# First visit with Endo



## applepie (Apr 6, 2011)

I had my first visit with the Endo last week. I'm mixed if I liked her- but am looking to change Doc's b/c she has NO appointments...not good for follow up care for hyperthyroid/suspected graves disease.

Background my TSH level was .002 (don't have the scale handy) and T4 was 17.something. Symptoms include EXTREME weakness, frequent BM's, irritability, tremors. Hair loss too- but hard to tell from already existing condition. (i'm female)

Saw the doc and before i can get out my symptoms she is pages through my labs saying I know what wrong with you. She said hyperthyroid probably caused by GD. Did an ultrasound of my throat and said my thyroid is 6x's the size of a normal one.

She prescribed Methmizaole 10 mg 1x/day to start, increase to 20mg/day if no reaction and atenolol 25 mg 2X per day. Sent me for blood work (sheet was marked with a bunch of things- I remember seeing all the ones recommended here checked off.)

1x/day methmi.. did nothing for me and I had no reaction. I started Methimizaole 2x per day yesterday, today I wake with jaw pain, feel like I was slugged in the mouth and it hard to open my mouth.

Anyone know of a connection the methimizaole and jaw pain?

I'm seeing a new endo tomorrow btw.


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## Andros (Aug 26, 2009)

applepie said:


> I had my first visit with the Endo last week. I'm mixed if I liked her- but am looking to change Doc's b/c she has NO appointments...not good for follow up care for hyperthyroid/suspected graves disease.
> 
> Background my TSH level was .002 (don't have the scale handy) and T4 was 17.something. Symptoms include EXTREME weakness, frequent BM's, irritability, tremors. Hair loss too- but hard to tell from already existing condition. (i'm female)
> 
> ...


Hi there and welcome! The jaw pain....................are you taking the atenolol she Rx'd to slow down your heart?

Here are the known side effect to methimazole.
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000686/

I had jaw pain w/Graves' and this may explain why ..........

Painful ThyroiditisThe second type of thyroiditis is called subacute granulomatous thyroiditis, or painful thyroiditis. Unlike most forms of thyroid disease which are more common in women, this type of thyroiditis occurs equally in both men and women. It usually starts out as a harmless viral illness such as the flu or a cold which invades the thyroid gland causing thyroiditis. This type of inflammation is quite painful and you may find that the front of your throat is sore to the touch. Often this pain extends to the jaw or ear and can be confused with a whole host of other diseases including temporomandibular joint problems (commonly referred to as TMJ), ear infections or even Strep throat. Sometimes only one lobe of the thyroid is affected causing pain and swelling on just one side of the neck instead of both
http://www.cumc.columbia.edu/dept/thyroid/thyroiditis.html

No matter what the reason, I sure would check in w/ the doctor about this because in women, jaw pain can be a sign of heart attack and since you are hyperthyroid, I would be concerned.

Better to be safe than sorry.

Let us know how you are doing.


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## applepie (Apr 6, 2011)

Andros said:


> Hi there and welcome! The jaw pain....................are you taking the atenolol she Rx'd to slow down your heart?
> 
> Here are the known side effect to methimazole.
> http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000686/
> ...


Thanks for the links Andros. yes the atenolol is to slow down my heart. I admit though I feel like I've been having more palpitations than when I was n the propanolol. My pulse is better, ~96, was about 120-130. funny about the description for thyroidisits...when I initially went to my PCP with all my (hyperT) symptoms it was a Friday. By the Monday- I was back at the PCP with all the symptoms you described, neck pain, sore throat etc. They tested for strep but it was negative.

I see the Doc tomorrow AM- the office as the hospital, so I imagine I'll be in good hands. I'll update you all tomorrow. Thanks.


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## Andros (Aug 26, 2009)

applepie said:


> Thanks for the links Andros. yes the atenolol is to slow down my heart. I admit though I feel like I've been having more palpitations than when I was n the propanolol. My pulse is better, ~96, was about 120-130. funny about the description for thyroidisits...when I initially went to my PCP with all my (hyperT) symptoms it was a Friday. By the Monday- I was back at the PCP with all the symptoms you described, neck pain, sore throat etc. They tested for strep but it was negative.
> 
> I see the Doc tomorrow AM- the office as the hospital, so I imagine I'll be in good hands. I'll update you all tomorrow. Thanks.


You are quite welcome and I will remain concerned until we hear from you!

Wishing you the best and once again, welcome!


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## applepie (Apr 6, 2011)

Saw the doc today. I'm officially a member of the Graves' Disease club! Don't have my labs but doc said my labs" are showing the proteins that is consistent with Graves disease."

Doc upped my methimazole to 2 10mg in am, 1 in evening. Switching me back to propranolol since my heart likes it better.


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## Andros (Aug 26, 2009)

applepie said:


> Saw the doc today. I'm officially a member of the Graves' Disease club! Don't have my labs but doc said my labs" are showing the proteins that is consistent with Graves disease."
> 
> Doc upped my methimazole to 2 10mg in am, 1 in evening. Switching me back to propranolol since my heart likes it better.


I am very glad you are back on the propranolol; what a relief.

Hate that you are officially a member of the Graves' Disease Club but all of us here will try to be supportive and helpful.

Can you tell me if this is the protein?
http://www.ebi.ac.uk/interpro/DisplayIproEntry?ac=IPR002167

Inquiring minds like to know!

Will your doc be sending you for RAIU (radioactive uptake scan?)


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## applepie (Apr 6, 2011)

I don't know if that is the protein--don't have the labs. I had RAIU done in October 2010, 32%uptake, but thats when my levels were just a hint of being out of whack. There was no mention of them doing it again.


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## Andros (Aug 26, 2009)

Andros said:


> I am very glad you are back on the propranolol; what a relief.
> 
> Hate that you are officially a member of the Graves' Disease Club but all of us here will try to be supportive and helpful.
> 
> ...


I am amazed! This is something new to me! Thank you for sharing this. I will be doing more research on it. I wonder when this protein was discovered and labeled as Graves' Disease Carrier Protein?

Holy cats! A great diagnostic break though and maybe a tool to portend what is to come by way of familial autoimmune diseases.


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