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Autoimmune / Thyroid Help
Hello, I'm hoping someone here can help me a bit. I've suspected something was off with my thyroid for a number of years, but according to multiple blood tests, my results were usually "normal". This week however, my ANA results came back abnormal with a homogeneous pattern. I'm a 26 yr old female and my symptoms include fatigue, dry skin, weight fluctuation, muscle and joint aches (most noticeably in my wrist, hands, shoulder, and neck), inconsistent sleep patterns, TMJ, recurrent urinary tract infections, hair thinning, hives, dizziness after standing, heavy menstrual cycles and occasional headaches. I also bruise pretty easily. My GP diagnosed me with ADD around age 19 and prescribes Adderall XR 25mg monthly. I take Adderall about 4-5 days a week. Some days my regular dose doesn't feel like it kicks in, other times I'll only take half a dose and that's plenty. (I never take more than one 25mg XR capsule a day)
Over the last 5 years, I've had unexplained hives or allergic reactions which have become more severe with each occurrence. The hives usually last about 9 days and require treatment of steroids along with hydroxyzine and cimetidine, and in recent years include facial swelling (lips, ears. My internist prescribed a epi pen to keep with me in case of a anaphylactic reaction). The last time I had hives, they went from mosquito bite size on my arm to almost completely covering it in about 20 minutes and led to my internist calling in emergency meds. They typically seem to move to different areas on my body (legs, arms, hands, scalp, chin, stomach, back). The hives or allergic reactions have left my allergist, GP, dermatologist and internist stumped as blood work typically appeared normal and we weren't able to determine a specific cause. My allergist suspected a underlying autoimmune disease, but until this week, my blood work appeared normal. Last November my internist had me take the Immuno 1 Bloodprint (Bloodprint 154, IGg ELISA test results) test, which showed my blood serum reacted to 29 food antigens including dairy, egg, wheat, and yeast. I was told to avoid the reactive foods and noticed a slight increase in energy.
Within the last few months, my hair thinning has become more excessive. I'm filling the shower drain each time my hair is washed (every other day), my eyebrows appear thinner and both my husband and I notice a lot of hair dropping throughout the day. The hair loss was the reason for my recent visit to my GP. After doing a physical exam and seeing a photo of the amount of hair I've been losing in the shower, she ordered new blood work to check my thyroid and the ANA test. I wasn't asked to fast prior to the appointment this time) My TSH results were 1.02 mIU/L and T4 Free 1.2 ng/dL. My ANA screen/IFA screen was abnormal with a homogeneous pattern. My ESR (SED rate) was 6 mm/h. My RBC was 3.69 million/uL (low), HGB was 11.3 g/dL (low), HCT was 33.7% (low), EOSIN was 12 cells/uL (low) and everything else lists normal. My doctor said the ANA could be a false positive, but is suggesting I see a Rheumatologist once my new insurance starts in September.
Adderall is the only prescribed medication that I take. Occasionally, I take Aleve for headaches or menstrual cramps and Zyrtec for allergies. I don't drink often and I don't use recreational drugs. I work on a computer often, so that may account for the wrist pain and achey shoulders. I was in a car accident at age 16 and have a few disc issues as a result, but went through physical therapy years ago and have been mostly fine since. As far as family history, I don't know much about my father's side of the family but here's any relevant information I've gathered from my mother's side: My grandmother (68 yrs old), mom (47 yrs old), and sister (8 yrs old) all have issues with their bladders. All have had recurrent bladder infections and doctors have suggested possible reflux. My great-grandmother is 90 years old and has some memory issues and may have had melanoma at some point. My great-grandfather died of a heart attack at age 48. My great-grandmother's sister died from lymphoma 4 years after being diagnosed when she was about 79 years old. My uncle who is 36 has Wolff-Parkinson-White syndrome which he takes medication for. My other uncle had melanoma removed and as far as I know has been healthy since. My younger brother had heart issues. I was a pretty healthy kid, I recall a skin rash once or twice, but nothing more than that. It seems unusual to me to develop so many symptoms in my 20's and my test results and doctors have left me confused. I don't know if my symptoms are connected, random, or a combination of both. There's been plenty of times where I've questioned my own sanity, but there's no denying the severity of some of my symptoms. I feel like I've been passed along to so many doctors with little or no resolution other than guesses, so any insight would be very greatly appreciated.
