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231441 tn?1333892766

New Here

Thanks Quix for inviting me over here.  I was most touched by your warm response.  I just copy-pasted my previous post and your response from the neuro forum here so people don't have to forum hop.

The endo just interpreted the report, she didn't see the MRI.

Hvae been researching more..... sarcoidoisis could be possible also.  Have high Vit D levels (endo said due to sun exposure), high prolactin (due to pituitary adenoma), swollen lymph nodes in neck, recent diagnosis of asthma (after unexplained coughing for about a year) - still not so well managed on inhaled steriods.  Eye problems - but eye & retinal examination was clear.... fatigue, today am so lethargic (but yesterday was reasonably ok).

Other tests: globulin low, calcium low normal, ipth mid-normal (in past was high) (other electrolyes when tested - though not recently were normal).  No evidence of autoimmune for the thryoid (no antibodies for any of the 3 tests - but then I've had thyroid diagnosis for 7 years now, maybe the immune response burnt out.  Though one antibody test was negative at the beginning - 7 years ago), Vit B12 low normal (just over 300) - have been started on oral B12. 8am Cortisol in 25%ile, same for all toher hormones tested.  Previous diagnosis of PCOS.

Have gone back to my old endo. He was a little alarmed by my described symptoms. He has the MRI and all my latest and old test results and says he will ask his colleagues.  He mentioned both MS and sarcoidosis as possibilities...  Will see what he says on Monday.  I hope he actually got to review what I sent him.

Sorry - this is long.  Am hoping I am a hypochondriac, but I fear not.... just want to find out what all this is and deal with it.

Time to go.  Swim session now.  Tomorrow is a 6 1/2 hr bike ride.  I need to rest!  I don't want to give up or modify my very active lifestyle!!!!!!

Looking forward to getting to know you all soon.

Sally

Below is from the neurology forum:



Hi,

Am wondering if MS is a possible option for what is happening to me.
I am 36 yo Caucasian female, Australian, but living in Philippines.  I have hypothyroid, pituitary adenoma (small) & suspected celiac - undiagnosed but severe tummy problems (dr. said ibs) have nearly disappeared since I eliminated gluten last year. Treated with natural thyroid and just recently my endo has me taking parlodel for slightly elevated prolactin levels.

Have been having weird visual symptoms for some months now. Usually is like flashes of light in peripheral vision.  Sometimes moving black shapes. sometimes feels like part of the vision is obscured, but when I check the visual field it all appears to be there.  A few episodes when it felt like the whole peripheral vision was shaking up and down (both major times this was after long intense bike rides).  This usually passes after a short while.  Flashes are every day, more when I am tired.  Had eye & retinal assessment and visual field mapping about a month ago.  All appears normal. The eye dr. wasn't concerned.  

I am a serious triathlete in my leisure time, though I work full-time in an office job.  Slower recovery from training now than before.  Often sore muscles - compared to my team mates who are doing the same training. Get major muscle cramping - particularly with swimming, often occurs after not during  training.  I am famous for bumping into and dropping things.  :}  Hands get numb - but I put that down to nerve compression from time on bike.  Strange tickling sensations on head and body.  Energy levels fluctuate dramatically.  On occasion parts of my face feel numb for a few hours and then are normal again - so far I have put this down to imagination - but now am getting concerned.

MRI 2 years ago showed only the pituitary adenoma (small). Latest MRI (about a month ago) showed white spots - about 5 (think that was not in the gadolinium enhanced film - but not sure how to read the film properly).  The endocrinologist who saw the MRI report thought such findings are not significant and says not to worry.  She thinks I am hyperthyroid (TSH about 0.02 but FT3 and FT4 are only low to mid range) because she says there is delay in eye tracking when I follow her finger movements and because I have fine tremor, also having hot flushes from time to time, and energy problems. No palpitations.

Question:  Should I accept the endo's reassurance that there is nothing wrong and go with her currently reducing my thyroid meds (I am concerned I am really being hypochondriac), or should I try to push for a second opinion to see if there is something else happening.

