the Connection Between Hyperthyroidism and Hashimoto's Thyroiditis

Hyperthyroidism and Hashimoto's Thyroiditis?

Doctor, I have been suffering from Hashimoto's thyroiditis for six or seven years, and it has been quite stable until this year when I discovered that the tumor has grown larger and the markers have increased.
I didn't have time for a biopsy, and last week I was diagnosed with hyperthyroidism and started medication.
I would like to know if there is a direct relationship between these two conditions.
In the state of hyperthyroidism, is it impossible to assess the status of the tumor? Additionally, after developing hyperthyroidism, is it normal to experience body aches, itchy skin, and acne? Thank you.

Dica, 30~39 year old female. Ask Date: 2022/06/06

Dr. Li Jian reply Internal Medicine

Patients with thyroiditis may sometimes experience hyperthyroid symptoms due to antibodies attacking the thyroid gland, leading to the release of thyroid hormones.
Patients with hyperthyroidism may experience itching or rashes on the skin.
In cases of hyperthyroidism, ultrasound can also be performed to monitor the structure of the thyroid gland.

Reply Date: 2022/06/06

More Info

Hyperthyroidism and Hashimoto's thyroiditis are indeed interconnected, but they represent different aspects of thyroid dysfunction. Hashimoto's thyroiditis is an autoimmune condition where the immune system attacks the thyroid gland, often leading to hypothyroidism (underactive thyroid). However, in some cases, particularly when the thyroid is initially damaged, it can lead to a phase of hyperthyroidism, which is characterized by an overproduction of thyroid hormones.

In your case, having had Hashimoto's thyroiditis for several years and then developing hyperthyroidism suggests that your thyroid gland may have been damaged to the point where it is releasing excess thyroid hormones into the bloodstream. This can occur due to the inflammatory process associated with Hashimoto's, which can cause the thyroid to leak stored hormones. This phenomenon is sometimes referred to as "thyroiditis-induced hyperthyroidism."
Regarding the tumor you mentioned, it is crucial to differentiate between the effects of hyperthyroidism and any potential thyroid nodules or tumors. When hyperthyroidism is present, it can complicate the evaluation of thyroid nodules. Elevated thyroid hormone levels can sometimes mask the underlying pathology of a nodule, making it challenging to assess its nature (benign or malignant) accurately. Therefore, it is essential to manage the hyperthyroidism first, as normalizing thyroid hormone levels can provide a clearer picture of the nodular status.

As for the symptoms you are experiencing—muscle pain, itchy skin, and acne—these can be associated with hyperthyroidism. Hyperthyroidism can lead to a variety of systemic symptoms due to increased metabolism, including muscle weakness, fatigue, and skin changes. The increased metabolic rate can also lead to skin issues, such as itching and acne, as the body may produce more oil and sweat. However, these symptoms can also be influenced by other factors, including stress, hormonal changes, or even the medications you are taking for hyperthyroidism.

It is essential to have a thorough discussion with your healthcare provider about your symptoms and the management of both Hashimoto's thyroiditis and hyperthyroidism. They may recommend monitoring your thyroid function tests regularly, performing imaging studies for the nodules, and possibly a fine-needle aspiration biopsy if there is concern for malignancy.
In summary, while Hashimoto's thyroiditis and hyperthyroidism can be related, they require careful management and monitoring. Your symptoms should be evaluated in the context of your overall health and treatment plan. Regular follow-ups with your endocrinologist will be crucial in managing your conditions effectively and ensuring that any potential complications are addressed promptly.

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