graves disease / addision's disease

[Totie]

Dr. Lupo,

I was finally diagnosed with addision's disease. I had graves disease that destroyed my thyroid gland about 14 yrs ago. Could the graves disease cause addision's disease. I am just curious. I have not be referred to any endo yet because my PCP does not like the one around here.

My symptoms are: extreme weight loss (99lbs), in Jan. i weighed 125lbs. I crave salty foods and when i crave them and don't have them i feel jittery. I did develope thrush as well last week. I still have night sweats, and constant urination.My bones ache right down to the core. The only thing my dr. said to me was some thing called Aldoren (sp?) was low and my potassium had been all over the place in recent blood work. My PCP still has not figured me out yet.

CT RESULTS FROM RADIOLOGIST: (1.9X 2.5 X 1.7cm) mass withing the midline just anterior to the L5, S1 disk space.

They did find a retroperitoneal mass in the midline with fatty density ( 1.9 x 2.5 x 1.7cm) , Should be concern for a teratoma, however, the appreance is really quit unusual for a teratoma given that the calcifications are circumferential and  rim like. It is possible the patient had a lipoma with infarction. Low density, but calcified lymp nodes can be eseen in various granulomatous diseases. Does the patient have a history of prior histoplasmosis? (NO). Nonetheless, believe that this lesion should at least be followed inf not sampled in order to ensure benignity

They did a re scan of it 3 months later and it did not show growth, but they still do not know what it is. They can no biopsy it because of its location. My PCP does not think any of this is of urgency. I have been low on B12 and Vit D, She did state that the mass has nothing to do with any of my symptoms. I feel horrible and just want to lay down all the time.

Any suggestions.

[Totie]

Thanks. I can't go anywhere outside my insurance coverage, so in the mean time until she finds an Endo she trusts i suffer. I have had high potassium levels , low B12 and low Vitamin D. I currently take a vitamin B12 pill, but once i ran out of my vit d prescription she did not feel i needed anymore. She did not say anything about what to do about my potassium level. I have no appetite whatsoever, I use to crave salty foods, now that does not appeal to me any longer. NO i do not have a problem eating, if i were hungry i would eat, but the appetite is just not there anymore. The only real pain is my neck, and the deep pain in my thighs, bones i guess, i just keep taking advil for that since i refuse to be on any narcotic, all those do is mask the symptom.

Thanks for your input.....

[Mark Lupo, M.D.]

Graves does not cause addison's - they are both autoimmune diseases of the endocrine system.  If it destroyed your thyroid, it may be more of a Hashimoto's, but in either case it is autoimmune hypothyroid disease at this point.

The treatment of addison's is steroids -- usually hydrocortisone or prednisone and this is a life saving treatment.

Would recommend testing for other endocrine autoimmune issues
Celiac sprue (sprue antibodies, 25-OH vitamin D, iron panel)
Pernicious Anemia (B12)
Parathyroid (PTH and calcium)
Diabetes (glucose)

Also can see mild immune system problems in these cases that will lead to yeast infections.

In some cases may see lymph-tissue masses in the body due to these immune system disorders and in rare cases lymphoma can be seen.

Would consider travelling to a university based endocrine department for a thorough evaluation.