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Hashimotos? Lupus?

Hi everyone! :) I am so confused about my health and it’s so difficult to get answers. I’m a 25 year old female that was diagnosed with Hashimoto’s thyroiditis when I was 14. Aside from 2 times throughout those 11 years my thyroid levels have always been good so no treatment. Over the past couple years my body has started destroying my platelets, and I’ve developed lichen sclerosis. One doctor told me that because of how high my antibodies are that I’m most likely developing lupus. My question is- is this just hashimotos or is it something more? I’ve had testing for lupus and it was negative but other doctors have said because of my ANA titer it’s likely that I’m in the beginning of lupus. I’ve had other doctors tell me I don’t have hashimotos at all because my thyroid levels are normal. I’m so confused! My Ana titer was 1:1260 homogenous pattern. Thyroglobulin antibody was 2.5 (range 0-.9) and thyroid peroxyidase antibody 179 (range 0-34)  Does anyone know what might be going on or have similar situations?  

Incase symptoms might be relevant I am fatigued pretty constantly, if I step foot in the sun it’s 1,000x worse. I’ve been having a decent amount of wrist, knee and occasionally hip pain recently. Gastritis, esophagitis and bloating (despite avoiding triggers and taking meds), over the last couple weeks I’ve been noticing about a 99.5 temp although it’s usually closer to 97 for as long as I can remember. I’d say pretty extreme heat and cold intolerance. Postural orthostatic tachycardia sunstone. Irregular periods. Headaches. Anxiety, panic attacks. Dry skin. Raynaud’s disease. Mild face and finger/toe swelling when I wake up. Have had trace amounts of blood in urine for awhile now. That’s all I can really think of right now, idk what’s relevant and what isn’t. Thanks for anyone who takes a look :)
2 Responses
1756321 tn?1547095325
You have Hashimoto's thyroiditis.

"Hypothyroidism and Hashimoto's are not interchangeable terms. Hypothyroidism — an underactive, non-functioning, or missing thyroid gland — is a condition with many causes. ... Some people have Hashimoto's disease — evidenced by elevated thyroid peroxidase (TPO) antibodies — without being hypothyroid." - Health Central

There are a number of autoimmune diseases and non autoimmune conditions associated with Hashimoto's thyroiditis. Autoimmune thrombocytopenia (platelets are destroyed by antibodies) is on the list. So is Systemic lupus erythematosus. Google: Outsmart Disease - List of diseases associated with Hashimoto's thyroiditis. This is not a complete list but it is quite a long list.

Homogeneous pattern is associated with:

Systemic lupus erythematosus
Mixed connective tissue disease
Drug induced lupus
Juvenile idiopathic arthritis

Excerpt from Hypothyroid Mom - Top 5 Reasons Doctors Fail To Diagnose Hypothyroidism...

Thyroid Tests "Normal" But You Don't Feel Well?

If you're undiagnosed, or a thyroid patient taking thyroid hormone replacement medications, being in the "normal" range does not mean you feel well, or that your treatment is optimized. What levels are considered "optimal*" by many integrative physicians?

~ TSH - Typically less than 2.0
~ Free T4 - Top half of the reference range
~ Free T3 - Top half - top 25th percentile of reference range
~ Reverse T3 - Lower end of normal range
~ Thyroid Peroxidase Antibodies (TPO) - Within reference range
~ Vitamin D - Above 50
~ Ferritin - Above 60 (Above 80 if experiencing hair loss)

* we are all different, one size doesn't fit all, so these are guidelines. Your optimal levels may vary."

Just to add to that, the vitamin D listed above is in ng/mL so above 50 ng/mL converts to above 125 nmol/L.
3 Comments
Thank you so much for the info! I just had my TSH tested but he didn’t test t3 or t4 or any vitamins. My TSH was 2.49. I just find it so confusing that I have had such high antibodies for 10 years now and my thyroid is still working as if it wasn’t being attacked? And there’s nothing to do to treat the attack. It’s so confusing to me. Especially because I feel so crummy. I’ve devloped more autoimmune issues so I feel like I’m just waiting to get lupus or for my thyroid to be destroyed or something. I can’t find any doctors who know anything about hashi :-/  
Selenium helps lower TPOAb antibodies. Brazil nuts are high in selenium (50 to 90 mcg per nut depending on the soil). Studies show 200 mcg daily of used to help lower TPOAb levels. You may need to see an endocrinologist and rheumatologist. Research the doctor for reviews.
*studies show 200 mcg daily of selenium is used to help lower TPOAb levels.
1756321 tn?1547095325
Here are a few clinical trials on selenium and TPOAb...

Greece - October 2010 - Thyroid Journal. In this study, participants who received selenium supplementation for 3 months demonstrated significantly lower TPOAb titers and reported a greater sense of well being and improved mood than those who did not receive selenium.

Crete - 2007 Thyroid Journal.  This study reported a 21% reduction in TPOAb after 1 year of selenomethionine supplements (200 mcg per day).

Turkey -  2006 Journal of Endocrinology.  This study showed a 30% decrease in anti-thyroid antibodies after 3 months of 200mcg per day of L-selenomethionine supplementation for in women with Hashimotos Thyroiditis. The starting average TPOAb was 803 and after 3 months the average was 572.  

Germany - 2002 Journal of Clinical Endocrinology & Metabolism. This study showed 40% reduction in antibody levels after selenium supplementation with 9 of 36 (25%) patients completely normalizing their antibody levels.
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