# Hypo or levothyroxine complications - HELP



## backtonormal (Apr 7, 2011)

Hi, I'm so grateful to have found this site. I have no med insurance and have been navigating hypothyroidism with the help of a nurse practitioner in our area. My story is lengthy, I'm sorry so I'll try to shorten. I'm 46, married 25 yrs, 4 young kids, never really been sick in my life until the past year and here are the high points: *June 2010- pneumonia, severe, treated in hospital twice with IV antibiotics, oral antibiotics, IV steroids (which caused need for insulin for a few days), various, constant breathing treatments, recovered fully toward first of August and haven't smoked since that June (I had smoked lightly for 30 years...) *October 5, 2010- non-invasive but excruciating surgery (not related to any current condition, I hope I don't have to give the details...), unable to resume any activity level for about 7 days and during that time began to experience swelling in arms, face, stomach. Surgery site healed very slowly and the upper body swelling was gradually worsening. *Halloween- tried to go trick-or-treating with kids and was unable to follow them around due to shortness of breath and fatigue. The next morning my face was so swollen my husband took me to the emergency room. Hospital staff did exhaustive testing on heart, including nuclear medicine scans, found only that my triglyceride level was 9503, not a typo. Put me on lopid (gemfibrozil) and sent me home after 18 hours. The next morning my swelling was unbearable and my husband took me to a different emergency room where they did an abdominal CAT scan and told me that my liver was extremely enlarged from the hypertrygliceridemia and that they would run thyroid test. Sent me home with instructions to contact the hospital for test results the next day. I did, and the staff refused to give results by phone, I would have to pick them up in person. By this time, around Nov 3, I was unable to drive, and my husband was out of town working. I talked with someone I knew from the hospital and they assured me that if anything was wrong, the staff would have insisted that I come to get my results or see another dr right away. I then decided that it was all in my head and that I had to push myself harder. Day after day, my symptoms grew worse until I could barely speak, couldn't chew food, couldn't use my swollen hands and arms...I ended up back at the last hospital on Dec 2, where a perky intern informed me that my TSH had been 144 the month before and that they were admitting me to wait for the results of another TSH, which came back the next morning at 194.46. They gave me a 75mcg dose of synthroid several hours later and sent me home with a prescription for levothyroxine and best wishes. Over the next few weeks, it was as if the death sentence was lifted, I improved every day. I contacted a nurse practitioner's office to get my blood work done at the six week mark and it came back that my TSH was still at 75. She increased my levo to 100 mcg and that's when the real trouble started. During the next two weeks, I became more and more aware of my heart beat in my ears, then dizziness, then heart pounding in my chest and extreme breathlessness. I told her about my problems and she prescribed metoprolol 50 mg twice daily. No help, but I take it anyway. At the next blood test, my TSH was 15 and she went up to 112mcg. The palpitations, breathlessness, overall fatigue, miserable mood (I just despise myself), all are growing worse by the day. I am worthless to my husband and children and I have no clue what to do about it. The harder I try to get BACK TO NORMAL, the more elusive the state seems. I can't even stand up from a sitting position without feeling like I'm going to pass out. I'm aware of my pounding heart in my ears right now, even tho I've been sitting and composing this whining plea for most of the past hour. Please help. I know I need better med care but it's very difficult to get help without insurance, even when you promise to pay, which I can only do when the terms are reasonable to begin with... Help, please. Also should mention that ultrasound on thyroid on Dec 2 2010 showed large goiter and small nodule on thyroid, btw.


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## Andros (Aug 26, 2009)

backtonormal said:


> Hi, I'm so grateful to have found this site. I have no med insurance and have been navigating hypothyroidism with the help of a nurse practitioner in our area. My story is lengthy, I'm sorry so I'll try to shorten. I'm 46, married 25 yrs, 4 young kids, never really been sick in my life until the past year and here are the high points: *June 2010- pneumonia, severe, treated in hospital twice with IV antibiotics, oral antibiotics, IV steroids (which caused need for insulin for a few days), various, constant breathing treatments, recovered fully toward first of August and haven't smoked since that June (I had smoked lightly for 30 years...) *October 5, 2010- non-invasive but excruciating surgery (not related to any current condition, I hope I don't have to give the details...), unable to resume any activity level for about 7 days and during that time began to experience swelling in arms, face, stomach. Surgery site healed very slowly and the upper body swelling was gradually worsening. *Halloween- tried to go trick-or-treating with kids and was unable to follow them around due to shortness of breath and fatigue. The next morning my face was so swollen my husband took me to the emergency room. Hospital staff did exhaustive testing on heart, including nuclear medicine scans, found only that my triglyceride level was 9503, not a typo. Put me on lopid (gemfibrozil) and sent me home after 18 hours. The next morning my swelling was unbearable and my husband took me to a different emergency room where they did an abdominal CAT scan and told me that my liver was extremely enlarged from the hypertrygliceridemia and that they would run thyroid test. Sent me home with instructions to contact the hospital for test results the next day. I did, and the staff refused to give results by phone, I would have to pick them up in person. By this time, around Nov 3, I was unable to drive, and my husband was out of town working. I talked with someone I knew from the hospital and they assured me that if anything was wrong, the staff would have insisted that I come to get my results or see another dr right away. I then decided that it was all in my head and that I had to push myself harder. Day after day, my symptoms grew worse until I could barely speak, couldn't chew food, couldn't use my swollen hands and arms...I ended up back at the last hospital on Dec 2, where a perky intern informed me that my TSH had been 144 the month before and that they were admitting me to wait for the results of another TSH, which came back the next morning at 194.46. They gave me a 75mcg dose of synthroid several hours later and sent me home with a prescription for levothyroxine and best wishes. Over the next few weeks, it was as if the death sentence was lifted, I improved every day. I contacted a nurse practitioner's office to get my blood work done at the six week mark and it came back that my TSH was still at 75. She increased my levo to 100 mcg and that's when the real trouble started. During the next two weeks, I became more and more aware of my heart beat in my ears, then dizziness, then heart pounding in my chest and extreme breathlessness. I told her about my problems and she prescribed metoprolol 50 mg twice daily. No help, but I take it anyway. At the next blood test, my TSH was 15 and she went up to 112mcg. The palpitations, breathlessness, overall fatigue, miserable mood (I just despise myself), all are growing worse by the day. I am worthless to my husband and children and I have no clue what to do about it. The harder I try to get BACK TO NORMAL, the more elusive the state seems. I can't even stand up from a sitting position without feeling like I'm going to pass out. I'm aware of my pounding heart in my ears right now, even tho I've been sitting and composing this whining plea for most of the past hour. Please help. I know I need better med care but it's very difficult to get help without insurance, even when you promise to pay, which I can only do when the terms are reasonable to begin with... Help, please. Also should mention that ultrasound on thyroid on Dec 2 2010 showed large goiter and small nodule on thyroid, btw.