Sorry this is long.

Thanks all.

S
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Quixotic1

07/20/07
Sally Hi, I thought I recognized your nickname.  You responded over on the MS forum to someone's post about a child with FTT.  I din't respond to you becasue you were posting with info for someone else.  Thanks for that by the way.

Fluccuating thyroid can certainly play havoc with the nervous system and energy levels, but it sounds to me like there is more going on.  Part of what tells me that is that an elite athlete knows their body far better than "normal" people.  Your muscle issues of increased soreness and cramping - have you had basic blood work?  Has anyone checked your electrolytes (including magnesium), B-12 level, muscle enzymes (CK and aldolase) and do you know why you are hypothyroid?  Is it felt to be the pit adenoma?  Has anyone done the basic work up for autoimmune thyroiditis?  Celiac is an autoimmune disease with a high association to autoimmune thyroid disease (and others).  Have you had any dark red urine?

Muscle cramping while swimming speak to the easier cramping in cooler temperatures.  Do you muscles feels stiff?  Any problems with the heat?  Hmm, you're in the Phillipines, how would you tell.  Is your work out stronger at night?

It has been my experience that serious athletes don't go around somaticizing.  As I like to say, "They are do'ers, not stewers."  Yes, you have some definite signs of high thyroid levels and reducing your dose does seem prudent.  BUT, and this is a big one, I would not sit with the endocrinologist's reading of the MRI.  Did she actually look at the MRI herself or was this her interpretation of the interpretation?  My MRI of the brain was misinterpreted by a neuroradiologist and a highly-respected neurologist for two years delaying my diagnosis of MS.  I'm not saying you have MS, but I mistrust any "dismissing"  of white matter spots in the face of neurological symptoms.  I'm really serious about this.  Yes, older people (older than you) do acquire such spots.  Even so, they CANNOT be assumed to be normal if someone is having problems!!!

You need the MRI's to be looked at directly by a neurologist who specializes in MS.

At this point I invite you over to the MS forum.  Our current specialty is helping the undiagnosed, the misdiagnosed and the diagnosed, but pissed off.  We also have several cyclists and at least one triathlete.  We're a cosier bunch than here and you're are most welcome to come and tell us your story and swap competition/cramps/fatigue/vision problems stories with us.
9 Responses
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231441 tn?1333892766
Hey Quix,

You were not insulting at all. :)  Anyway, I am not easily insulted - so you'll have to try a lot harder if you want to insult me :).

Listening to my body is exactly what my coach is always telling me to do - so do join the club :).

I posted about my dr. visit in new post yesterday.  We negotiated, and I'm to rest for 3 days (relatively speaking.... cause work still calls - though I got the feeling he would have liked total rest....)... but he knows me well enough to know that I won't...  will see neurologist he referred me to on Thursday.... got full electolyte testing plus muscle enzymes... (more details in the other post, plus I did a timeline of sorts).

Take care!  You do a phenomenal job here on this forum.  Thanks.

Sally
Helpful - 0
147426 tn?1317265632
I really hope I wasn't insulting about telling you to listen to your body.  It was presumptuous, and I meant it in the best way.  Quix
Helpful - 0
Avatar universal
Welcome to our virtual family,

Your very impressive with all you do.My workout for years was chasing 4 kids,now 2 have left the nest and the other 2 work and are not home much.However I do go to a fitness center and PT 3 days a week.

You know your body,just keep listening to it.

I have found with MS it's about conserving energy and doing what you can do,well what your body wants to do.I hate the crash and burn.On Saturday I couldn't get out of bed until 5 pm,which isn't like me.

I would get into a good MS neuro and have them look at your MRI's and do further testing.

It took me 2 years to get a neuro to just listen,I was dx'd in Dec 2006 and after 2 years I have been left with permant residual disabilities.Mainly the legs.I am slowly trying to rebuild them,treadmill and bike work,plus some light weight lifting.