Over the last 5 years, I've had unexplained hives or allergic reactions which have become more severe with each occurrence. The hives usually last about 9 days and require treatment of steroids along with hydroxyzine and cimetidine, and in recent years include facial swelling (lips, ears. My internist prescribed a epi pen to keep with me in case of a anaphylactic reaction). The last time I had hives, they went from mosquito bite size on my arm to almost completely covering it in about 20 minutes and led to my internist calling in emergency meds. They typically seem to move to different areas on my body (legs, arms, hands, scalp, chin, stomach, back). The hives or allergic reactions have left my allergist, GP, dermatologist and internist stumped as blood work typically appeared normal and we weren't able to determine a specific cause. My allergist suspected a underlying autoimmune disease, but until this week, my blood work appeared normal. Last November my internist had me take the Immuno 1 Bloodprint (Bloodprint 154, IGg ELISA test results) test, which showed my blood serum reacted to 29 food antigens including dairy, egg, wheat, and yeast. I was told to avoid the reactive foods and noticed a slight increase in energy.
Within the last few months, my hair thinning has become more excessive. I'm filling the shower drain each time my hair is washed (every other day), my eyebrows appear thinner and both my husband and I notice a lot of hair dropping throughout the day. The hair loss was the reason for my recent visit to my GP. After doing a physical exam and seeing a photo of the amount of hair I've been losing in the shower, she ordered new blood work to check my thyroid and the ANA test. I wasn't asked to fast prior to the appointment this time) My TSH results were 1.02 mIU/L and T4 Free 1.2 ng/dL. My ANA screen/IFA screen was abnormal with a homogeneous pattern. My ESR (SED rate) was 6 mm/h. My RBC was 3.69 million/uL (low), HGB was 11.3 g/dL (low), HCT was 33.7% (low), EOSIN was 12 cells/uL (low) and everything else lists normal. My doctor said the ANA could be a false positive, but is suggesting I see a Rheumatologist once my new insurance starts in September.
Adderall is the only prescribed medication that I take. Occasionally, I take Aleve for headaches or menstrual cramps and Zyrtec for allergies. I don't drink often and I don't use recreational drugs. I work on a computer often, so that may account for the wrist pain and achey shoulders. I was in a car accident at age 16 and have a few disc issues as a result, but went through physical therapy years ago and have been mostly fine since. As far as family history, I don't know much about my father's side of the family but here's any relevant information I've gathered from my mother's side: My grandmother (68 yrs old), mom (47 yrs old), and sister (8 yrs old) all have issues with their bladders. All have had recurrent bladder infections and doctors have suggested possible reflux. My great-grandmother is 90 years old and has some memory issues and may have had melanoma at some point. My great-grandfather died of a heart attack at age 48. My great-grandmother's sister died from lymphoma 4 years after being diagnosed when she was about 79 years old. My uncle who is 36 has Wolff-Parkinson-White syndrome which he takes medication for. My other uncle had melanoma removed and as far as I know has been healthy since. My younger brother had heart issues. I was a pretty healthy kid, I recall a skin rash once or twice, but nothing more than that. It seems unusual to me to develop so many symptoms in my 20's and my test results and doctors have left me confused. I don't know if my symptoms are connected, random, or a combination of both. There's been plenty of times where I've questioned my own sanity, but there's no denying the severity of some of my symptoms. I feel like I've been passed along to so many doctors with little or no resolution other than guesses, so any insight would be very greatly appreciated.
Please have your doctor test you for Hashimoto's disease. Not just TSH, but all the t4, t3, and free t4, t3. Sounds like you may have a thyroid problem.
Hi Jane and welcome to the forum.
It's unfortunate that we meet under these unpleasant circumstances,
however, the good news is that you may find some helpful answers.
For starters your thyroid testing may keep you in limbo.
TSH and Free T4 are not enough to rule out hypothyroidism.
I would suggest Free T3 (fT3) and Reverse T3 ( rT3) in addition to fT4
which you already have. TSH is to my opinion not very useful.
You definitely need the rT3 and fT3 , as the fT3/rT3 ratio is probably the most reliable marker for low cellular thyroid function.
Look for a ratio of over 20 for healthy thyroid function. (divide Free T3 by reverse T3, but make sure you are in the same unit measurement for both.)
Your results which indicate low levels of RBC(red blood cell count), HGL( the protein in red blood cells that carries oxygen) & HCT (% of red blood cells in the blood) -do you see a pattern here?-, are not "dramatically" low to instigate any immediate action, however, even at this sub-clinical deficiency level (that's how your doctors are probably considering it) it may affect greatly thyroid function ( making the case for thyroid hormone resistance even stronger ) and overall cellular health.
Your symptoms support the suspicion of hypothyroidism AND hypoadrenalism
(low adrenal function* or adrenal fatigue- due to ongoing biological and external stress).
* Probably need an Adrenal Stress Profile Test to verify.
Also there are suspect underlying causes of your multi-faceted Urticaria (Hives)- such as Dermatographic and Food Urticarias- and food allergies:
1. Methylation issues associated with excessive Histamine, due to low SAMe
production (SAMe breaks down Histamine)
Look into possible normal or high levels of folic acid, but with low levels of methylfolate which is necessary for SAMe production.