Oh, you poor poor dear!! This is so not good. Do you know if the nodule was solid or cystic? Could you find out?

Here is info I turned up.

• Hyperchylomicronemia The most severe form of hypertriglyceridemia occurs when levels rise above 1000 mg/dL, a condition called hyperchylomicronemia. When the triglycerides are greater than 2000 mg/dL, a constellation of symptoms may occur called the chylomicronemia syndrome. Pancreatitis is not always the cause of abdominal pain although it is frequently a part of the syndrome. The symptoms may also be confused with appendicitis or a gall bladder attack. Other common symptoms include shortness of breath and changes in mental status.

The chylomicronemia syndrome includes physical findings as well. Examination of the retina reveals a condition called lipemia retinalis. The retina is pale orange and the blood vessels are white (Figure 2). Similarly, blood withdrawn from a vein also has a white or milky appearance and is described as lipemic (Figure 3). In prolonged chylomicronemia, small, pimple-like lesions may appear, most prominent on the trunk, arms, and legs. These are eruptive xanthomas and will resolve when triglyceride levels remain below 500 mg/dL for an extended period

These are the causes.............

Table 2. Selected Causes of Hypertriglyceridemia
•Inherited Syndromes 
Familial combined hyperlipidemia - common disorder, strong risk for CAD

Familial hypertriglyceridemia - may not increase risk for CAD 
Familial dysbetalipoproteinemia - strong risk for CAD 
Familial chylomicronemia - exceedingly rare with very high risk for pancreatitis but not CAD

•Medical Conditions 
Diabetes mellitus, particularly if not well controlled 
Kidney disease (chronic renal failure, nephrotic syndrome) 
Hypothyroidism, untreated explode 
Human immunodeficiency disease 
Pregnancy 
Obesity, particularly central (male-pattern) obesity 
Acute pancreatitis

Here you can read the whole article.
http://knol.google.com/k/high-triglycerides-hypertriglyceridemia#

Clearly, untreated hypothyroid is a cause.
http://www.jabfm.org/cgi/content/full/19/3/310

Do you have a teaching hospital where you live? You might be able to get some gratis intervention that way. We are all on such hard times and not being able to get medical care is going to be an undoing of this nation.

I am so upset for you and the only thing I know to do outside of helping you with what I know is to keep you in my prayers which I will do.

All the info above won't do any good if you cannot get adequate medical care. That TSH has to come waaaaaaaaaaaaaay down. Most of us feel best w/TSH @ 1.0 or less. AACE recommends the range to be 0.3 to 3.0 but 3.0 is still too high for a lot of us. Just depends.

Worried about the pancreas too. I know you share that opinion and much more.

Also, I did consider this but do not find a case where trigycerides are so high.
http://www.turkjem.org/sayilar/5/33-43.pdf (Hashimoto's Encephalitis)

Sending caring hugs,


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## backtonormal (Apr 7, 2011)

Thank you so much for your advice and knowledge, but most of all for your prayers. I know that God will help me to get this resolved but in His time. I will investigate about a teaching hospital, that gives me a ray of hope. Also, about the triglyceride syndrome. You know, it's interesting that this is not the first time I've had high triglycerides. I had a fasting level of 3000 back in 1994, and yes my blood looked milky then. I was treated with gemfibrozil back then and went off when we were trying to have a baby. I don't remember if the doctor advised this or not, but I think she did. In the years that followed, any time my level was checked, it was between 300 and 600, and I was usually pregnant and the drs said not to worry. It's really strange though, that I went from a normal, hard-working mom to this vegetative state in such a short time. Please keep praying and I'll return the consideration!


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