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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
Hashi's complication
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.
Hashi's complication
by Bella0906, Jul 15, 2007 12:00AM
HI,
I am a 43 yr old female. I have had a goiter for 8 years no problems. IN OCt 2005 got neck injury and hashi's kicked in full blown. The goiter does affect the neck injuty.
The docs cannot seem to control my Hashi's and stabilize my TSH. In March I started at 50 mcg of syntroid at a THS of 6.0. It rapidly went down to 1.29 but I felt awful. After taking the med each morning I would get terrible burning symptms and various neuro symptoms. I stayed on it for two monthsand was feeling so bad we decided to try something else.
Next we tried 50mcg of levoxyl and 10mcg t3. As of right now my TSH is less than 0.01 and they have taken me off the thryoid meds and I am now hyperthyroid from the meds. I am on beta blockers but the tyroid goes through these phases of swelling and pain throughout the day.
When I am on the meds my neuro symtpoms are worse.
When on the meds,shrinking the goiter becomes uncomfortable as the goiter pulls me forward and my neck and spine get painful.
My neuro has suggested Hashi's encephalitis. And the other interesting thing is that the neck muscles near the goiter have all turned fibrotic.
Questions:
Is Hashi's encephalitis a possible dx? Or is it Hashi's Toxicosis and a thyrotoxic myopathy? Are either of these reasons for surgery
If you take out the thryoid will the antibodies go away making the neuro effects stop?
IF I have it removed will I be able to tolerate the meds better?
Thanks!
I am a 43 yr old female. I have had a goiter for 8 years no problems. IN OCt 2005 got neck injury and hashi's kicked in full blown. The goiter does affect the neck injuty.
The docs cannot seem to control my Hashi's and stabilize my TSH. In March I started at 50 mcg of syntroid at a THS of 6.0. It rapidly went down to 1.29 but I felt awful. After taking the med each morning I would get terrible burning symptms and various neuro symptoms. I stayed on it for two monthsand was feeling so bad we decided to try something else.
Next we tried 50mcg of levoxyl and 10mcg t3. As of right now my TSH is less than 0.01 and they have taken me off the thryoid meds and I am now hyperthyroid from the meds. I am on beta blockers but the tyroid goes through these phases of swelling and pain throughout the day.
When I am on the meds my neuro symtpoms are worse.
When on the meds,shrinking the goiter becomes uncomfortable as the goiter pulls me forward and my neck and spine get painful.
My neuro has suggested Hashi's encephalitis. And the other interesting thing is that the neck muscles near the goiter have all turned fibrotic.
Questions:
Is Hashi's encephalitis a possible dx? Or is it Hashi's Toxicosis and a thyrotoxic myopathy? Are either of these reasons for surgery
If you take out the thryoid will the antibodies go away making the neuro effects stop?
IF I have it removed will I be able to tolerate the meds better?
Thanks!
Doctor's Answer
by Mark Lupo, M.D., Jul 15, 2007 12:00AM
, Jul 15, 2007 12:00AM
This does not sound like hashi's encephalitis - that, if it exists, is a dementia-like illness.
The symptoms perhaps can be attributable to goiter, aggravated by the injury.
Surgery may or may not help -- would talk to an experienced thyroid surgeon to see if in this case it would help. The antibodies usually decrease, but may not disappear after surgery. The meds are sometimes more tolerable, but this usually should not be an indication for thyroid surgery.
You may have intermittent subacute thyroiditis on top of the hashimoto's given the pain and the low TSH -- but the low TSH may have simply been too much medication.
The symptoms perhaps can be attributable to goiter, aggravated by the injury.
Surgery may or may not help -- would talk to an experienced thyroid surgeon to see if in this case it would help. The antibodies usually decrease, but may not disappear after surgery. The meds are sometimes more tolerable, but this usually should not be an indication for thyroid surgery.
You may have intermittent subacute thyroiditis on top of the hashimoto's given the pain and the low TSH -- but the low TSH may have simply been too much medication.
