Tightness in throat - back on rollercoaster with Hashis

[ShelleyN720]

After a few months on 1 grain Armour (60mg) with good labs,a reduction in symptoms and 2nd benign UGFNA in November - I have had a week of sh_tful days!
My throat is tight and I feel like I ate something that is lodged in my throat. My neck is sore - including sore to the touch.
My understanding of Hashimotos is that it takes years for the auto-antibodies to destroy the thyroid tissue. (I thought they had their heyday and I was on the backside of the disease!!) And even though I am taking thyroid replacement hormone, I suspect the auto-antibodies still like to gang up on the remaining tissue. I think this may be what is happening now. My neck feels tight and it hurts.
I know that doctors (at least the 2 endos I've seen) think that Hashimotos is painless. I say - bullstuff!
Does anyone on the forum take an anti-inflammatory during a flare-up? I am not having any "hyper" symptoms other than some increased anxiety & even some paranoia.
Do others have discomfort that accelerates then subsides?
And now I have some tinnitus going on - a humming sound (although it does not impair my ability to hear)
My next appointment is Feb 23rd. I'll probably have more blood drawn just prior to.
My labs on Jan11th drawn at about 4pm in the afternoon were:
TSH      0.936        Range: 0.270 - 4.200
FreeT3  2.9            Range  2.3 - 4.20
FreeT4  0.98          Range: 0.76 - 1.70

In contrast my Nov 11th labs were:
TSH      0.493
FreeT3  4.9
FreeT4  1.0        (all same ranges as above)
So ShelleyN, who was getting on so well - is now back on the fretful side of this autoimmune game!
#%$^(&%^)*(& I will be asking for another ultrasound to see if the nodules are growing. Why else would I feel like I am gagging? Can the gland still swell & the subside?

[Barb135]

Some people do get celiac and hypothyroid.  They are both autoimmune diseases and when one gets one autoimmune, chances of getting another become greater.

Have you been diagnosed with both? Do you have labs that you could post, along with reference ranges?

[michael265]

Does anyone have celiac disease and hypothyroid?

[ShelleyN720]

Just as Barb135 wrote, if you suspect thyroid disease, be sure to ask your doctor to run thyroid profile blood tests - TSH, FreeT3, FreeT4 and antibody tests too. Having those numbers should be helpful in determining if your symptoms are thyroid related.

[Barb135]

Have you had any thyroid tests done?  There are a variety of issues that could cause these symptoms.  

Do you have other symptoms of hypothyroidism, such as fatigue, weight gain, brain fog, constipation, or others?

[aadi228]

hi!! i think i have a throid disease!
i have similar symptoms! tightness in throat and stiff neck even effects my ears!  i have it in episodes ! and its such a hard feeling to ignore!
please advise me if these are the symptoms you had before you were diagnosed!
Regards

[ShelleyN720]

I agree about the consistency with the lab draws. Time of day/ before or after meds. I remember having the lab work in the afternoon that time because I was at the medical building for a dermatology appointment and rather than take more sick leave from work thought - I'm just going to do it now. The information from the results was interesting to me though - that my FreeT3 had dropped that much from the morning.
I think I'm going to add 15mg (cut a 30mg in half) for a week (this week) and take it in the afternoon at least an hour after lunch. Then maybe add a full 1/2 grain the next week and do the blood draw in the morning (before meds) so I can look at the numbers.
Does that sound like a reasonable plan to you?

[Barb135]

It's important to be consistent with your lab draws; if you normally have them in the morning, you should try to always do it in the morning; if you normally take your med before hand, you should always do that.  I was always told NOT to take my thyroid med(s) before having labs; I did this last time and guess what --- my FT4 was way higher than it had been before - I take the gelcap, Tirosint.  I had not, however, yet taken my T3 med for that day, so my FT3 level was consistent with the previous one.

If your endo won't give you an increase, you might be better off going back to your pcp, if you can.  If you point out how low your levels are, maybe he will see that you really do need an increase.  

In my opinion, your FT3 level is a long way from causing issues with your osteoporosis.  Somewhere, along the way, you have to find a balance - to keep your thyroid issues from causing symptoms, without hastening bone loss.  Do keep in mind that it's *excessive* amounts of T3 that cause the issues, not normal levels that make you feel good.  I do hope you can reason with him.  

My throat feels the same as yours; like I need to gag, but neither do I, have trouble breathing.  You might find that the "flare" will be over before you can get another appt.  Mine don't usually last more than a week or two, if that long.  

Yes, I think we all get visions of the little pac-man creatures - that's easiest way to describe it....... and no, an increase in medication, won't stop the inflammation, but it will make you feel better and hopefully, more able to fight it.

