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thyroid/gastro
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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thyroid/gastro

Epigastric pain/burn and discomfort,Thyroid disease (unclassified)
I was affected with a bell’s palsy (facial nerve palsy) 18 months ago(March 2008). The palsy lasted about 3 months for which I took very high doses steroids(glucocorticoids). My consulting neurologist spoke of Bell’s palsy being of viral aetiology which made sense as I had treated and was in close contact with a patient with Herpes simplex virus type 1. This led to me testing for HSV which came up positive and  I started antiviral therapy (Zelitrex). To date my bloods still show up positive for HSV.While I had the bell’s, I was on high dose steroids and one day I experienced sudden discomfort, pain and watery diarrhoea which I thought was rupturing of my stomach mucosa (ulcer).
I have since then been suffering with my stomach, having abdominal discomfort, burning, pain and reflux. I have to eat smaller meals and wash down with alot of water as I get a felling of  partial gatstric outlet obstruction. My symptoms worsen on ingestion of certain foods: hot liquids, tea, spices, which I have excluded from my diet.
I don’t smoke or drink alcohol.I have been on PPI’s : 1 tablet daily and gaviscon and Ulsanic for the last 17 months or so. I recently added an extra PPI (nexiam alt with pantocid) to my existing rx.In the last 2-3 months I experience tingling and numbness of my hands and weakness, fatigue and difficulty maintaining concentration which I thought was due to alkalosis (milk alkali syndrome) for which I did do a blood gas which did reveal mild alkalosis.I have been for 3 gastroscopes,showing intestinal metaplasia and chronic gastriris.6 months ago I was diagnosed with a thyroid illness, whereby my T3 and T4 are normal but TSH was high and still continues to increase. Last checked it was 22. I also have high levels of antithyroid globulin and antithyroid peroxidise which is in keeping with Hashimotos BUT thyroid ultrasound showed multiple small cysts which is in keeping with subacute thyroiditis
97953_tn?1193367871
This is not subacute thyroiditis - it is chronic thyroiditis (Hashimoto's) which look similar on ultrasound.  Anyway, you have subclinical hypothyroidism -- high TSH with normal T4 and T3.  This should likely be treated as it may increase reflux/gastroparesis if untreated as well as have a negative impact on brain, heart and cholesterol processing.

However, it may not be the only abnormality - so continue to work with your doc to address the other issues as well
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YEP, WE ARE TREATING IT AS HASIMOTOS NOW AS PR ENDOCRINOLOGIST
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Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
Sarasota, FL
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