Eat healthy and see a MS neuro.
Helpful - 0
147426 tn?1317265632
I see what you mean.  But I'll share my concern about the thyroid preparation anyway and you can take it for what it is worth.  In the States for a LONG time, and even now with some endo's, Synthroid is the ONLY  preparation they will use.  Other brands and formulations have had horrible problems with predictable bioavailability.  The same dose would be too much for one prescription then inexplicably be too little.  The unpredictability was backed up by independent pharmacokinetic testing.  In all honesty, this info is probably 10 years old and if you react better to something else then the point is moot.

Your energy boost with "activity" is likely a combination of endorphins and andrenaline.  If this is the case, you run the risk (not serious in a life-threatening way) of overshooting your reserves and crashing hard.  Maybe this prediction is colored by my experience.  My fatigue is borne of vertigo (needing to use my eyes to consciously stay upright - which is enormously fatiguing) and MS which causes an almost insurmountable fatigue.  I take a stimulant to fight the fatigue.  It allows me to do things like accept an invitation to visit with someone, or do the dishes.  If I go too long, the crash is hard and painful and may put me out for several days.   So I may be transferring my esperience with fatigue to you.  Anyhow, if you keep pushing and it is a neurological fatigue, rather than a hormonal thing, you will find out soon enough.

When I was struggling to stay in pediatric practice I found that I felt the same way, heavy all over, even my hair was tired.  I compensated by sleeping more and more.  Over the course of about a year I found that my day was spent seeing patients - napping during lunch - seeing patients - napping thru dinner - seeing hospital patients - to bed for the night - Repeat.  In order to work a short day I had to sleep 12 hours or more.  When my brain quit functioning one morning during a crisis I left medical practice.

You didn't need to hear that.  I'm sorry.  Should I post this??  (she asks)  Yes, info is info.  I think the moral in this rambling is take note of what you are needing to do to maintain your life as it is.  If you are getting behind, realize that you can do damage pushing beyond the fatigue.  Wow, what a stupid thing to say to a triathlete!!  Anybody reading, keep in mind that the person writing this may be crazy (Charter member of Hypo Gamma Chondria)  But, Sally, do take care.

And....uhh...yes, remember to eat.  Eating is a good thing.

Has anyone checked yur electrolytes?

Chris - Chasing your children is a legitimate exercise.  I always called it "Aerobic Parenting!"

Quix - confused and out!
Helpful - 0
231441 tn?1333892766
Hi Quix,

Hope you're having a good day!

Currently thyroid med is the premade desicated thyroid, with iodine (this one from Canada - started it about 3 weeks ago) - in tablet form.  For the past year was on one from Australia, made in a compounding pharmacy.

Here in Philippines, the only thryoid drug available in T4.  Not even T3.  The reason I started the 'natural' is that on T4 my FT3 was always lower than range.  FT4 was also  below range, when TSH was around 1.  Can get FT4 within range only when TSH is very low.   There was a difference in symptoms when changed to the dessicated (I can only describe it as in 'colors  became brighter', and helped my moods).

Have got conflicting feedback between doctors: the last endo I saw said she only looks at TSH (not the other results). This is the Dr. who told me not to worry about my symptoms and that they could all be explained by being hyperthyroid (I wish!) and that the visual stuff wasn't a problem though if it annoyed me should could refer me to a neurologist).  My old endo (I already went back to him) says TSH is the only things to consider, but that FT3 and FT4 show what's really happening.  However he did reduce the thryoid meds to see what happens... anyway, have to retitrate with this new brand.

Now I am currently on about 60% of my previous dose - for the past 3 weeks.  Am still having hot flushes! Having one at the moment.... so hot!!!! (though the weather is also hot - and the aircon is having trouble keeping up)  I think I am too young for menopause!  My energy levels are noticably dropping (even further than usual)... my arms, legs, back, head, all feel so heavy...  I am constantly finding myself propping myself up on walls, etc.  It is hard to sit up straight.  Can overcome it with activity (did the usual weekend training - about 9 hours - but also did a lot of extra sleeping), but as soon as I stop, the heaviness descends again.  Cramping is also noticably worse.

Anyway, would welcome any input.  Will see Dr. Mike later today.

