Hashimotos disease, neck pain and warm feeling throat

[superaddie]

I was diagnosed with hashimoto's thyroiditis a little over two years ago, since then my medications have continued to increase as well as my fatigue.  In the last month I have found myself having gained at least 10 pounds (with more activity than normal), I could fall asleep at the drop of a hat and I have trouble moving my neck from side to side without severe pain.  Also I have this warm sensation in my throat, almost at the base of my neck (towards the front).  It feels as though when I breathe in it cools it and that i have warm air coming out, it also feels somewhat tighter than normal.  I constantly want to drink something cold to cool it but it doesn't feel like a sore throat at all.  I can talk normally and my neck doesn't appear to be swollen (with the exception of the weight gain).  I think it all has something to do with my thyroid but I don't want to be a worry wart and call my endocrinologist - any advice?

[Mark Lupo, M.D.]

Hard to say what's happening -- to explore the thyroid:  ultrasound and TSH -- keep TSH around 1.0 -- if already there, consider combination t4/t3 treatment (ie synthroid & cytomel).

[straw_citizen]

Has your cortisol rhythm been evaluated?  Adrenal gland function must be attended before thyroid.

[superaddie]

My cortisol level was checked with 24 hour urine sometime last year (and was fine), is that different than cortisol rhythm?

[straw_citizen]

Yes, the 24 hour test only gives a total cortisol.  Cortisol rhythm is determined by saliva samples taken over a period of time.  Cortisol release is biologically fixed so it's easy to determine if too much cortisol is being released at the wrong time.  This affects all hormone production and activities.  Excellent "whole picture" explanation can be found here:

http://www.nutrition4health.org/nohanews/NNSp05Harding.htm