Auto-Immune Thyroid Disorder

[lilypuss]

Systemic symptoms for 2 years with a combination of both Hyper and Hypo-Thyroid symptoms often extremely severe. 2010 diagnosed Hyperthyroid/Thyroiditis and discharged November as Euthyroid but 2 months later symptoms returned and gradually increased in severity and virtually house and bed-bound most of 2011. Also diagnosed with peripheral neuropathy which has progressed to large fibres. Despite recent thyroid history, signs and symptoms GP refused referral back to Endocrinology as TSH & FT4 normal and suggested referral to a psychologist? A different GP finally referred to Endocrinology and diagnosed Hyperthyroid/ Thyroiditis with high TPO Antibodies. Severely inflamed swollen throat for 12 months but not had any physical examinations and Informed that cancer and nodules can be identified from blood tests. Informed that thyroid is now settling down but might take a while before symptoms clear up but very concerned that symptoms will return with a vengeance as apparently autoimmune. No treatment for symptoms and zero quality of life for the last 2 years and now lost my job causing financial difficulties as I live alone with mortgage and financial commitments. I would be most grateful for some advice as my body and life fallen to pieces over the last 2 years. Thank you.

[Professor John Lazarus]

As you have thyroid antibodies you do have autoimmune thyroid disease. But,as you say, your thyroid hormone levels have been normal so there does not seem to be an indication for any thyroid treatment at present. Clearly, your thyroid function tests should be checked regularly.
Your other complaints are not easy to diagnose but seem unrelated to thyroid dysfunction and I think you should see a general physiscian

[lilypuss]

Many thanks for your reply and would be grateful for clarification as I understand that with Hashimotos TFT’s can often be within range due to fluctuating hormone levels which might explain the combination of symptoms and also inflamed throat, cough and breathlessness. Could there be a possibility of problems with T3 or Cortisol? Blood test showed normal Cortisol levels but I understand this is not a reliable test. Cause of neuropathy not yet identified but my Neurologist has said there is a link between thyroid disorder and neuropathy.

When symptoms at the worst point my body temperature was also very low averaging 35 deg dropping to 34 and extremely cold for months despite warm weather. Combination of symptoms which included unexplained weight loss, hair loss, constant palpitations, overwhelming fatigue, constipation, shaky, digestive problems, skin problems, dry mouth, eye irritation and visual disturbances and inflamed swollen throat, dizzy and muzzy head.

I am not confident that TFT’s alone could eliminate the possibility of thyroid disorder causing these unexplained symptoms and in view of positive TPO antibodies and other symptoms I would have thought that additional examinations and tests would be necessary?

[Surburbian]

Have you thought of asking to be checked for Sjogrens Syndrome? Some of your symptoms would explain that and Thyroid Antibodies and Sjogrens often run hand in hand. Ask your GP to do a Schirmer's test which is when they put a small piece of filter paper in the lower eyelid and leave it there for a few minutes. Depending upon how much liquid it absorbs - if at all, it will give an indication or not if this is a likely dx.