Also look into possible low MB12 (methylocobalamin B12, which is the only form which can go through the blood-brain barrier to supply the brain and the neurological system) A separate test is needed for MB12.
It's a homocysteine CSF test (The standard MMA test won't indicate MB12)
MTHFR gene mutation is something to explore, as this alone would explain
many of the above imbalances.
I can expand on this further, but I don't want to overwhelm you with science.
2. Intestinal Permeability also known as Leaky Gut syndrome.
You need to rule this out by having one simple urine test--> PEG
(Polyethelyne Glycol Test)
3. Cross reactivity of food antigens.
Your body forms antibodies against gluten, which may cross-react with other foods. Having a sensitivity to gluten, may lead your body to recognize
non-gluten foods as one and the same as gluten.
Look into Cyrex Labs gluten cross-reactivity blood test, ( Array #4) for more details.
Another thing to look into-perhaps after the aforementioned are considered, as it could be the most complex- is Ovarian-Adrenal-Thyroid Axis
(a.k.a. O-A-T Axis) Imbalance.
My concern is this: There's a good likelihood that some of the answers you're looking for are here, nonetheless, most conventional doctors
cannot help you, as it is not within their scope of practice.
Most tests which I mentioned probably won't even have an insurance code!
The only way to get this done properly, is through a knowledgeable Functional Medicine or Naturopathic Doctor.
Please let me know if you need more details, however, my comments and suggestions are not intended as a replacement for medical advice.
Best wishes.
Niko
It's unfortunate that we meet under these unpleasant circumstances,
however, the good news is that you may find some helpful answers.
For starters your thyroid testing may keep you in limbo.
TSH and Free T4 are not enough to rule out hypothyroidism.
I would suggest Free T3 (fT3) and Reverse T3 ( rT3) in addition to fT4
which you already have. TSH is to my opinion not very useful.
You definitely need the rT3 and fT3 , as the fT3/rT3 ratio is probably the most reliable marker for low cellular thyroid function.
Look for a ratio of over 20 for healthy thyroid function. (divide Free T3 by reverse T3, but make sure you are in the same unit measurement for both.)
Your results which indicate low levels of RBC(red blood cell count), HGL( the protein in red blood cells that carries oxygen) & HCT (% of red blood cells in the blood) -do you see a pattern here?-, are not "dramatically" low to instigate any immediate action, however, even at this sub-clinical deficiency level (that's how your doctors are probably considering it) it may affect greatly thyroid function ( making the case for thyroid hormone resistance even stronger ) and overall cellular health.
Your symptoms support the suspicion of hypothyroidism AND hypoadrenalism
(low adrenal function* or adrenal fatigue- due to ongoing biological and external stress).
* Probably need an Adrenal Stress Profile Test to verify.
Also there are suspect underlying causes of your multi-faceted Urticaria (Hives)- such as Dermatographic and Food Urticarias- and food allergies:
1. Methylation issues associated with excessive Histamine, due to low SAMe
production (SAMe breaks down Histamine)
Look into possible normal or high levels of folic acid, but with low levels of methylfolate which is necessary for SAMe production.
Also look into possible low MB12 (methylocobalamin B12, which is the only form which can go through the blood-brain barrier to supply the brain and the neurological system) A separate test is needed for MB12.
It's a homocysteine CSF test (The standard MMA test won't indicate MB12)
MTHFR gene mutation is something to explore, as this alone would explain
many of the above imbalances.
I can expand on this further, but I don't want to overwhelm you with science.
2. Intestinal Permeability also known as Leaky Gut syndrome.
You need to rule this out by having one simple urine test--> PEG
(Polyethelyne Glycol Test)
3. Cross reactivity of food antigens.
Your body forms antibodies against gluten, which may cross-react with other foods. Having a sensitivity to gluten, may lead your body to recognize
non-gluten foods as one and the same as gluten.
Look into Cyrex Labs gluten cross-reactivity blood test, ( Array #4) for more details.
Another thing to look into-perhaps after the aforementioned are considered, as it could be the most complex- is Ovarian-Adrenal-Thyroid Axis
(a.k.a. O-A-T Axis) Imbalance.
My concern is this: There's a good likelihood that some of the answers you're looking for are here, nonetheless, most conventional doctors
cannot help you, as it is not within their scope of practice.
Most tests which I mentioned probably won't even have an insurance code!
The only way to get this done properly, is through a knowledgeable Functional Medicine or Naturopathic Doctor.
Please let me know if you need more details, however, my comments and suggestions are not intended as a replacement for medical advice.
Best wishes.
Niko
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