Rare case of subacute

[snorris]

Kind of a long story but stick with me because i need to know what is going on. First of all i will start out with who i am. I am a 20 year old male. Very healthy, not overweight, exercise everyday. I work as a helicopter flight instructor which i have been for 3 years. Back in mid December i started noticing tremors every once and a while but majority a sense of non well being and tiredness. it was almost like the tremors showed up every once and a while. The rest of the time i was considering myself to have the symptoms of hypo(but at this point i didn't know what was going on). so anyway through jan i received several cold viruses where sinus infections were a result. Bascially i got a few infections from jan-early march after i noticed the hypo symtoms. Becuase of this i was on about three diffeent antibiotics to take care of the infections.  Well in jan i was sick of feeling tired so the doctor got some blood work up and the results were as follows.

tsh          5.57   normal was .49-4.67
free t4       .78   normal was .61-1.12

with thyroid antibodies all normal. so after the result my general practicition perscribed levothroxine for the underactive thyroid. I was taking 25mcg from about mid jan till early march when all of a sudden the symptoms of hypo returned along with a huge thyroid and massive thyroid pain. I was in bed for about a week. From that point i got into a ear nose and throat doctor and they refered me to a endocrinologist after an ultrasound came back positive for an enlarged and inflammed thyroid.  After the diagnosis with the endocrinologist we had blood work up and the tsh levels were 3.65 which were normal. So she called it subacture thryorits and perscriped 40 pills of steroids. Which is 40 mg a day for 4 days, 30 mg a day for 4 days and so on. and also told me to stop taking the levothryoxine. This first appointment with the endocrinologist was march 20th. So anyways march 20th was a friday. I felt good sat-tuesday. Then wednesday came along and i was bed ridden with thyroid pain again along with the symtoms of hypothyroism. so thursday i got more blood work up and it came back as tsh 6.19. Friday the 27th was so bad i was considiering going to the hospital but got a hold of the doctor and she told me to start up on the levothryoxine. Well anyways over the weekend i was bed ridden with pain and discomfort so got appointment today with the doctor. She mentioned to me that usually after the steroid people are back to normal and has not encoountered a situation like mine. She put me back on 40 mg a day of steroids and 75 mcg of levothroixine. I feel a little better but i really have missed 25 days of work and this should not happen to a 20 year old healthy male. Does anybody have an experience with this? What if after this next round of steoirds it still doens't take care of it. I am looking for any guidance as possible as i have been dealing with this for over three months and i can't afford it anymore. Being a pilot i only fly when i am in tip top shape and this has not been the case.

[snorris]

i have spoken to a few doctor about this and they really feel that it is not an adrenal insufficiency. My blood pressure and pulse and so on have been extremely good and stable each time they check it.

[KB1205]

Swollen lymph nodes are a sign of infection and/or disease so will swell because of the inflammed thyroid.
These are the symptoms of adrenal insufficiency:Notice how they are very similar to Hypothyroidism.
* fatigue
* decreased tolerance to cold
* poor circulation
* low blood sugar level (hypoglycemia)
* low blood pressure
* allergies
* apathy or depression
* low stamina
* low self-esteem due to low energy output
* joint aches and pains
* low levels of gastric hydrochloric acid
* tendency to constipation
* muscle weakness
* need for excessive amounts of sleep
* fears, due to low energy and secondary copper toxicity
* lowered resistance to infection
* subnormal body temperature

Definately find out about the adrenals because steroids at the wrong dose will affect both adrenal and thyroid function. Its all about finding the balance. If adrenals are affected then they will balance that first which should normalise the thyroid. If your adrenals are fine then its a case of finishing the steroids and trying a different dosage for the hypothyroidism. Unfortunately it is a case of what works for you may not work for the next guy ... thats why thyroid is such a difficult thing to handle, stay strong and make sure the doctor gives you the full picture.

[snorris]

Even short term use of corticosteroids can lead to problems in the future ( I should know I had my daughter on them for many years till I changed doctors and they went through the roof at how the previous doctor never treated her correctly!)

i am only on them for 30 days so i am not worried to much. with regard to the levothroixine remember that the doctor took me off of it completely at one point. which now i see is just ridiculous. i  am going to call today to find another docotr.

KB1205  i am not sure if they have chekced for the secondar adrenal insufficieny but will metnion it. If it means anything i also have noticed swollen lymph nodes along with the inflammed and enlarged tryorid.

[KB1205]

Have you had more than just a thyroid blood work up?
Secondary Adrenal Insufficiency can occur after infection and does have an affect on the thyroid gland. I have been hypo for years and have recently developed new symptoms which made me suspect adrenal insuffiency, maybe you should have a look at the website below.

http://autoimmunedisease.suite101.com/article.cfm/adrenalinsufficiency

[redheadaussie]

Personally I would say you need a lot more thyroid replacement hormone. The fact you stopped taking it and your TSH started to climb and you felt lousy is a good indicator that 75mgs is not enough, even though you felt better a little while after taking that dose.
I really have never heard of taking steroids to reduce thyroid inflammation, and find it a bit difficult to even know for how long this doctor wants you to continue taking the pills.
Even short term use of corticosteroids can lead to problems in the future ( I should know I had my daughter on them for many years till I changed doctors and they went through the roof at how the previous doctor never treated her correctly!)
   I would be going to get a dose of even up to 150mcgs of your Levothryoxine. You could start at 100 and see how you feel in around 6 weeks get your levels checked again. It is easy to get to being hyper if on too high a dose.
I would also be seeing a new doctor..this one really obviously has no idea and it is not in your best interests to continue seeing them. Take all your test results and find someone else!
    3.65 TSH may be regarded as 'normal' to that doctor as they are obviously using lab reference ranges which are totally out of date. You are still hypo...don't let anyone tell you are normal and then still be suffering!!!
You obviously don't have Hashimoto's...I would say it is more the dose is not high enough and it is keeping you hypo.
Good luck!
Cheers.

[snorris]

throid antibodies results were the following

thyroperoxidase ab 1 normal is (<10)
thyroglobulin ab <1 normal is (<4)

i thought the tsh and t4 test i listed above were the free t3 and free t4. Prednisone i have read is a common perscription to reduce the inflamtion of the thyroid. My main concern is that even with the steroids and all of the meds it is still not going down and the pain is still there.

[Smilerdeb]

Steroids and Corticosteroids are only usually prescribed for Thyroid Eye Disease (TED) to bring down the swelling of the eyes.
Why your Doc has persisted on you taking Prednisolone is beyond me.
You are showing classic symptoms of Hypo and Thyroiditis and should be having a Free T3 and Free T4 test done with the bloods along with an antibodies test for Hashimoto.
The antibodies can be 'normal' one day and in the 100's the nest day.
If it is Thyroiditis, then the thyroid is malfunctioning and your Endo should be trying to find a reason why.
I had the opposite of you before being diagnosed with Graves Disease and Hyperthyroidism.
I had T3 Toxycosis (T3 too high)  and Thyroiditis where the Graves antibodies were attacking the thyroid.
Go back to your Endo and ask for the usual tests to be done and explain the situation.
My guess is you are suffering from Hashi's.
I hope I am wrong.
Let us know how you go.