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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
Hashimoto's with autoimmune array
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
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.
Hashimoto's with autoimmune array
by litl, Nov 29, 2006 12:00AM
I am a 53 year old female with Hashimoto's, diagnosed 25 years ago. In the interim years, I have also been diagnosed with "undifferentiated" connective tissue diseases. My current thyroid replacement is 0.75mg Synthroid. Every 2-3 years or so I have episodes of alopecia areata, loosing as much as half my scalp hair and eyebrows and eyelashes, or as little as areas that are silver dollar size. My current ANA is 1:5120, speckled. My antithyroid antibodies are in the 5000 range currently. Apparently the type of elevated ANA I have is "unknown", but most often associated with autoimmune liver disease. I also have anti parietal cell antibodies and am currently slightly anemic. I've also had episodes of elevated potassium and calcium. I have recently been on plaquenil for painful and swollen joints, but was taken off it when I developed pneumonia in August. Occasionally I have esophagitis that has to be treated with steriods as a result of GERD. My current symptoms are extreme cold intolerance, memory problems with brain "fog", constipation and very dry skin. My Dr. feels that I could alternate the 0.75mg Synthroid every other day with 1.0mg Synthroid. My question is that even if my labs indicate that I am adequately replaced, is it possible to safely benefit from increased supplement without the risk of OVER replacement? THANKS!
Doctor's Answer
by Mark Lupo, M.D., Dec 03, 2006 12:00AM
, Dec 03, 2006 12:00AM
Target TSH is 0.5-2.0 in most cases. Too much medication can lead to heart over-stimulation and to bone loss. There is an .088mg (88mcg) dose that could be taken daily (rather than alternating 100 and 75) IF there is "room" to increase the dose after looking at the recent TSH values -- ie, if the TSH is >2.
Normal test scores??? What are the exact scores, and where are they in the range? Free T3, free T4, TSH, etc.
Have you had your adrenals tested?? High potassium can be caused from low aldosterone, an adrenal hormone. Need to get aldosterone, cortisol, and DHEA tested, as well as the sex hormones since they are also produced from the adrenal glands, not just the ovaries. Could very well have adrenal insufficiency. This increases your hypo symptoms!
Also, connective tissue conditions CAN be caused from low thyroid and adrenals. The thyroid hormones are needed in every cell of your body...so you can have systemic problems with undertreated hypothyroidism.