Can your thyroid flip from underactive to overactive?
Autoimmune Switch of Hashimoto’s thyroiditis to Graves’ Disease: A Rare Case Report
Not medical advice. For informational purposes only. Always consult a healthcare professional. Terms
Surprising Findings
TRAb antibodies emerged after a decade of stable euthyroidism on levothyroxine, despite no change in medication or lifestyle.
Doctors assumed Hashimoto’s was a permanent, one-way destruction process—this case proves the immune system can pivot from destructive to stimulatory autoimmunity.
Practical Takeaways
If you have Hashimoto’s and suddenly feel hyperthyroid (racing heart, weight loss, anxiety), ask your doctor to test for TRAb—not just TSH and TPO.
Not medical advice. For informational purposes only. Always consult a healthcare professional. Terms
Surprising Findings
TRAb antibodies emerged after a decade of stable euthyroidism on levothyroxine, despite no change in medication or lifestyle.
Doctors assumed Hashimoto’s was a permanent, one-way destruction process—this case proves the immune system can pivot from destructive to stimulatory autoimmunity.
Practical Takeaways
If you have Hashimoto’s and suddenly feel hyperthyroid (racing heart, weight loss, anxiety), ask your doctor to test for TRAb—not just TSH and TPO.
Publication
Journal
Bangladesh Journal of Nuclear Medicine
Year
2026
Authors
Sujon Mahmud, Md. Sunny Anam Chowdhury, Md Nazmul Hossain, Fariha Zerin, Bahalul Hasan
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Claims (6)
In some people with autoimmune thyroiditis, the immune system's attack on the thyroid gland can lead to either an overactive or underactive thyroid, depending on how much damage has occurred and at what stage.
In some people with Hashimoto’s thyroiditis who later develop hyperthyroidism, thyroid-stimulating receptor antibodies can be found in the blood, but their presence alone does not prove they cause the shift to hyperthyroidism, because other biological processes like thyroid damage or changes in immune activity may also be involved.
A woman with Hashimoto’s thyroiditis, who had been stable on thyroid hormone replacement for ten years, developed hyperthyroidism alongside a change in her autoimmune antibodies from those targeting the thyroid peroxidase to those targeting the thyroid-stimulating hormone receptor.
In some people with long-term Hashimoto’s thyroiditis who later develop hyperthyroidism, antibodies that activate the TSH receptor can be found, suggesting a change in the type of immune response directed at this receptor.
Although autoimmune thyroid diseases like Hashimoto's and Graves' disease are common, switching from one to the other is very rare, with fewer than 50 confirmed cases reported in medical records.