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. It is now april 8th and i am on 20 mg a day of steroids and the thyroid has gotten big again. Not as painfull but still painfull. Also the tremors have returned.

[Smilerdeb]

Maybe I have missed it but have you had the antibodies test done for Hashimoto's?
Why she has you on steroids, I dont know!
Not unless you are showing signs of Thyroid Eye Disease (TED) ?
Are you takeing the T4 med ALONE?
Do not take the steroids at the same time as the T4 med....they have to be 4 hours apart.
If you are taking the 2 meds togther, the T4 isnt absorbing as well as it should be and therefore, not working as well as it should.
Thyroid problems dont go away overnight......some here have been battling them for years (like myself).
The sooner you know whether you have Hashi's or not, the better the treatment can be and be managed properly.
Long bouts of steroid use does harm to your immune system.
Sorry but I wouldnt be satisfied with what your Doctor is telling you.
I would want answers.
Regulating the T4 med can take up to a year in some people and sometimes even longer.
It requires a lot of 'tweaking' and is not just a case of 'take a pill and you'll be fine'.
Sorry to be so blunt but I say it as I see it.
Google Hypothyroidism and learn all about the thyroid.
You may be surprised.

[snorris]

sorry, thyroid antibodies were normal. So it is not hashi's. By t4 med do you mean levothroxine? I am new to this thyroid thing but ready for the pain to be done.

[snorris]

i also retrieved this from typing in subacute thryoitis in googls.

Pain in subacute painful thyroiditis: The thyroid pain can be extreme. Nonsteroidal medications are administered. Avoid high-dose aspirin because, in some circumstances, aspirin can competitively displace thyroid hormone from its binding protein and increase the free, or bioactive, fraction of thyroid hormone, which can make patients feel more thyrotoxic. In extreme cases, stronger pain medications, including narcotic analgesics, are indicated for a brief period of 2-3 weeks. In the most extreme cases, high-dose steroids (eg, prednisone 40-60 mg qd) must be administered. The high-dose steroids rapidly and dramatically decrease the pain and thyroid swelling, but the natural course of thyrotoxicosis and pain (ie, 4-6 wk) is not altered, and the glucocorticoid treatment must be continued for this period.

[estrelinha]

Your doctor thinks you have subacute thyroiditis, that is an acute inflammatory disease of the thyroid probably caused by a virus. The disease has been described following a wide variety of URIs. It's a self-limited subsiding in a few months; occasionally it recurs, and rarely results in hypothyroidism. Treatment consists of aspirin  (only as a last resort), glucocorticoids.......(5 mg, every 6 h).. It's described on discontinuance of the later, there is often a severe rebound in symptoms...The only thing I don't agree is the high dose of prednisone, usually is 5 mg orally q 6 hours, but your doctor is looking at you and may be there is a reason for that. I would suggest you to do an ultrasound of your thyroid, that will help (confirm) the diagnose.

[snorris]

i had an ultrasound when the pain started and it came back enlarged and inflammed

[modine]

Hi all
the paragraph above said: "Avoid high-dose aspirin because, in some circumstances, aspirin can competitively displace thyroid hormone from its binding protein and increase the free, or bioactive, fraction of thyroid hormone, which can make patients feel more thyrotoxic."

so how does one know what to do or listen to whom?

snorris, my trouble began after a CT scan with Isoview contrast dye, I hope we both get some answers