Autoimmune thyroid

[Bodyman95]

Hi, I'm a 35 year old white male and over the course of 1 year I've developed several thyroid symptoms  Thyroid disease runs in my family with my one sister being hypo, the other sister having Graves disease, my mother has Hashimotos and my dad had a brief thyroid problem in Vietnam.  The symptoms I first developed were of racing heart, confusion, anxiety(no family history of anxiety or mental disorders), and elevated blood pressure.  This slowly developed into flushed palms and fingers, anxiety attacks, irregular heartbeat, weight gain of 45 pounds over the course of 9 months, fatigue followed by at times bursts of incredible energy, worsening sinus and allergy problems, heel pain, gritty feeling in my one eye, mood swings, depression, trembling hands, and acid reflux.   Strangely enough, alot of these symptoms started after I took an Avelox pill for a sinus infection and subsequently had a severe reaction to it.  Another unusual thing is that I was treated for bronchitis two months ago with Zithromax and Prednisone and my irregular heartbeat, gritty eye feeling and heel pain all went completely away and have never returned.  Over the course of this year I have been tested for everything from carcinoid to heart disease, all of which turned up negative and my thyroid hormones were normal all along.  I finally insisted on having my thyroid antibodies tested and my thyroid peroxidase were 467 with normal being less than 35.  In March I was told that my thyroid was enlarged but now it is normal sized with multiple nodules according to an ultrasound and I have been told I have an autoimmune thyroid condition-but not told which one.  My questions are: Could the Avelox have triggered my thyroid to destruct and what will be the treatment now for me with elevated antibodies but normal tsh, etc. ?  Thank You for your time

[Mark Lupo, M.D.]

The elevated thyroperoxidase (TPO) antibody means the immune system is attacking the thyroid.  This is more frequently going to be Hashimoto's (chronic inflammation of the thyroid leading to hypothyroidism) but may also be Graves (the immune system attacking/tricking the thyroid into making excessive thyroid hormone).

Would look at TSH-receptor antibodies (aka TSI and TBII) to complete the auto-immune eval.  If positive, then increased risk of Graves.

You may have had a case of silent/sub-acute thyroiditis as part of the sinus infection - this would cause some swelling of the thyroid that would then improve.

These are tough cases sometimes -- if the TSH is very normal (0.3-3.0) then no treatment is usually recommended.  Selenium 200mcg/day may help lower the antibodies -- this can be found over-the-counter or may already be in your multi-vitamin.

[Bodyman95]

Thank you for your insight into this.  I actually had several doctors along the way try to tell me it was all in my head, but I know myself better than that.  When I went to an endocrinologist in Louisville thinking that a bigger city doctor would be better, he wasn't even going to do an antibodies test on me until I absolutely insisted on it...and lo and behold I had elevated antibodies.  After this I went to my sister's thyroid doctor in Bowling Green who really didn't think it was thyroid until they did the ultrasound and found multiple nodules.  What I really hate is the inability to lose weight and the inability to relax...it seems I'm always jittery or on edge and chocolate of all things makes this worse by ten-fold.  What things should I do at this point since they don't want to treat me until my tsh goes out of wack even though I'm suffering the symptoms?
Thanks, Rick

[GravesGirl]

Your symptoms sound hyper, it could be the pills you took had a decongestant or something in them which makes hyper worse. Sometimes it's treated at first with prednisone, that explains why you felt better. You need your tsi checked for Graves disease or the other tests for Hashi's perhaps. You have auto-immune something thyroid!