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Thyroid / Autoimmune 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.
did you have blood work for thyroid antibodies? That is how I was diagnosed with hypothyroid. And a follow up ultrasound that showed typical hashimoto scarring and enlarged thyroid. My TSH was 4 so still "in range" according to my doctor. I am on synthriod and it helps but it can go up and down since it is autoimmune it fluctuates.
Thank you so, so much! I'm going to take your list to the rheumatologists, I don't think they will have a issue ordering all those tests. I may see my internist sooner and if so, will have him check Free T3, Reverse T3, Vitamin D, B12, and Ferritin.
FP Notebook - ANA staining Pattern..
"II. Homogenous Pattern
Systemic Lupus Erythematosus (Very specific)
Further evaluation
Anti-dsDNA
Anti-ssDNA
Anti-Smith"
About 10% with lupus will suffer with hives. Your other symptoms are also listed possible symptoms of lupus.
"II. Homogenous Pattern
Systemic Lupus Erythematosus (Very specific)
Further evaluation
Anti-dsDNA
Anti-ssDNA
Anti-Smith"
About 10% with lupus will suffer with hives. Your other symptoms are also listed possible symptoms of lupus.
You have some symptoms that can be related to several possible causes; however, in its entirety, that list looks most like typical hypothyroidism symptoms. Of course, with the TSH level shown and the Free T4 result, most doctors stop with that and declare it is not thyroid related. With all you are going through, I would insist on more thorough testing. I would request Free T3, along with the Free T4 and TSH. Just to establish a base I would also request to be tested for Reverse T3. Since hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin, I would also request those.
For info, Free T3 is the most important thyroid test since it largely regulates metabolism and many other body functions. Scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all. I threw in Reverse T3 also because occasionally a patient's body will convert an excessive amount of T4 to Reverse T3. This inhibits normal metabolizing of Free T3. There are reports that the best indicator of actual tissue thyroid levels is the ratio of Free T3 to Reverse T3.
If the doctor resists, just insist on all those and don't take no for an answer. Tell them you are tired of suffering with no identified causes and no plan for improvement.
Do you think you can get all those done?
For info, Free T3 is the most important thyroid test since it largely regulates metabolism and many other body functions. Scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all. I threw in Reverse T3 also because occasionally a patient's body will convert an excessive amount of T4 to Reverse T3. This inhibits normal metabolizing of Free T3. There are reports that the best indicator of actual tissue thyroid levels is the ratio of Free T3 to Reverse T3.
If the doctor resists, just insist on all those and don't take no for an answer. Tell them you are tired of suffering with no identified causes and no plan for improvement.
Do you think you can get all those done?
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