Hashimotos Issues???

[Kersten]

I'm hoping the Dr. can provide some general information for me.  I was diagnosed in 2002 with Hashimotos Disease.  Thyroid antibodies were present.  I was put on Thyroid Treatment and currently I now take 150mcg. of Levothroid.  I thought it would be easier to have my condition managed through my Physician's assistant, but I'm thinking this may not be the case.  The PA only knows to run one test which is TSH and I know there are so many other thyroid tests that should be run.  I delivered my 2nd child in February and I was on the 150 mcg even prior to me getting pregnant and remained on that dosage for my whole pregancy.  In May I started having throat issues. Pain in the front of my throat and my voice was slightly raspy.  I also had jaw pain and right underneath the jaw it hurt.  My lymph nodes on the right side of my neck and under the jaw were swollen and sore.  I also had ear pain.  My dentist thought maybe it was TMJ.  It went away and it has surfaced 2 more times. I've been into the PA 3 times and they tested me for strep, mono, ear infections, etc.  They say the lymph nodes feel fine they are just swollen due to a virus.  I'm really not thinking this is virus related.  Here are some additional symptoms I've had:

Extreme fatigue/no energy levels
No Sex Drive
Heavier Menstration since April
my throat issues.

Any thoughts if this could be thyroid related?  I asked my PA and they said "no", since I was on medication.

Any thoughts on maybe what tests should be done?  Thank you!

[tjosephs]

Thank you for responding. At least I can cross that off the list as poss reasons.
many thanks.
tjosephs

[Mark Lupo, M.D.]

Not sure why forum is closed to new questions -- but have put in request to re-open

This amount of knee pain and disease is not likely thyroid related.  Would consider a second rheumatology opinion to identify any secondary causes of joint disease besides injury/wear-tear and bad luck.

[tjosephs]

Hi I am a 38yr old. I have two children under 6yrs. I was diagnosed with Hashimoto's 8yrs ago! I have been on 150mg of thyroxine for all this time, including pregnency! I have stomach problems due to chronic reflux, but most stressfull is an ongoing Knee problem. I have had two arthroscopy's to repair maniscus damage and now have just had another MRI and have been told it has gone again and need a third. I have seen orthopaedic surgeons, Rheumatologist and Pain clinics!! nobody can tell me why this keeps happening. I have asked if it could be anything to do with my Thyroid and they all look at me like im mad!! I also have a lot of kneck pain and headaches. I hope you can shed some light on this for me as i have been i a lot of pain for a long time. I am a very active person, but always follow the physio's advise post opp, It seems to be about four weeks post opp i do something like bend to pick up something and i can feel the knee rip inside!! I look forward to hearing some advice.

[Kersten]

Thanks all- I appreciate your concerns and information.  Did I also mention that I've experience slight muscle twitching throughout my calves, toes, fingers, etc.  along with the joint aches/pains.  My throat issue comes and goes.  Could this possibly mean a change in dosage?  Also, when looking back to previous labs, my TSH will be 1.47 and then 3.57 a few months later, and then back to 1.47 and on the same dosage.  Why is it fluctuating so much.  Is that normal in Hashimotos?

[Mark Lupo, M.D.]

There is likely not a whole lot more that can be done - but some ideas include making sure the TSH is around 0.5-2.0 -- if it already is, consider a trial of adding cytomel (t3) to the levothroid (ie, in your case 5mcg cytomel am and 2pm and 112mcg levothroid)- sometimes that helps but the medical research on this says there's no difference.

An ultrasound of the thyroid to look for nodules would be the other thing to consider.  THyroid antibodies to confirm that your hypo is due to hashimoto's may be of interest, but not likely to change treatment.

[npnurse]

I wondered, have they ordered an  ultrasound of the thyroid? With all your neck pain, I would want to make sure that you do not have a single thyroid nodule that may need to be biopsied. Just a thought.

[npnurse]

I also would advise checking a vitamin D3 level, as some women have very low levels of Vit D which can cause fatigue, muscle aches, bone pain etc. Also I would recommend changing to organic milk that is free of hormones and your periods may improve. Add a mineral supplement to your daily vitamins. Make sure you are exercising daily. Good luck.

[Eileen C]

Hi Kersten,
I was diagnosed with Hashimotos in January... I have a 2 1/2 year old child and have had 4 miscarriages since then.  The first three ending early-on, and the last one ending in18 weeks and me hemoraging... The doctors decided to test me finally and realized that I have Hashi's.  They say my Thyroid has been destroyed.  In March and April, my knee and hip joints started hurting and I couldn't barely walk at times... the doctors said it wasn't the Thyroid issue, so I checked for Arthrydis and other stuff and it wasn't anything... and finally the pain all faded away.  I am now just pregnant again, and I have an endroconologist and they do want me to be checked right at the beginning and then during each trimester.  
I would say that the thyroid does a lot of strange things that the doctors can't know all about, so I would get checked by an endroconologist and keep questioning it until you get an answer.
Best of Luck.

[Maggie2007]

Hi Kersten,
I was diagnosed with Hashimotos a few months ago. For quite some time...on about a monthly basis, I'd have a day where my glands in my neck and under my jaw line would be swollen. It would cause my ears to hurt and I'd be miserable all day. I've been on thyroid meds for about 2 months now and haven't had any of that pain since. I wonder then if your issues are thyroid related. I'd recommend you see an endocrinologist rather than a PA. I thought that one's dosage should be increased during pregnancy....
Keep us posted. I'm interested in hearing what it is and how you feel. Good luck.