Live WebChat - NOW - with Dr. Mark Lupo, Endocrinologist

[ChitChatNine]

We'd like to welcome Dr. Mark Lupo, Endocrinologist, as our guest this evening from 5:00-6:00PM EST.  Dr. Lupo will be answering thryoid-related questions which were previously posted by our community members earlier this week.  

After a member-question is posted by Co-CL ChitChatNine, Dr. Lupo will answer the question with a few minutes for member comments and then another question will be posted.

I know we'll enjoy this WebChat and thank Dr. Lupo for his time!  

Let's give Dr. Lupo a warm welcome!

Your Community Leaders
Cheryl, Laura & Stella

[Barb135]

You won't be able to reach Dr Lupo through this thread.  This is the patient forum, and this "live chat" was almost a year ago.  You will need to go the expert forum to try to reach Dr Lupo.

If you have questions that we patients might be able to help with, I'd advise that you begin a new post to ask your questions.  

Good luck.  

[Addie61]

I had radiation on my tonsil area (neck) over 23 yrs ago and they said my thyroid would probably go out.   Now I get funny number and get examined and they come back normal everytime.  I feel like a guinea pig, they always want more blood in a 3 months to have my numbers not where they should be and after testing - NORMAL AGAIN?  What is causing this up and down numbers with my thyroid?

[stella5349]

Again I apologize for not being part of the chat last night due to family issues.

Thank you Dr. Lupo for coming over last night and helping so many members.

[Cloulou]

Although I missed the live chat, the question that I posted previously was answered. This is such a terrific forum, thank you Dr Lupo, thank you Leaders, thank you Members, this is just GREAT!!!
Cindi

[ChitChatNine]

Thanks Dr. Lupo and all our members for your time participating in this wonderful live WebChat!

Any unanswered question during today's WebChat will be moved over to Dr. Lupo's Doctor-to-Patient Forum and answered this coming week by Dr. Lupo!

http://www.medhelp.org/forums/show/120

C~

[Me967]

Thank you for your time.  It was very kind for you to join us.  I bet your finger are tired!  LOL
Thanks again.  ;~)

[shannon828]

Thank you Dr. Lupo!

[baz5]

Thank you for all of your time!!  It is much appreciated! :)

[mommy2two2008]

Have a great evening Dr. Lupo and all!

[baz5]

I do have an RA doctor.

[Mark Lupo, M.D.]

WE WILL TRY THIS AGAIN -- MORE REAL-TIME -- IN THE FUTURE..

THANKS.

MARK LUPO

[ChitChatNine]

THANK YOU Dr. Lupo for being our guest on this Thyroid Live WebChat!

We will refer to your valuable information for many years to come as we continue to help members with thyroid questions who are in need of support!

We thank you, also, for the time you give to answer questions on your forum on a daily basis, and we will be sure to stop by!  Dr. Lupo's Expert Forum:  http://www.medhelp.org/forums/show/120

Again Thank You -- this is the end of Thyroid Awareness Month but you have really made a difference helping us here tonight!

Thyroid Community Leaders

[Mark Lupo, M.D.]

LAST QUESTION FOR THIS WEBCHAT....

Posted by: bet643

Jan 21, 2009 08:48PM



To: Dr. Lupo

You are a Prince, thank you so much!!!!  After my total thyroidectomy 4 yrs. ago for pap. carcinoma and dx with hashimotos, I was placed on 150 mcg. of Synthroid.  Even though I have the problems of joint pain, brain fog, lack of sleep and all of the other lovely problems that go along with it, the most trouble I am having is heart palps. I have them quite often. I was told that it would slow down over 3 yrs. ago, but nothing yet. They cause me to lose sleep, which I do not need since I barely sleep as it is. I am worried that I will end up with a heart attack. I can't give you my labs since I will not see my Endo until this Friday, that's when he will go over my labs with me. I am a walking zombee most of the time. It takes me about 2 to 3 hrs. to function after my meds are taken at 7:00 AM and I am wiped out by 3;00 PM.  So I guess you can say that I'm only good for about 4 to 5 hrs. a day. I am concerned that my ths is alway high, but I have yet to get a good explaination on why it's alway high. I'm just so tired and  feeling weak and would like to know if it will ever get better?


IF TSH IS IN TARGET RANGE (O.5-2.5) THEN ASK ABOUT A TRIAL OF ADDING T3 -CYTOMEL --USUALLY DOES NOT HELP BUT MAY BE WORTH A TRIAL -- SEE ABOVE POSTS ON THIS.

[SueYoung55]

So much to learn. Thank you for your time.

[laura1967]

Were you the one Dr Lupo just answered the question above under autoimmune and see a RA dr?

[Mark Lupo, M.D.]

Posted by: rohit_786

Jan 21, 2009 08:20PM



To: Dr Lupo



Subject: Hashimoto's thyroditis / Pituitary adenoma



Thanks Dr Lupo for your time here. I have been posting my questions/answering other here for last 3 years . I have two questions.



About Me first :-



Male , 37 years , diagnose Hashimoto's in 2006



Question # 1

I recently diagnose Pituitary tumor because of hig prolactin level , the size of tumor is 6mm. My question is , do you think my hypothyriodism is because of pittuitary disorder ?.

