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Idiopathic Itch
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Idiopathic Itch

Dear reader,

This is a call out to Graves companions, isotretinoin takers, experts and medical professionals - I am experiencing an unbearable itch around my neck and upper back for 6 months now, and more importantly, much difficulty concentrating at work (financial analysis). My boss has informed me of my lack of problem solving skills three months into my probation (new job) and has asked if I would like to leave.

The itch is inconvenient because it occurs under warm, stuffy, crowded, undue stress, and mostly in poorly-aired environments - getting around and to work has been a problem. There are however no visible signs on the skin, only mild redness on the skin upon scratching but no raised bumps.

The itch started when I was on isotretinoin x 30 mg daily morning, more than halfway into the course. (I have been on a few courses of isotretinoin since 2009, with acne vulgaris reappearing despite completion of x10mg planned courses.) I have since stopped consumption of isotretinoin since 07 Jan 2014. The itch persisted, and not improving despite consuming cetirizine, telfast + prenisolone, and desloratadine.

A positive blood test was reported for hyperthyroidism when we were finding the possible cause of itch. The endocrine doctor has not identified the cause for the itch, and the only solution is to consume antihistamines at x03 daily. I will add here that it can be a 9 when the itch occurs (1 - 10, 10 being the most unbearable) - have sporadic suicidal thoughts but have learnt to fight from it, which is a good thing.

This is a summary of my records with some observations over the years. I attempt to document as much information as I can recall, without overstating unnecessary information.

neck, back itch - 6 months to present
heat intolerance - 1 year to present
hand tremors - 2 years to present
fatigue - 6 years to present
trouble sleeping -   6 years to present
nervousness - 9 years to present
irritability - 9 years to present

frequent bowel mv - 2 months to present
weight loss (3kg) - 1 year to present

No goiter
No Graves ophthalmopathy
No voice changes

Blood Work - 17 Jan 2014
Haemoglobin Determin. 11.95 L G/DL   (N 14 - 18)
MCV 65.67 L FL (N 76 - 96)
MCH 20.11 L PG (N 27 - 32)
MCHC   30.63 L G/DL (N 32 - 36)
Lympho % 43.66% H (N 16 - 40)
Neutro % 42.53% L (N 48 - 80)
(not mentioned items in full blood count are within normal range)

Blood Work - 04 Mar 2014
Creatinine = 61.00 L umol/L (N 65 - 125)
TSH < 0.02   L mIU/L (N 0.45 - 4.5)
Thyroxine, Free (FT4) = 32.00 H pmol/L (N 10 - 23)

Blood work - 14 Mar 2014
TSH Receptor Ab   = 4.2 IU/L (Normal < 1.0 IU/L)
T3, Free   = 7.1 H pmol/L (Reference Interval 3.5 - 6.0)
Thyroxine, Free = 26 H pmol/L (Reference Interval 8 - 21)
TSH < 0.01 L mIU/L (Reference Interval 0.34 - 5.60)

Ultrasound, Thyroid - 14 Mar 2014
The isthmus measures 0.1 cm.
The right lobe measures 5.2 x 2.1 x 1.3 cm.
The left lobe measures 5.2 x 2.3 x 1.2 cm.

The gland is normal in size and shape. It shows heterogeneous echogenicity but normal vascularity. Few bilateral thyroid nodules are seen.

At the right upper pole there is a 0.3 x 0.3 x 0.1 cm hypoechoic nodule, no suspicious features.
At the left upper pole there is a 0.7 x 0.4 x 0.3 cm, hypoechoic nodule, no suspicious features.
At the left upper pole there is a 0.4 x 0.3 x 0.1 cm cystic nodule, no suspicious features.

Thyroid returns heterogeneous echogenicity (?thyroiditis?
Multiple thyroid nodules are seen, these do not demonstrate any suspicious features.


My concerns are (i) I heard Carbimaole / PTU will cause itch when first consumed, how can I work on avoiding this? (ii) Is there a way to recover from the concentration/memory + alleviate the itch? If not does that mean I will have to find a way to work freelance at home? (humid country 0.79 with overpopulation 7301 px/km2)

Would gladly hear your views and advise. Cheers.
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