Sally
Helpful - 0
147426 tn?1317265632
I've meant to ask you what you meant by natural thyroid.  Is it specially prepared for you?  If so I have some thoughts.  Quix
Helpful - 0
231441 tn?1333892766
Hi,
Thanks for your response.  Looking forward to getting to know people here.
Haven't seen a neurologist yet.  I guess that is probably the next stop.
Yeah, the tickling sensations feel like goosebumps.  Vary over different areas. At the moment it is my face. THey don't alwayas last for long.
Survived my bike ride.  Don't seem to be made worse by heat (it is really hot here - today's ride got up to about 40 degrees C).  So that's good.  But am really tired - almost a drugged out feeling (well don't know what that is actually, but is what I imagine it to be :)).  (Eating now... that seem's to be helping... but then I did burn close to 3500 calories today! (Note: don't forget to eat!!)).
Have wondered about possibility of visual migraines.  I also get a base of skull headache often these days.  A weird kind of painful. But not like a regular headache.  Somewhere a cross between sore neck and pressure/pain.  That's also something for the neurologist.  I told my endo I don't get headaches, cause I didn't consider these "headaches" - but guess I better tell him on Monday.

Hope you all have a great weekend.  I am joining a run tomorrow to accompany my friend's 60 yo aunt (she has only recently started running - to accompany her partner who suffered a stroke 6 months ago and got back into running as part of his rehab).  My friend will run with the uncle - we want to keep them apart so that they don't complete against eachother.  It will be a very slow 10km. :)

Sally
Helpful - 0
230625 tn?1216761064
Hi Sally and welcome to the MS forum.

I'm seriously impressed by your althletic resume too!   LIke Momzilla, my althetic workout is chasing after my 4 kids all day.

I'm sorry that you are going through all of this uncertainty.  You're the only one who knows what's "not right" or normal with your body.   I don't believe you are a hypochondriac.

I hope all goes well with your endo appt on Monday.  Hopefully, you can see a neurologist to have a look at your MRI.

Take care and welcome again!  Pat
Helpful - 0
220917 tn?1309784481
Hi, Sally!  Welcome!

I remember you before from your comment about Rachel's child.  I'm glad your here!

Wow!  What an athletic resume!  I call chasing my children a workout.  I'm impressed.  Like Quix has said, it's really significant when an athlete like yourself is having a roadblock like you are with your health, or it can be, I should say.  I'm sorry you're having so many symptoms and for so long without any real answers.  That's so frustrating.

When I was reading your post (maybe I spend too much time doing this!) I instantly became "Momzilla, M.D."  Much of the first blood work part is way over my head, but the eye flashes are all my specialty.  I think those may be migraine related, if an ophtho has ruled out neuritis.  

It could be a form of either occular migraine or what's called acephalic migraine.  I have had both.  Neither are serious at all, just highly annoying, particularly the acephalic.  Sometimes mine last a couple of weeks and make me quite dizzy.  Does that happen to you?  The flashes could also be visual snow, sort of like static on a television, which is my sub-specialty.  Do you see a pattern here?  (I do, because I have visual snow!)  This is usually not peripheral, but in the main field of vison.  Have you ever discussed  these flashes with a neurologist?  Migraines and MS are often comorbid.  

You could also talk to the neuro about the tickling sensations.  Those are not normal.  I get them.  I am not formally diagnosed with MS, but my one of my health care providers is pretty convinced I have it, and we are trying to get to the right specialist for that elusive diagnosis.  Does it sort of feel like goosebumps?  I don't want to lead you.  That's what I felt like in the beginning.  Like I said, I don't know what I have, but I would definitely go for a second opinion.

I don't think you're a hypochondriac.  We've all had those feelings, accusations around here.  Stick around.  You'll hear all about it.  We even have a Greek Sorority House for you to join, if you wish.  Someone will fill you in, I'm sure.

Anyway, I am glad you popped in again!  Feel well.  Listen to the good thoughts of the great gals around here (guys, too).  

Take care!

Chris*
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