Please help -Polyglandular Autoimmune Disease (Thyroid/Adrenal/IDDM)

[kathryn32940]

Age 46 female -
-Symptoms getting progressively worse recent weeks, no insurance,.. Therefore I've been trying my best to diagnose (and treat) myself,
while trying very hard to find an appropriate doctor willing to accept a "self-pay" new patient.

I've been trying to schedule an appt w/ endocrinologist, without success (so far). Next available appt not until April, etc.

Visit with Internal Medicine Doctor last week (I did not care for), who probably incorrectly, wants to treat me for HYPERthyroidism and she ONLY ordered Xanax (severe insomnia & anxiety) - and Lexapro (I'm not taking...yet).

Any help diagnosing with info on appropriate tests and treatment, (conventional and alternative), would be greatly appreciated.
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Multiple symptoms (too numerous to list), most troublesome S/S include severe insomnia, weakness, lethargy, dizziness, eyes blurry etc. ataxia (new sympt few days), hair loss, hirsutism, and increased anxiety/depression + (panic attacks-new).

At present, after a week of research,
I'm guessing I have an AUTOIMMUNE disorder,
probably something called PGA-Type II (polyglandular endocrine disorder): Hashimotos (?), Adrenal Insufficiency (?), combined w/ hx of IDDM,

Although with lack of access to proper testing, including pituitary, I'm not sure exactly what's causing illness/syndrome. (Other than obvious causes including increased physical/mental stress and demands, over recent years/months).

Please note, I test blood sugars every 2-3 hours (s/s not related to abnormal BS).
As expected, BS recently harder to control, due to other endocrine malfunctions and decreased activity, poor appetite, etc.

I HAVE BEEN VERY ACTIVE, HEALTHY and productive my entire life - and I need/want to feel better asap.

Any help diagnosing and treating would be very much appreciated - Thanks:)
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SUMMARY of RECENT LAB TESTING:
(I ordered labs myself  b/c of feeling worse),
except thyroid peroxidase which was ordered by MD I saw 1st visit last Friday.)

My results = Low FT4 - Low TSH - low cortisol - - High T3 uptake - -Very High Thyroid Peroxidase.

T3 Uptake:                 High = 38     (Lab range =22.5-37.0).
FT4: Low = 0.9     (0.89-1.80)
TSH: Low= 0.299 (0.3-4.5)
Thyroid Peroxidase:                   Very High = 4,425                                 (0-60)
Cortisol: (am)                 Low= 8.5                 (8.7-22.4)
Repeat Cortisol (eve)                  Lower= 5.5

Other Labs:
Testosterone 64.4 (normal upper limits).
Microalbuminemia increased = 10.1  (IDDM hx)

Chemistry & Lipid Profile Evaluation - WNL.

CBC with Diff - WNL
H & H = 13.9/40.9,  WBC slightly high = 9.56 (4.3-10.0),  Platelet = 320 (150-400),
Bun/Creat = 16/0.7,

Progesterone - WNL (I think) = 2.6  (Day #5 of menses).

Medical History Summary:
Healthy IDDM x 34 years, since age 12, HTN & microalbuminea since 2000 post 2nd pregnancy. Menses WNL q30 days, regular w/ heavy bleeding.

Meds:
RX: Humalog insulin via Insulin Pump & Captopril 50 mg BID or TID;
Xanax -(new this week, only took few times, has not noticeably helped w/ insomnia or shaking/tremors or anxiety, but does make me feel more lethargic).

Vitamins include multivit, high B's, Ca/Mg/Zinc, Coenzyme Q10, St. John’s Wort & 5 HTP.

Low carb diet, body type: thin size 4-6.

Let me know if you need more specific labs  - I only included abnormal labs and/or significant to dx & tx.


Thank you very much for reviewing this post -
I look forward to a helpful response with diagnosis and treatments. If possible, please respond asap.
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BTW - Career hx: Currently employed in business/internet (non-medical), but I am also an RN x 20+ years- so feel free to use medical jargon in response.

[amylauren123]

Though I do not suffer from Diabetes(yet thankfully) I do have everything else you have and an even lower cortisol Am level..Went to MAYO and they did a cortisol test(forgot the name)and I did fail which means my body as you  know is not making enough...I also suffer from Premature Ovarian failure and thyroiditis as well as Sjogrens,Lupus, RA and Sarcoidosis..or as some would like to say Severe Mixed Connective tissue..(though the sarcoid was dx'd by bronchoscopy so there is no way to jam that one in with the rest) On top of that I have congenital heart disease and defects...My question and hope is that by now you have found someone....and if you have may I know who?
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[kathryn32940]

Thanks for responding - I quickly read your "mystery illness" story (I'll read more carefully later today - Very interesting, thanks for info -
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(Question)
I'm wondering if both your "T4 and TSH were low" with low cortisol during your illness?
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(Question)
I've been trying to determine if my very high peroxidase (4 thousand+) means my thyroid will be killed quickly (if so, is it days, weeks, months or years?) - -

And since both T4 and TSH low (not usual combination) I'm not sure what tx's (alternative or conventional) will straighten them out (?)

My s/s are consistent with both hypo and hyper thyroid + adrenal dysfunction.

IMPORTANT QUESTION(s):
Since I'm usually very healthy, energetic and active, do you think the low TSH,T4 & cortisol, is the only thing that's making me feel crummy - or something else?

If yes, what natural/dietary/OTC things can I do to increase T4/TSH and cortisol.
(The earliest endo appt I could obtain is not until April).
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I do eat alot of wheat/gluten products (I just finished making some yummy pineapple, flax seed Muffins w/ recipe I just invented this am, spur of moment) BTW, kids loved them - just by adding a little extra honey/sugar, I can get them to eat almost anything really healthy - LOL

I have no GI problems or stomach/digest s/s - (other than poor appetite)
Only problem I have w/ foods is with chemical preservatives/additives eg. zero tolerance to MSG, sulfites, etc.

If I remove "flour (gluten)" and "milk" from my diet - I may have nothing left to eat!
I already limit carbs, fats, salt, etc.

BTW, I won't have access to any highly specialized (expensive) testing or MD's, for food sensitivities due to lack of insurance -

Look forward to your response - -
I had hoped MD would also address this post, but I guess they only answer some.

P.S. I can't imagine feeling crummy for 17 years! So sad -
Just feeling bad past few months is destroying my life and finances -

I guess my expectations of a quick resolution for new adrenal/thyroid dysfunction is unrealistic - (?) -
But I'm still hoping I'll be cured feel better in very short period of time (weeks at most) -

With IDDM (autoimmune diabetes type 1) you just take insulin - keep your BS stable and WNL and you're Very healthy and active almost all the time - with a very normal highly productive life (My past hx past 3 decades) - -
Sounds like this thyroid-adrenal stuff is much more complicated and difficult to dx and tx. (?) I hope not...

[edra]

I also experienced hypothyroidism and near-total adrenal collapse during my 17-year illness.  Since you are showing a high TPO, you should find out if you have antibodies to gliadin, one of the proteins in gluten.  If you do, get off the gluten and onto a program to heal gluten enteropathy.

You'll find the complete history of my illness at the following URL, perhaps this will give you some ideas.

ftp://ftp.ucar.edu/era/mi/MysteryIllness.htm