Thyroid Disorders Community
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10059661 tn?1407565170

Grave's and Fibromyalgia

How can I tell which symptoms are from which disease? I have all the pain pressure points and patches of hypersensitive, burning skin of fibromyalgia but some of the other symptoms could be either/or. Muscle weakness, tiredness, sleep problems, diarrhea, and foggy brain. A couple of months ago I noticed my legs getting weaker. And they would shake when I tried to get up from a sitting or squatting position. Then I started to hurt all over, my appetite disappeared, and I couldn't sleep. I started to poop out in the middle of shopping trips, breaking out in a cold sweat, my legs giving out so I had to find a place to sit down. Then the shaking started. And hot flashes. I thought maybe I had a virus. But it was going on too long. And I lost 30 lbs. in a month. Finally saw my doctor and she diagnosed the fibromyalgia right away. She gave me Cymbalta and ordered a whole slew of blood tests including TSH and free T4. Well the TSH came back >0.01 and the T4 was 2.7 (normal range 0.8-1.5). Surprised my Dr. She gave me methimazole, 5 mg a day, ordered a T3 test, and gave me a referral to an endo. T3 came back 390 (normal 58-159). Mr. endo man upped my methimazole to 10 mg per day after diagnosing me with Grave's Disease. I've only been on it for 3 weeks but I'm still shaky, tire easily, and hurt all over. I had to be off it for 3 days to prepare for my thyroid uptake test and scan I had 2 days ago so I'm really a mess right now. They told me after the test my uptake was 60, with normal being 5-15. I see my regular doctor next week and she's going to ask how the Cymbalta's working. Ha! How should I know?  I'm still a mess but I'm happy. (Cymbalta is an antidepressant) Also I have to determine the future of my thyroid. If the scan shows nodules or growths I'm having it surgically removed. RAI scares me. I have the eye problems now with Grave's and I've read that RAI can sometimes make it worse. I only have one good eye as it is. Because I've only been taking the thyroid meds for 3 weeks (I also take the beta blocker Atenolol 25 mgs a day split into 2 doses) should I be seeing better results? I've read elsewhere about the half-life of methimazole so maybe I should split my dose? And does anyone else have fibromyalgia? I'm sick and tired of being sick and tired.
14 Responses
Avatar universal
Thought you might appreciate the info in this link.  It is an interview with a good thyroid doctor.  I think you will really like to know that, "If you remember it was a long time before the medical profession admitted that there were two new diseases to appear in the world that were not there before. Chronic fatigue and fibromyalgia were non-existent before 1980. This is seven years after the 1973 consensus meeting. So where did these two new diseases come from? The symptoms and signs of chronic fatigue and fibromyalgia were described in the literature in the 1930's as one way that low thyroid could be expressed."

1104206 tn?1407475591
have you been tested for hyperparathyroidism?
10059661 tn?1407565170
No I haven't. I will ask my doctor to order the tests. Thank you for the heads up. I found an article out of UCLA that says Grave's and hyperparathyroidism usually overlap in females over the age of 45. That's me. I'm learning more each day about this and am so glad I found this site.
1756321 tn?1547095325
Excerpt from Medscape: Aerobic Exercise 'Most Effective Weapon' for Fibromyalgia

"There is no magic drug against fibromyalgia and, in my opinion, there will never be. Psychotherapists don't work miracles, but psychotherapy can help and, in a few cases, turn people with fibromyalgia into nonpatients. Drugs may help, but patients don't like them," said investigator Winfried Häuser, MD, from Technische Universität München in Germany, who has published widely on fibromyalgia.

"Aerobic exercise is the most effective weapon we have; healthy people profit from continuous physical exercise, and so do patients with fibromyalgia," he explained.

