Doctors Lounge - Endocrinology Answers
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Forum Name: Endocrinology Topics
Question: TSH decompensation after being stable
|30yrsUnDxd - Sat Apr 19, 2008 8:49 am||
Age 54, Female, postmenopausal seven years.
Diagnosis 2003: Diagnosed with Subclinical hypothyroidism and then under treated.
February - March 2007: Continued under treated hypothyroidism and experiencing extreme symptoms; fluctuating back and forth from very hot and sweating to ice cold and temperature plummeting to 95.8, shaking chills, extreme fatigue, insomnia, chest pain, shortness of breath, heart palpitations, exhaustion and more.
Mid July 2007: Endocrinologist diagnosed me with Hashimoto's Thyroiditis based on heredity.
Fall of 2007: Diagnosed with perimyocarditis; very ill with complications - hospitalized three times in CCU. Placed on high-dose Ibuprofen, and Colchicine.
In January 2008: Perimyocarditis healed as per cardiologist and internist.
Mid January 2008: Diagnosed with fungal infection (originally dx as yeast infection), groin area due to suppressed immune system from long-term, high-dose, Ibuprofen and Colchicine.
February 2008: Diagnosed with ID Reaction due to incorrect treatment for fungal infection.
March 2008: Diagnosed with Thyroid Eye Disease by ophthalmologist.
Current medication: Synthroid 200 mcg
Vitamins and minerals: 1200 mg calcium, 600 mg magnesium, 2-a day high-potency multi-vitamin, 1000 mg Vit B12, q 3 days Vit B-50's.
Current test results 4/14:
TSH 1.07 nr 0.5 - 5.45;
FT3 2.83 nr 2.5 - 3.9;
FT4 1.21 nr 0.58 - 1.64.
4/14: My doctor felt a nodule and enlarged thyroid, ordered an ultrasound. The ultrasound showed a normal thyroid without a nodule. I have a cough, sometimes choke on saliva/water, don't tolerate dry foods, feel pressure on throat.
Previous test result 3/20:
TSH 0.58 nr 0.5 - 5.45
For about 4 months, starting in mid-June, I was stable on 150 mcg Synthroid. Then I required dose increases to 200 mcg over the next 4 months never being stable since. However, I would appear to be stable and then my thyroid would fail some more.
My symptoms started again two weeks after my last TSH result of 0.58. I began an exercise program, slowly. When I worked up to 12 minutes per day, three times a week, my hypothyroid symptoms returned with a vengeance; ice cold, shaking chills; profuse sweating; muscle cramping of entire left side from foot to hip; nausea; dizziness; fatigue; exercise intolerance; muscle aches and pains and twitching; joint pains; insomnia; shortness of breath; chest wall pain; heart palpitations; cold hands and feet; blurry vision left eye (new symptom); dry skin; swollen fingers, hands, eyelids; boils and worsening rashes; headaches which are sudden and painful and quick to go (new symptom). I usually feel great around 0.5. I was surprised to find my TSH had jumped to 1.07 in only 3.5 weeks.
Is this normal to not be stable when you have Hashimoto's Thyroiditis with a normal-sized thyroid gland? If not, what could be the problem? I'm getting referred to an endocrinologist because the internist is stumped and because he doesn't want to keep my TSH under 1.07, where I feel my best. I feel good around 0.5 to 1.0. As soon as I get over 1.0 I know it, all my symptoms return and I become very ill.
Could it be all the illnesses I had which caused my thyroid symptoms to worsen?
Thanks for your time.
|John Kenyon, CNA - Thu Jul 31, 2008 9:07 pm||
While this is far from my specialty I can tell you that stability doesn't always settle in quickly with thyroiditis, and even then things can become unstable from time to time (which is why thyroid panel is performed periodically in supposedly stable patients anyway). Also, yes, normal thyroid size is sometimes noted even with thyroiditis. One wouldn't think so, but this is one of the vagaries of Hashimoto's disease.
I would get a second opinion, however, since you seem to know where your comfort zone lies, and you need someone who is willing to work with you instead of strictly by the book.
I hope this is helpful. Please follow up with us here as needed. Good luck to you.
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