Hypothyriodism...or something else?

[Bengalborn]

Hi...Just trying to find some piece of mind. I'd recently starting have strange symptoms, both physically and emotionally, all of a sudden about a month or so ago. Most of them I have experienced before but, due to their infrequency, had never imagined they would be linked. Issues like serious moodiness, lack of motivation, constipation and weight gain I had attributed to pre-medicated ADD. After starting Adderall six years ago, I lost 70lbs and kept it off, gained some motivation and was having normal bowel movements....until recently, that is. I have gained 30lbs out of nowhere and it is UNFALTERING. I have been having strange emotional twists and turns for the last few months. Sad and irrational in the morning and happy go lucky in the afternoon like nothing has even happened...and stress...I few months ago I thrived in stressful situations...now I can barly handle a minor change in schedules. I decided it was time to see my doctor. After describing my very generalize symptoms and after a barrage of testing, it appears that she is leaning towards Hypothyroidism. The initial testing started approx 1 month ago where I had a positive ANA and it was determined that I have a severe B12 deficiency (219). I was advised that my thyroid panel was "off" and additional testing was needed. Two weeks later I had a TSH (2.00), T4 Free (1.10), TPO antibodies (15), T3 Free (3.0) and a NEG ANA. I was scheduled for a thyroid ultrasound which proved inconclusive and a third round of labs were drawn on 2/6/13. Again, I was told the thyroid was off and again I have a positive ANA. (I don't have the values for the 1st or 3rd series of testing since these were drawn at the DR's office as opposed to the 2nd set being drawn at the hospital where I work. I am aware of the potential for discrepancy in values from different processing facilities)... I was started on Synthroid 50 and have been taking it for approx 2wks. I still have issues dragging myself out of bed, have terrible mood swings, wake up in the wee hours of the morning sweaty, hot and unable to get back to sleep. I wake up in the morning with swollen red fingers that ache from the second knuckle to midhand, so much so that at times it affects my grip. (this happens if I get overheated as well). After a shower the skin on the bridge of my nose, across the tops of my cheeks, on my forehead just above the brow and sometimes on the chin turn bright red and feels tight like a sunburn but fades in an hour leaving the nose and cheek area scaly. I have dry itchy skin, dry hair that has taken to "turning loose" but just in the front. I have always had a severe intolerance to heat, making me faint and ill tempered and though am known to have Raynauld's prefer much cooler climates. I have a paternal aunt with SLE and a maternal aunt with Graves. I am currently awaiting the results of my last slew of testing to rule out SLE. I just find it strange to have had these symptoms in "waves" (the last time I remotely had any of these symptoms and never at the same time was approx 6-10yrs ago)...Some symptoms seem related to Hyperthyroidism, some to Hypothyroidism and some make me feel like I am just imaging them...Is there anyone out there who can relate or shed some light on my situation? Does all this seem in line with straight forward Hypothyroidism or should I press for additional testing? But most importantly, if this truly is hypothyroidism, would I have noticed at least some improvement on synthroid after two weeks, even if only slightly so? ...Any feedback is appreciated!!!!

[Red_Star]

One of my hyperthyroid symptoms is a lupus like rash over my face after a shower that lasts about an hour afterwards. This was confirmed when this symptom worsened significantly during a two month bout of Hashitoxicosis.

I would like 219 to be classed as severe vitamin B12 deficiency but, to the unnecessary suffering and misdiagnosis of many, this is class as "normal" for most countries.  For your levels to drop to 219 however takes years.  Mood swings, ADD/ADHD, lack of motivation, are a few of the many listed symptoms of vitamin B12 deficiency.

Vitamin B12 deficiency elevates reverse T3 which blocks T3 from doing its job and leads to hypothyroid symptoms.  I had severe adrenal insufficiency due to severe vitamin B12 deficiency. Vitamin B12 deficiency can cause either cortisol depletion or high cortisol levels.  I couldn't handle ANY stress.  It took 18 months to get over this and back to my milder adrenal insufficiency until a two month Hashitoxicosis flare up changed that to severe adrenal insufficiency again.  

* Under-methylation means elevated homocysteine. Vitamins B12, B6, and B9 work together to control blood levels of the amino acid homocysteine.
One of the best health books i've read: "The H Factor Solution: Homocysteine, the Best Single Indicator of Whether You Are Likely to Live Long or Die Young by James Braly MD and Patrick Holford.

***

Info from Nutrititonal Healing - Dopamine:

"Dopamine deficiency signs/symptoms:

Reduced ability to feel pleasure
Flat, bored, apathetic and low enthusiasm
Depressed
Low drive and motivation
Difficulty getting through a task even when interesting
Procrastinator/little urgency
Difficulty paying attention and concentrating
Slowed thinking and/or slow to learn new ideas
Crave uppers (e.g. caffeine/nicotine/diet soft drinks)
Use these to improve energy/motivation/mood
Prone to addictions (e.g. alcohol)/addictive personality
Shy/introvert
Low libido or impotence
Mentally fatigued easily and physically fatigued easily
Sleep too much and trouble getting out of bed
Put on weight easily
Family history of alcoholism/ADD/ADHD

Factors which reduce dopamine levels:

Chronic stress
Inadequate sleep
Hypothyroidism
Lead, arsenic and cadmium exposure
Under-methylation *
Tyrosine (precursor) deficiency
Magnesium, iron, zinc & vitamins B3/B6/C/D deficiency
Excess copper levels
Genetic dopamine receptor abnormalities
Chronic opioid, alcohol & marijuana use
Adrenal insufficiency
Glutathione deficiency
Parkinson's Disease
Influenza
Estrogen deficiency
Human growth hormone deficiency"

[goolarra]

It would be good to see the other two panels.  Be sure to get the reference ranges, too.  The labs you did post are by no means stellar, but they're not awful, either.  We usually say midrange for FT4 and upper half for FT3 once on meds.  There's more latitude (I think) if you're not yet on meds.  The ones you posted aren't so close to range limit that they should have been "off" just two weeks before and 1-2 weeks after.

[Bengalborn]

I am currently taking 2500 mcg of B12 sublingual 3-4 times daily...and the night sweats and waking early in the morning all started after the initial dose of Synthroid...I have wondered what the long term effects of Adderall would be and if in fact it is a contributing factor. However, taking it made me regular and actually made me able to fall asleep at night. Now I can sleep at the drop of a hat whether I take it or not (as well as the mental fog) and my bm's have become irregular...I actually thought the thyroid panel I had access to wasn't bad, but will need to see how different the other two values were in comparison...those two reflected the positive ANA's...I will try and get copies so that I can post them....Thank you for your response. I have a follow up on 3/7/13 and it helps to go in armed with questions. Thank you again....will fill in the blanks as they are answered.