Hashimoto's treatment plan

I was diagnosed with "post-partum thyroiditis" 8 years ago.  My thyroid levels returned to normal, but my symptoms never went away.  I was told that it must not be my thyroid and suffered in silence for years.  Last year, I had another baby.  During my entire pregnancy I complained of chest pain and heart skipping a beat/palpitations.  I was told that it was because I was anemic.  Just after she was born.  I had sudden awful double/blurry vision, chest pains (radiating from my upper back), and blood clotting issues, which required 2 transfusions.  After months of complaining and ruling out my eyes, acid reflux, etc... all of the little things that I knew were not wrong with me... finally blood tests showed hyperthyroidism again.  30 mg of methimazole for a 2 months.  My thyroid levels were, once again in normal range, but my symptoms were worsening (chest pain, neck pain, sinusitis, joint pain (in awful flare-ups), severe weight loss (currently 95 lbs, no change in appetite, but severe nausea), pain in the bottom of my feet, swelling in hands, cold all of the time, difficulty swallowing (apple bit stuck in throat feeling), dry/thin/loose skin, dry nails, hair falling out (flare-up. not constant), weakness, shaky muscles during use, twitching/spasms, brain fog, blurry-double vision, ringing in ears, lightheadedness and vertigo, dry gritty eyes, dry mouth, and no sex drive (if I were male, I would label myself impotent).  My ultrasound showed one nodule, but small and heterogenous thyroid texture.  My blood calcium is always 10.2-10.8, but my PTH was only 37.  My TPO is >1000 and TSI was 59% (I was on methimazole when this was tested).  Consistent high RDW, WBC is always on the low end of normal 3.2-5.3 and my AST and ALT fluctuate wildly... as does my blood sugar levels that I've started monitoring at home.  Blood sugar, usually 70-80 even just after eating a fatty meal.  All of this and my doctors just shrug their shoulders and don't know what to do.  Please help!!!

[Mark Lupo, M.D.]

Calcium levels up to 10.8 with normal PTH may mean hyperparathyroidism, but high Ca can be seen in untreated hyperthyroidism (but usually w/ PTH <20 in these cases).  The TPO antibody is not diagnostic of graves, TSI is normal (but does not absolutely exclude graves) -- would titrate the methimazole to normalize TSH and also test adrenal (cortisol) levels.  you should be working w/ an endocrinologist if not already doing so.