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A Rare Condition: Oscillating Hypothyroidism And Hyperthyroidism




The condition oscillating hypothyroidism and hyperthyroidism is a rare autoimmune condition. However, to understand the implications of such fluctuations in the thyroid function it is imperative to understand hypothyroidism and hyperthyroidism. The identification of the underlying causes of the two conditions, hypothyroidism and hyperthyroidism, can lead to a better appreciation of this condition.

A Rare Condition: Oscillating Hypothyroidism and Hyperthyroidism

Hypothyroidism is a medical condition where enough thyroid hormone is not produced by the thyroid gland and can be characterized as underactive thyroid function. The lack of hormones produced leads to the disruption of the proper functioning of the body. This condition is quite common and thyroid function tests are available easily. Synthetic hormones are often prescribed to treat this deficiency.


Some of the causes of hypothyroidism include:

  • Autoimmune disease: An autoimmune disease Hashimoto’s thyroiditis involves the immune system attacking the thyroid gland since the antibodies inhibit the generation of thyroid hormone.
  • Thyroid surgery: The removal of a large, or small, part of the thyroid gland may hamper thyroid hormone production.
  • Radiation therapy: Radiation treatment used for head and neck cancers may cause damage to the thyroid gland and result in presenting hypothyroidism.
  • Drug interactions: Certain medications like lithium prescribed to treat psychiatric disorders may contribute to hypothyroidism as it may affect the thyroid gland.

Hypothyroidism Symptoms

The symptoms associated with hypothyroidism may vary since it is directly linked to the severity of the deficiency of thyroid hormone production. Often the symptoms emerge slowly and after years. However, some of the early signs include fatigue, gain in weight, constipation, weakness of muscles, and dry skin.

What is Hyperthyroidism?

Hyperthyroidism is a medical condition involving the overproduction of the thyroid hormone and can be characterized as an overactive thyroid function. Often, mild forms of this condition go undetected since the symptoms are not easy to identity. However, in cases where the production of the hormone is very high, it results that make a significant change in the individual’s body and it has consequences as well.


Some of the causes of hyperthyroidism include:

  • Grave’s disease: An autoimmune disease, Grave’s disease, where the immune system begins to attack the thyroid that often results in enlargement of the gland.
  • Overmedication: Patients prescribed with thyroid hormone replacements are at risk of developing hyperthyroidism and, for this reason, a thyroid function test is always recommended before hormone replacements are prescribed.
  • Goiter: Nodules of the thyroid gland produces excess thyroid hormone that can cause hyperthyroidism that is usually going undetected till the patient crosses 50 years of age.
  • Toxic nodule: A lump or a single nodule developed in the thyroid leads to excess production of the hormone and causes the hyperthyroidism condition.

Hyperthyroidism Symptoms

Hyperthyroidism presents symptoms that include higher blood pressure, elevated heart rate, hand tremors, irritable bowel, and a tendency to sweat due to low heat tolerance. The condition may attribute to an irregular menstrual cycle in the case of women. However, symptoms like shortness of breath, irregular heart rate, dizziness, and loss of consciousness require immediate medical attention.

What is Oscillating Hypothyroidism and Hyperthyroidism?

The underlying cause for both hypothyroidism and hyperthyroidism are autoimmune diseases that affect the thyroid gland. Grave’s disease which is often caused by hyperthyroidism may lead to hypothyroidism. This is a rare occurrence and it poses a unique challenge when it comes to the management of oscillating hypothyroidism and hyperthyroidism.

The main reason that can be attributed to the development of this condition is the production of two distinct types of thyrotropin receptor antibodies identified in thyroid disorders TBAb and TSA. However, it was found that a balance between TBAb and TSAb, for the most part, are altered as a result of hormone therapies. While the option to block and to replace the desired hormones presents an immediate treatment plan but requires close monitoring and testing.

How is Thyroiditis Connected?

In cases were no history of thyroid function problems were reported then the leading cause for any change in the thyroid function may be attributed to thyroiditis. Thyroiditis leads to an increase in thyroid function when it becomes inflamed which is followed by the release of the hormones stored. The thyroid function returns to normal and once it gets depleted it causes hypothyroidism.

It should be noted that if underactive shifts to overactive hormone production then thyroiditis may not be the source of the problem. In such cases, it can be linked to the medications prescribed. Additionally, one must take medication, if prescribed, consistently otherwise the desired results will not be visible anymore.

Management of Hypothyroidism and Hyperthyroidism

The best way to get ahead of this condition is through patient education. The presentation of the various treatment options available to manage oscillating hypothyroidism and hyperthyroidism can help manage one’s condition better. After being presented with treatment options, one can take a decision on the course of treatment best aligned with the individual’s condition. Regular follow up and the administration of thyroid function tests can help keep this condition in check.

Medical practitioners when presented with such a rare case of oscillating hypothyroidism and hyperthyroidism need to remain alert since the probability of switching between the two states is high. For this reason, along with regular thyroid function tests, the adoption of definitive therapy in the form of thyroidectomy, also referred to as radioactive iodine ablation, is presented as a viable treatment option.

Thyroidectomy is a procedure where a part of the complete thyroid gland is surgically removed. It is a form of minimally invasive surgery following which synthetic thyroid hormone is prescribed. Scarless thyroidectomy eliminates scars on the neck due to surgery performed. This surgery requires a day of hospitalization, if not more post-surgery.

Despite the fact that oscillating hypothyroidism and hyperthyroidism is a rare condition it must not be neglected. Regular health check-ups and following the doctor’s orders can help one manage this condition with ease.

LSI: thyroid gland, thyroid function, thyroid function tests

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