Dr. Häuser presented an overview of research on fibromyalgia treatment here at the European League Against Rheumatism Congress 2014."
10059661 tn?1407565170
I know I have to keep moving. For the past 11 years exercise has made me feel awful afterwards. But I didn't stop. I didn't realize that exercise induced fatigue was a symptom of fibromyalgia. After my doctor diagnosed me I started researching and found I've been experiencing fibro symptoms for years. I had no idea. I thought I needed more vitamins or something. I chalked it up to aging. Right now I have absolutely no stamina or strength. I'm hoping that once I get my thyroid problems straightened out I will be able to walk more than a few hundred yards without breaking out in a drenching sweat and having my legs give out on me. It's nice that I lose 5 lbs every time I go to the store though. Lol! I need to find the right amount of exercise that's beneficial but won't lay me out for 2 days. Today I went out in the garden, watered the plants, picked some tomatoes and plums, came inside drenched with sweat, out of breath, and exhausted. Sat on the couch a bit to catch my breath then went in the kitchen to scrub the sink (with me out of commission and 4 men in the house it was nasty. Yes they can load the dishwasher but obviously don't know how to use a sponge and cleanser). Sat down again and would really like to make a salad for lunch but I don't have the strength to get up and gather the ingredients. I can sit at the table to do the chopping and assembling but I need someone else to do all the getting and washing for me. I hate feeling this way.
649848 tn?1534633700
Were you diagnosed with Graves Disease, based on antibody (TSI) levels or simply because your FT4 was over range and your TSH was under range?

Sounds like you might have Hashimoto's, which is often characterized by periods of hyper, alternating with periods of hypo, in the early stages.  I agree, completely, with gimel's post referring to chronic fatigue and fibromyalgia not having been "discovered" until after the 1973 consensus meeting making TSH the thyroid test of choice.

Ask for Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb) for Hashimoto's and Thyroid Stimulating Immunoglobulins (TSI) for Graves Disease. These will tell you what thyroid disease you have, and you can scratch the fibro dx.  
10059661 tn?1407565170
I was trying to copy the link in your post and somehow it marked it "best answer". Yes it was interesting and helpful and caused me to do some more digging but I didn't want to mark it "best answer" lest it discourage others from giving advice. I wanted to know what his list of hypo symptoms was. Even though he listed pulse as an unreliable factor he did say that a consistently high pulse was a sign of hyperthyroidism. Since 1994 when I first was diagnosed with high blood pressure my pulse has rarely gone below 90.  When I exercised it would stay above 100 for hours. You would think it would be doing damage to my heart but my stress test and heart scan last year showed my heart to be perfect. The doctors can't explain it either. Only recently has my heart rate gone down because of the Atenolol. But if what he says is true this means that my fibromyalgia symptoms will disappear when my thyroid levels are made normal again. There's nothing wrong with hope.
10059661 tn?1407565170
OK taking notes. I'm glad my doctor listens to me. I'll bring the list of tests with me when I see her again next week. When I mentioned my sister has fibromyalgia and lupus she ordered the tests that could indicate the possibility of them. Only the Erothrocyte Sedimentation Rate test indicated inflammation. The ANA and Rheumatoid Factor were normal. And my monocytes in the White Cell Differential test were high, indicating possible chronic inflammatory disease. The endocrinologist said Grave's because of my eye symptoms. They sometimes feel like they're going to explode, and when I wake up in the morning they're very dry and my eyesight is cloudy (like I have cataracts) until I can get some eye drops into them. This stuff isn't that simple is it? So many tests. But better to have a complete and thorough diagnosis before making a decision about treatment. Thank you all for your input.
Avatar universal
Thought you might find this list of heart related hypo symptoms to be interesting.  


