thought that the antibodies balance each other out (though I wish they

would all go away!). I was wondering, did they say you have Hashi's based

on having TPO antibodies? This is where I get confused about my own

situation, as I have both TSI and TPO antibodies (198 and >70,

respectively, when last checked), but only was told I have Graves'. Do you

know if TPO antibodies remit?

I've heard (and from Elaine as well) that most people with Graves' have TPO

antibodies. So that's why it seems to me that the label you call your

condition depends on what's being expressed symptomatically, but I could be

wrong. So is it that if you have both, that means you are swinging hyper to

hypO in a relatively short period of time?