# Confused about Hosimoto diagnosis and symptoms



## Julieho (May 5, 2014)

I was diagnosed with Hosimoto's after a spinal MRI this winter and they found nodules on my thyroid which were ultra-sounded and then biopsied. I had breast cancer 18 months earlier and also had 3 severe infections and long term antibiotic use along with chemotherapy.

My diagnosis seemed to come from my antibodies being abnormal. Here are the test results I had:

Free T4 is 1.2

Free T3 is 2.9

TSH 1.31

Antibodies:

Thyroglubulin was 69

Thyroperoxidase was >1300

I have not been treated yet. I have had the following symptoms, getting worse with time. Muscle and joint pain (had this develop after chemo and never resolved). Doctors "diagnosed" me last year as having fibromyalgia and osteoarthritis. I have had worsening fatigue, last week to the point where I couldn't really do anything for three days and then felt exhausted after doing even the smallest bit of activity. Brain fog, sleep issues. I also had "breakthrough" depression during this past year. After my cancer diagnosis I was on Prozac and twice had to up the medication due to worsening depression. This spring I got very depressed, lethargic, had anxiety attacks and my doctor switched me to Effexor from Prozac. I also take hydrocodone for the joint and muscle pain. This helps relieve the pain and oddly even the fatigue but I have built up a tolerance to the medication.

Can Hostimoto's cause all these symptoms without having my T4 and T3 and TSH test being abnormal? I would love to hear what other peoples experience has been. Fatigue and pain are my worst on-going issues, with fatigue especially getting worse and worse. I am a very active person, have a small farm, lots of dogs, five kids (all grown now) and since chemo have not been entirely the same but the fatigue I am having now is worse or as bad as what I had with chemo.

I began physical therpay, physical training and daily walks to try to rebuild the muscle I lost from chemo and because fibromyalgia can cause muscle wasting. I am getting physically stronger (lifting more weight) but more and more fatigued after exercise - although it really helps me "feel mentally better" when I work out.

Thougts anyone?

Julieho


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## jenny v (May 6, 2012)

Can you please post the ranges for each of those labs? Different labs use different ranges, so it can be hard to tell much without them. Thanks!


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## bigfoot (May 13, 2011)

Julieho said:


> Can Hostimoto's cause all these symptoms without having my T4 and T3 and TSH test being abnormal? I would love to hear what other peoples experience has been. Fatigue and pain are my worst on-going issues, with fatigue especially getting worse and worse. I am a very active person, have a small farm, lots of dogs, five kids (all grown now) and since chemo have not been entirely the same but the fatigue I am having now is worse or as bad as what I had with chemo.


Yes, yes, and yes! I think autoimmune diseases like Hashimoto's are frequently mis-diagnosed as mood disorders or fibromyalgia. Like you, I did chemo and was never the same afterwards. The fatigue and brain fog has been downright awful at times, to the point of being nearly bedridden. Some docs feel that since the chemo is basically wreaking havoc with your immune system, that it can sort of get "stuck" in attack mode even after treatment has ended. Keep an eye out for other autoimmune diseases, too. Not only did I get Hashi's, I wound up with autoimmune liver disease after the fact. This is why you need to have a doc on your side who will investigate things.

Okay, enough of the bad news.  On to the good news! Provided that you have a good doctor who is an outside-the-box thinker and an active listener, you can have good treatment for Hashi's. I'll try to distill things down to a 'few' points below:

* TSH test is *not* the end-all, be-all thyroid test. It looks at pituitary hormone, not thyroid hormone. So if you already have Hashi's, or are taking thyroid mediations, TSH is not very useful at all for ongoing monitoring. Better to also test Free T3 and Free T4, which are the active hormones. Most folks here shoot for a TSH of 1.0 or less (keeps antibodies suppressed), and a FT3 & FT4 in the 50-75% range. This is all a little easier said than done, but makes for a good starting point.

* On that note, beware of docs who only go by TSH. Steer clear of these. You are wasting your time, money, and sanity. TSH is more of a "forest through the trees" approach. Since you already have high Hashi's antibodies, TSH is kind of a moot point. You should still run it, along with the FT3 and FT4 mentioned above, but only to get a very general picture.

* Following that, beware of docs who want to chalk everything up to a mood issue and hand out meds like candy. I'm sorry, a mood issue is not going to give you dry skin, hair loss, cold body temps, etc. I've seen the mood stuff completely disappear at times when adjusting thyroid meds. So it certainly is possible, you just need to optimize your thyroid hormone levels, not have them "in range" or "normal" on a lab slip. Find what works for you as an individual. Think of it as a narrow window you're trying to find and be in.

* Not all thyroid medications are the same. You have synthetics and natural / desiccated meds. All have to meet FDA regulations and USP standards. Whatever route you go, it's best to get brand-names only for consistency's sake. The FDA lets generics have a 10% fudge factor, and when you're dealing with micrograms of medication, that can be a big difference.

* Don't assume that because a doc has a fancy title or diploma on the wall, that they're better suited to handling your thyroid problems. I've gotten better treatment from a naturopath and a DO than any other docs and specialists.

* You might want to investigate Celiac disease and/or gluten sensitivity. They are not one in the same, and are different tests. There is a theory that gluten (wheat, barley, etc.) can aggravate the antibodies and cause them to flare up.

* Same goes for Adrenals/ Cortisol levels. Best test is one that measures either 24-hours of urine collection or saliva collection, broken into different time periods.

* Sex hormones like testosterone, estrogen, SHBG, and so forth can be all messed up, too. These being out of balance can cause a lot of problems on their own.

* Test for Vitamin D-25, B-12, Ferritin levels. Vitamins and minerals are important, too.

* Overnight sleep study consideration -- especially if you snore, have trouble breathing at night, wake tired, wake with headaches, are fatigued all day, have a little extra weight or a thick neck.

* T4 and T3 can be a great combo. Many folks who take only T4 languish, while those who add in some T3 (either by taking Cytomel or else a combo desiccated product like Armour or Nature-Throid) do better. Again, comes down to how you respond and react to the meds as an individual.

* Dr. Richard Hall has an excellent paper titled, "Anxiety and Endocrine Disease". The Cliff Notes version is that once your hormones are optimized and stabilized, you should be feeling better, both physically and emotionally: http://www.drrichardhall.com/anxiety.htm

* Look into Low Dose Naltrexone and mention it to your doc. It's an old drug that doesn't get much airtime, especially since it is cheap and readily available. Big pharma doesn't make much money off of it, but it can be effective. You would need to have a compounding pharmacy custom make this one. The dose ranges from around 2.5 - 4.5 mg, with getting to 4.5 mg the eventual goal (or else signs & symptoms subsiding). This is getting re-discovered by a lot of docs treating fibromyalgia, chronic fatigue, MS, etc.


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## CA-Lynn (Apr 29, 2010)

I'd like to look at this from a peripheral perspective, focusing on the muscle and joint pain. If I was in your shoes, I'd be interested in ruling out any arthritic autoimmune diseases. For this you do need a doctor with a fancy board certified title after the name....a board certified rheumatologist.

I'm sure others will disagree with me, but I am so tired of fibromyalgia being used as a diagnosis when, in fact, Fibromyalgia is not a disease; it's a set of symptoms. It's important to get to the cause of the symptoms......and for that, a rheumatologist is a good place to start.

Good luck.


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