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santaclara Forum Elite Topics: 67 Posts: 299	Aug 03, 2004 - 7:14 PM       #1 in graves disease intially pt is hyperthyroid b/c of T4. is it hypothyroid in the end if TSH goes down? thanx.
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mdwannabe Forum Guru Topics: 37 Posts: 1131	Aug 04, 2004 - 8:19 AM       #2 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 falls...pt becomes hypothyroid, and TSH goes up.
amitjosh Forum Senior Topics: 9 Posts: 116	Aug 08, 2004 - 11:01 PM       #3 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
mani Forum Guru Topics: 104 Posts: 1400	Aug 09, 2004 - 2:02 PM       #4 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?
mdwannabe Forum Guru Topics: 37 Posts: 1131	Aug 10, 2004 - 4:07 AM       #5 i don't remember exactly, but could be big Robbin's.
santaclara Forum Elite Topics: 67 Posts: 299	Aug 10, 2004 - 6:48 AM       #6 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 TSH.so 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. bye.
tdr Forum Senior Topics: 18 Posts: 70	Aug 17, 2004 - 5:48 PM       #7 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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