- The most common is someone who takes their thyroid medication dutifully, but still has symptoms of hypothyroidism despite continued increases in dosage of thyroid hormones. In this case the body has mistakenly recognized the thyroid gland as a foreign invader and progressively attacks it. TSH levels may be artificially “normal” due to thyroid medication, but symptoms steadily increase as thyroid tissue is destroyed.
- The other presentation is someone who fluctuates from hypothyroid symptoms (fatigue, cold hands/feet) to hyperthyroid symptoms (heart palpitations, inward trembling, increased pulse rate, feelings of nervousness and emotional distress, insomnia, night sweats). In this case the immune attack is not consistent. When the thyroid tissue is destroyed T4 and T3 are released into the bloodstream (unregulated by the pituitary) causing levels to increase, producing symptoms of hyperthyroidism. When the attack ceases, hypothyroid symptoms return.
The typical treatment for this condition is to prescribe thyroid hormone with dosage adjusted according to TSH levels. Other associated symptoms are suppressed with various drugs such as Prozac. The thyroid eventually burns out due to autoimmune destruction of tissue and the patient is left with no option but thyroid replacement hormones for life.
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