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Author7 Posts

in graves disease intially pt is hyperthyroid b/c of T4.
is it hypothyroid in the end if TSH goes down?


Graves is autoimmune dss...TSH is low from the offset of dss...due to stimulatory effect of the a/b to TSH receptor on gland. So TSH will be low due to high T4. However, as the gland is useed up, T4 becomes hypothyroid, and TSH goes up.


I think in Graves disease a person never becomes hypothyroid.

He shows hyperthyroidism initially and then hypothyroid features in Hashimotos thyroiditis

Correct me if I am wrong.

Amit Joshi


well i havent ever read anything like hypo as a consequence of graves dis. santaclara, have u read it somewhere?
mdwannabe, would u plz give the reference?


i don't remember exactly, but could be big Robbin's.


well i also study again this Q and i didn't find any where that in GRAVES disease initially pt is hyperthyroid and then hypo.
i think that is HASHIMOTO'S DISEASE.
in GRAVES as we know that this is an autoimmune disease and AB act directlt on thyroid tissue so b/c of this T4 increses in circulation and circulatory T4suppress the this means hyperthyroid is due to T4 not b/cof TSH.and later on circulatory T4 suppress the TRH also.

well may be i m wrong.if so correct me and i will post any thing if i find it.


You're totally right Santaclara. TSI (TS immunglobulin) acts like TSH, stimulates folliculer cells of thyroid :arrow: T4 increase :arrow: TSH dec.

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