    High blood pressure
    Low blood pressure
    Slow/weak pulse (under 60 bpm)
    Fast pulse (over 90 bpm at rest)
    Arrhythmia (irregular heartbeat)
    Skipped beats
    Heart flutters
    Heart palpitations
    Chest pain
    High cholesterol
    High triglycerides
    High LDL (“bad”) cholesterol
    Mitral Valve Prolapse
    Coronary Artery Disease
    Elevated C-Reactive Protein
    Plaque buildup
    Fluid retention
    Poor circulation
    Enlarged heart
    Congestive Heart Failure
    Heart Attack
10059661 tn?1407565170
Wow. You would think hypo would slow everything down. Interesting. Though it's fine now I did have high cholesterol and my triglycerides were through the roof. They're lower now too but still not where they should be. How the heck are we supposed to know we're hypo when the symptoms are so all over the place? Doctors need a reason to test your thyroid. If you're not shaking or hangdog tired all the time they don't even think of it do they? Even then all they do is the TSH. I had one done 5 years ago (can't remember why). Yeah it was normal. Now I know that doesn't mean much. Frustrating. Thank you for the list. I didn't find one that long in my search. Gotta dig deeper I guess. Or just ask you! Lol!
1756321 tn?1547095325
Look up the article from Hypothyroid Mom: 300+ Hypothyroidism Symptoms...Yes REALLY. That is not all the symptoms or related autoimmune diseases but a pretty long list.

There have been other terms for chronic fatigue states (eg: neurasthenia) since the 1700's. After an outbreak of chronic fatigue cases that showed up in Lake Tahoe Nevada in the early 1980's, there was a renewed interest in chronic fatigue states and the CDC developed a consensus case definition of Chronic Fatigue Syndrome in 1987.  Conditions that have been studied to see if they cause/trigger CFS include infections, immune disorders, stress, trauma, and toxins.

Causes/risk factors for fibromyalgia have been loosely associated with stressful or traumatic events (such as car accidents), post traumatic stress disorder, repetitive injuries, illness (eg: viral infections), certain diseases (i.e: SLE, RA, chronic fatigue syndrome), genetic predisposition, obesity.
649848 tn?1534633700
Doctors shouldn't really need any more reason to test thyroid than they need to test anything else because thyroid disease is becoming so prevalent these days.  It should automatically be tested whenever certain sets of symptoms are present.  They need to start testing more than TSH, as well, but until AACE and ATA change their guidelines, that's probably not going to happen any time soon, except for those who have already figured out that TSH isn't the end all, be all that it's cracked up to be.

I understand the eye issue bringing up thoughts of Graves; however, those same eye issues can be present with a hyper phase of Hashimoto's, as well.  It's not the Graves or Hashimoto's that causes the eye issue, it's being hyper, just like it's being hypo that causes the symptoms of Hashimoto's.  You do want to make sure you're getting the proper diagnosis.  It's rare, but there are those that have both, Graves and Hashimoto's.  
10059661 tn?1407565170
Oh yes I'm going to make sure now I'm getting the correct diagnosis. No one's touching my thyroid until I know for sure what's going on. I found that website 300+ symptoms of hypothyroidism. I've been dealing with quite a few of those for almost 25 years. After my youngest was born I came out of the hospital weighing more than I did when I went in. And it just kept going up. I thought well, your metabolism slows down as you get older no matter how much you exercise. And boy was I! I didn't learn to drive until I was 40 so in the meantime I'm walking or bicycling and usually with one or more small children in tow. I had a housekeeping job at the time. It was a two story 4 bedroom 3 1/2 bath house and I do believe that vacuuming over 1800 sq. feet of carpet (stairs too) is quite a workout. Still I gained weight. I also suffered from numerous allergies, lung infections cellulitis on my nose, panic attacks, meningitis, numerous bacterial infections from the smallest cuts or scratches,  migraines with and without pain but always with half my vision disappearing behind flashing floaters and black clouds, and the list goes on. If I went to the ER every time I had something wrong I would've been there over 300 days a year. I self-treat a lot. Benadryl is my friend. Lol! I got through plantar fasciitis by myself. No more panic attacks either. I'm going to have to be proactive through this too it seems. That's OK. Bring it!
1104206 tn?1407475591
I hope things workout for you, keep us posted on the results : )
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1756321 tn?1547095325
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