NOT IF TSH WAS HIGH AT TIME OF INITIAL DIAGNOSIS.   MORE LIKELY IT IS PRIMARY HYPOTHYROIDISM DUE TO HASHI
UNTREATED HYPOTHYROIDISM HOWEVER CAN ELEVATE PROLACTIN.....
Question # 2:



My thyroid level keep bouncing for last 3 years, current number is TSH 1.67, FT4 = 1.37 FT3 = 3.32.



I still have muscles pain/joint pain , fatigue and still weight gain issue.Can't hold my temper , fuse very quickly and very low sex drive and low libido.


LEVELS NORMAL, NOT MUCH MORE TO DO W/ THYROID HORMONE TREATMENT.
Some more data about my hormone which is tested pretty recently



Total Testosterone 300 (300-1090)

LH  1.67 (1.5-9.0)

FSH 3.2 (3.0-10)



Free testosterone level is also in low side.



My question is , do you think those hormones are responsible for my symptoms as my thyroid numbers are fine  ?.

TESTOSTERONE IS  A BIT LOW -- MAY CAUSE SYMPTOMS.  LOW TESTOSTERONE IS SOMETIMES SEEN IN UNTREATED PROLACTINOMAS.

Current medicine



Levoxyl 88mcg/day

Bromocriptine  2.5mg/day.





I really appreciate in advance for your response.

====================

[Aurorah]

tyvm for you time today Dr. Lupo

[baz5]

I did not take my methotrexate last night due to my trip to the hospital.  Would skipping a dose be that awful for me?  I have a sneaking suspision thats what put me there in the first place.

[mommy2two2008]

Great chat!  Thanks so much for your time.  I think a lot of people will get answers with the information provided!

[Mark Lupo, M.D.]

Posted by: laura1967

Jan 21, 2009 06:30PM



To: Dr Lupo



Thank you for your time here Dr Lupo. I am one of the community leaders here and I would like to touch on 2 questions that are asked frequently.



1- Can a person have Both Graves and Hashimoto's? Or is it only considered Graves regardless of both tests showing positive.

AUTOIMMUNE THYROID DISEASE SHOULD BE CONSIDERED A SPECTRUM -- HYPO ON ONE END (HASHI) AND HYPER ON THE OTHER (GRAVES).  SO A PERSON COULD SWING FROM ONE PICTURE TO ANOTHER.....

2- Do you know an approximate timeframe that one would expect from Hashimoto antibodies attacking the thyroid to completely destroy of the gland?

IT VARIES FROM PERSON TO PERSON -- HARD TO PREDICT.

Thank You.

Laura

[ChitChatNine]

Dr. Lupo will have time for one more question.  

Thanks for your time participating in this wonderful live WebChat with Dr. Mark Lupo.  Any questions not answered during today's WebChat will be moved over to Dr. Lupo's Doctor-to-Patient Forum and answered this coming week by Dr. Lupo

http://www.medhelp.org/forums/show/120

C~

[baz5]

I am not on any thyroid meds right now. I am the one who went to the emergency hospital to find out all of my thyroid tests are now normal...what does that mean?

[Mark Lupo, M.D.]

I DON'T KNOW ABOUT THE TRIAL OF PARATHYROID HORMONE PUMP -- I IMAGINE IT WOULD BE FOR PATIENTS WITH HYPOPARATHYROIDISM (USUALLY POST-SURGICAL) AND NOT FOR PATIENTS WITH OSTEOPOROSIS (WHO ARE TREATED W/ FORTEO INJECTIONS - PTH - ONE A DAY)

[Mark Lupo, M.D.]

Autoimmune



Thank you for your time!  I will try and make this quick.  At age 33 I had a stroke...reasons unknow...doctors think possible migraine induced. I did have a PFO corrected shortly after....just in case that was the cause.  I have always had painful joints, infections and actually alot of "Lupus" symptoms growing up but I have always tested negative on my ANA's.  Until recently when I decided to see a Rheumatologist (9/08) because I thought enough is enough.  I tested positive for Anti-nuclear antibody ab (A) , Thyroid Microsomal ab >1300, Vitamin D level low, DHEA level low, Free T4 1.1, TSH 5.97.  My Doctor seems to think I have UCTD but now doing some research I am wondering why Hashimoto's wasnt a consideration.  I will be talking to my Rheumatologist about it but I wanted to here what you had to say.  I am also going to set up an appointment with an Endocrinologist.  Any thoughts? Thank you for your time! I forgot to tell you that my Rheumatologist put me on methotrexate for the UCTD. How do you feel about that? I am also on Lexapro 10mg, Inderal 80 mg, Aspirin 325mg. I am now also taking fish oil, One a day vitamin and vitamin D daily. I am a little weary of being on methotrexate personally.  I am trying to trust my doctor but the more I read and ask questions the more I am unsure.

LOOKS LIKE YOU HAVE HASHIMOTOS WITH EARLY HYPOTHYROIDISM -- GIVEN THE COMPLEX HISTORY, I WOULD CORRECT THIS VARIABLE W/ A LOW DOSE OF 25-50MCG OF LEVOTHYROXINE TO BRING THE TSH TO AROUND 1.0 THEN SEE IF THAT HELPS ANY SYMPTOMS.

METHOTREXATE IS COMMONLY USED FOR CTD BUT HAS MANY SIDE EFFECTS -- MAKE SURE TO REVIEW THESE W/ THE RHEUM.  IT DOES NOT HAVE A ROLE IN TREATING THYROID PROBLEMS