[ShelleyN720]

Yes, the numbers with the higher FreeT3 was about 2 hours after taking the 60mg Armour in the morning. I'll post my new numbers next week and hopefully I'll be able to see whats going on. I'll do the draw in the morning before I take the Armour. I suspect that if my TSH is in range my endo will give me a hard time about an increase. My former primary care was willing to up me to 90mg (60 mg in morning & another 30mg in afternoon) I stayed at that dosage for a while until my current endo took over my care and having seen my .045 TSH would only prescribe 60mg.(figures, eh?) Still, I suspect that since he knows I have osteoporosis T-2.7 he doesn't want me to hasten the bone loss with too high T3 readings. (you already know I don't do the bisphosphonates)
I don't recall ever having this much discomfort in my thyroid gland - I feel like I am gagging, although I have no trouble breathing. I also feel a bit nauseous.
I think it would be safe to take some Advil hoping it will reduce the inflammation. Right now I am paranoid that its going to choke me! I may just have to try to get into the endo before my scheduled appointment.
Even an increase in dosage wouldn't stop the inflammation - right? I mean like you said, the antibodies are chomping away. I have this vision of little pac-man creatures...

[Barb135]

Thank you for your kind words; it's always nice to know the we may be of some help to other members.  I, too, received a lot of help from members of this forum, which is the reason I'm still here -- so I could help pay it forward.......

You know - a member once said that in the wee hours of the morning, our thyroid "spurts" and we get a huge slug of T3 into our system; supposedly, that's why so many of us wake up in a sweat........... don't know if there's the slightest bit of truth to that or not, but with your FT3 level at 4.9 on a morning draw and down to 2.9 on a late afternoon draw, it makes me want to do some research on that issue.  But then, I wonder, too - do you take your thyroid med before you have labs drawn in the morning?  If so, since you take Armour, you would have had a big slug of T3 before the morning draw.

We, also, have to keep in mind that these labs were 2 months apart, and since we know you have Hashi's, the destruction of your thyroid could be going relatively rapidly; it's not a stretch to believe that your thyroid simply isn't producing now, like it was 2 months ago.

It would appear that you are having an attack of thyroiditis, and the only thing I can tell you, is to "ride it out" and treat the symptoms as well as you can, i.e  a cold cloth on your neck may help decrease the swelling, and ease the pain; a pain reliever, if approved by your doctor, may help relieve the inflammation etc.  Do make sure you don't rub or irritate, or put pressure on the thyroid area; this seems to really make those little buggers (antibodies) angry!!  

I will be very interested in seeing new labs; can't help thinking you are destined for an increase in med.

Not everyone reports a difference with taking selenium; you may be one of those.  It does seem to help me, and since I've slacked off on taking it, I can tell a difference, so I've got to get back into the practice of taking it every day.

I know how frustrating it is, to think we are "well", when things are going along smoothly, only to have a flare or something go wrong and we have to go back to the drawing board.  I've had this happen too many times, since my diagnosis 3+ yrs ago....  I'm at the point where I just want my thyroid to be dead, so the antibodies will (hopefully) not have anything further to chomp on and will quit wreaking havoc with my body ........... You've done well, for a while, so you know it's possible; don't give up.  This disease takes more patience than most of us ever imagined, so that's the key word - patience, patience, patience, and when you've run out, you'll have to find some more.

[ShelleyN720]

Barb, thanks for your response...I've been hoping you'd see & respond - I seek out your comments whenever I am logged into the forum. You and a couple other people are my unpaid physician assistants - and more trusted than doctors!
I will probably do new labs next week before my endo appointment on the 23rd. I thought my FT3 & FT4 looked a bit low too - but the blood was drawn at about 4pm in the afternoon that day. My early morning draws are usually much different - my FreeT3 was well over the reference range (4.9)
I am pretty religious about taking 200mcg of selenium every night with my calcium/magnesium regimen. Also very faithful with the 4000 IU of Vitamin D3.
So you agree that what I am experiencing is probably a flare-up (inflammation) of the thyroid gland...I mean it is thyroiditis.
When I had my last FNA on November 22nd (my endo performed it) he indicated that it had not grown in size, the largest nodule anyway which is the one he always focuses on.
I have been very bummed out, having done so well only to have the last several days bring back memories from my initial frightening realization that I have thyroid disease. Where would I be without this forum and people like you? I hate to think of it!

[Barb135]

I'm so sorry to hear that you are having a "flare"........ your latest labs still show that you may be a bit hypo, as both FT3 and FT4 are very low in their ranges.  Your symptoms would seem to bear this out.  I didn't begin to feel better until both my FT3 and FT4 hit at least mid range.

I still get the same feelings in my throat that your describing - tightness, and a feeling of "something" in there!!  I do find that if I make sure to get a daily dose of selenium, I don't have this issue nearly as badly or as often.  Some studies have shown that selenium can help with the conversion of FT4 to FT3, as well as other benefits.

I keep thinking I'm on the backside of the disease, too, and I'm finally beginning to think it's true for me, as my thyroid levels are stabilizing, and everything seems to be leveling off; however, I am fully aware of the fact that things can go "haywire" at any time.

Hope you feel better soon.

[medicmommy]

I may be going out on a limb here, but when I had thyroiditis my thyroid felt the same way. I didn't start getting hyper symptoms until about 4 weeks (or was it 6?) after it became inflamed. On the other hand, I was going through a chemotherapy treatment at the time so maybe I was already feeling so cr@ppy that I didn't notice for a while...Hmm. perhaps this wasn't much help after all...:P ~MM