Raynaud's + Hashimoto's?

[Mynx537]

Is it quite common to get Raynaud's Phenomenon with Hashimoto's? I only ask as I had an attack today when outside. It was not cold, but wet and windy. My fingers and toes went numb and tingly and my fingers turned white and stiff. I thought the thyroxine was meant to reduce this?

I was diagnosed Hashi's in January this year. My test results back then were:

Anti-TPO antibodies - 41 kIU/L (<34)
TSH - 4.6 (0.2-4.2)
FT4 - 15.6 (10-22)

My TSH reduced in February to 2.7 (0.2-4.2) but rose to 3.6. (0.2-4.2) No FT4 results.

My TSH is currently 1.87 (0.2-4.2) with the following other results:
FT4 - 16.6 (10-22)
FT3 - 4.0 (3.1-6.8)
Anti-TPO antibodies - 33.5 (0-34)
Anti-TG antibodies - 103.5 (0-115)

I had a positive ANA result, too, done on ELISA I believe. It was a HeP2 (speckled). No titre and no other inflammatory markers.

I thought that since the antibodies have reduced, my TSH has gone down and my FT4 is a bit better than before meant I would not get any more Raynaud's? It wasn't even especially cold outside so I don't understand how it could affect me so badly!

Thanks for any help. :)

[Barb135]

Do you know if you have primary or secondary Raynaud's?  Secondary Raynaud's can be caused by thyroid malfunction, but not specifically related to Hashimoto's, as an underlying condition.

If you have primary Raynaud's, improving thyroid function probably won't help much.  

Stress can also cause an "attack"

[Mynx537]

Thanks for reply.

I don't know if I have primary or secondary I'm afraid. Is there any way of knowing?

I was first told I had Raynaud's in November/December 2011 but diagnosed with hypothyroidism in May 2013, Hashimoto's in January 2014.

One other thing to note is that I had high plasma viscosity when the Raynaud's occurred but not sure if it's a coincidence or not.

[Barb135]

Did you have any symptoms of hypothyroidism when you were diagnosed with Raynaud's?  Hashimoto's is often present for many years before the antibodies do enough damage to show up on labs and warrant a diagnosis of hypothyroidism.  

It's also important to note that even if the Raynaud's is secondary to hypothyroidism, it  may not completely resolve even when thyroid levels are optimal.  You should talk to your doctor and find out what steps you can take to prevent the attacks, and of course, do be sure to keep your fingers/hands protected when you're out in "iffy" weather.

[Mynx537]

Hi thanks for your reply.

I had symptoms that were suggestive of hypothyroidism before the Raynaud's diagnosis, yes.

Symptoms were (and still are for the main part) :

- Constipation
- Weight loss (not weight gain as with typical hypo)
- Joint/muscle/bone pain
- Fatigue
- Depression
- Mood swings (bipolar-type symptoms)

Doctor said the only treatments they could offer me were a sympathectomy where the nerves to my fingertips get cut and/or a course of vasodilators - which no longer became an option when the nurse practitioner said that since I looked anemic (this was not yet diagnosed at that time) she did not want to prescribe me vasodilators as they would make me pass out.

I do wear knitted gloves at times but they are cheap and offer me little warmth. Thermal ones are too expensive for me at £100+ a pop.

I do sometimes wear a bit more on the rest of my body but I generate a lot of heat when out and about and so end up sweaty. I can't win and this is why I am having so much trouble. :(

If I wear too much I sweat and if I wear too little I end up getting Raynaud's. I don't know what more the doctor can do for me at present.

[Barb135]

Your pre-Raynaud's symptoms are definitely those of hypothyroidism (not everyone gains weight when hypo).  

What type of anemia do/did you have?  

I know it might be a pain in the butt, but perhaps, if you can't afford good thermal gloves, you could wrap your fingers in gauze before you put your gloves on, or even wear double gloves.  Have you looked into wool gloves, as opposed to thermal?  They may work better, if they are a tight knit.  

[Mynx537]

Thanks for your reply. :)

Not sure about what anemia I had at the time I had the pre-Raynaud's. All I was told was that my iron was at 29 (30-400) and that I had borderline iron deficiency anaemia.
I don't have the results of any of the other results as I moved surgeries and did not think they were relevant. Would they still have this information on file if I request it and even though I am no longer a patient with them? Also I don't know if iron deficiency and anaemia are the same thing as my current doctor has said that I have low iron but not anemia so I'm in conflict with myself over this.

I have low iron still even now. Results are as follows:

August 2013 - Ferritin 15 (30-400)
I was prescribed Ferrous Fumerate at 210mg but I did not like the medication so I switched to a liquid form of iron with Vitamin C added.

November 2013 - Ferritin 21 (30-400)
This was after I had started the liquid iron in October as it took me a long time to find it.

Other results that are questionable are in my full bloods which have only been done in January 2013 and August 2013 are as below:

Red blood cell count as of January 2013 - 5.33 (3.80-4.80)
Red blood cell count as of August 2013 - 4.94 (3.80-4.80)

Mean corpuscular volume as of January 2013 - 82 (83-100)
August 2013 result was normal.

Mean corpuscular Hb. concentration as of January 2013 - 350 (315-345).
August 2013 result was normal.

These are going back a year though, so I don't know if these are relevant still.

I haven't thought about wool gloves, oddly enough. I just did a quick Google search on them and wow, yes, they are cheaper! Thanks for the suggestion!

:)