# Newbie Here.. Stressed and depressed



## Ksum (Jun 21, 2014)

Hi Everyone,

I'm a 22 year old male, normal bmi.

I was diagnosed with Hashimoto's a few months ago and I have subclinical hypothyroidism.

My world came crashing down after this diagnosis just because I never expected to be on a lifelong drug.

I've since made peace with my diagnosis but now it's my future that concerns me.

I know that since I have Hashimoto's I'm at an increased risk to get other autoimmune diseases, but so far all my research has not provided numbers.

The thing I'm most concerned about is diabetes. I really wouldn't be able to handle such a diagnosis.

My uncle has Hashimoto's and doesn't have any other autoimmune diseases, so I'm hopefully that my outlook is the same in that regard.

So my question is, how much more likely are we to get autoimmune disease? And what about diabetes in particular?

Thank you,
-KB


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## joplin1975 (Jul 21, 2011)

Autoimmune disease do tend to come in clusters. I appreciate wanting to be prepared, but if don't think anyone can give you percentages of developing another issue...well, at least not with any degree of accuracy. Unless you count allergies, I haven't developed anything else.

Again, I get it. It shakes us up when our bodies don't cooperate. That said, I can't help but think you have two choices here: 1) educate yourself about Hashi's, be proactive and conscientious about your health, figure out what you need to do to feel your best, and then go on and re-start living your life to its fullest; or, 2) fixate on the maybes and possibilities while the world passes you by.

My thyroid cancer could reoccur. How often do I really give it much thought? About 15 mins a year, when I go in for annual testing. I'm a stubborn chick...I wouldn't dream of giving that disease that much power over my life. Keep your head up, you are going to be fine.


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## shafree (May 8, 2014)

A figure I've seen mentioned in several books is that you have perhaps a 1 in 5 chance of developing an additional autoimmune disease once you've gotten your first. However, I'm not sure that this applies to Hashimoto's, an extremely common disease that seems to be a standalone occurrence for many people. The truth is autoimmune diseases are so tricky to diagnose (if they get diagnosed at all) that I'd doubt the veracity of any statistic.

It's easy to get caught up in worrying about "what if's," especially when your initial diagnosis is new or unexpected, and unless you suffer from chronic health anxiety it's something you'll make peace with in time. It is important to remember that autoimmune diseases are a complicated beast and when clustering occurs it's most likely because of a combination of genetics and complex environmental factors.

When I was diagnosed with Hashimoto's earlier this year (the latest in a string of autoimmune diseases), diabetes was also my first concern. The more I read about it, the more I realized that many studies connecting the two are about diabetics developing thyroid disease, and not the other way around. There are also those with Hashimoto's who end up developing diabetes, but the literature I've found about that tends to leave out important details like whether the Hashimoto's patients had family histories of diabetes and the state of their general health and diet. My conclusion was there's no point in dwelling on it. If it continues to upset you, discuss it with your doctor and they might offer to run some blood work to put your mind at rest.

You have a lot of things working in your favor. You're young, presumably active, and you're informed enough to make as many lifestyle changes as possible now to benefit your health long into the future. That puts you light years ahead of many "healthy" people in terms of knowledge, empowerment and incentive to always maintain or improve your health. You're obviously thoughtful and want to be proactive about your Hashimoto's, so I have no doubt the same strength and determination would still be there on the off-chance you developed a second illness, even if you don't think so now.


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## CA-Lynn (Apr 29, 2010)

My two cents: there is no evidence to support a direct correlation between Hashimoto's and other autoimmune diseases. The reason why it "comes in clusters" is simply because people are already seeing a doctor for Hashimoto's and in the course of the checkup or follow up visit the doctor asks, "What ails you otherwise?" If you respond and give a list of symptoms, tests will be ordered. The upshot of this is that you catch the disease [whatever it might be] early.

Diabetes is not an autoimmune disease.

In my years with Hashimoto's and visiting forums such as these, I notice people often get sedentary and eat more........gaining weight and predisposing themselves to insulin resistance. So just keep active and odds are excellent that you'll be absolutely fine. Don't worry about it. Trust me, in the grand scheme of things, Hashimoto's is easily treatable.

As far as taking a pill every day for the rest of your life......no big deal. You brush your teeth every morning.....equate it with that.


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## shafree (May 8, 2014)

Type 1 diabetes is autoimmune. There's also a type 1.5 diabetes that is autoimmune; it's called both latent and late-onset autoimmune diabetes. There are antibodies tests doctors can order if you're symptomatic or have a family history.

Clustering is something doctors can't really explain, but there are established links between various autoimmune diseases and other diseases and disorders. An example of this is the link between IBD and ankylosing spondylitis, psoriatic arthritis and enteropathic arthritis. If you visit a rheumatologist and say "My back hurts," there are many things they will initially consider. If you visit a rheumatologist and say "My back hurts and I have ulcerative colitis," testing for ankylosing spondylitis and similar diseases will jump from the bottom of their list to the top.

That said, I think Lynn's right on the money with her observation about health message boards.


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## Ksum (Jun 21, 2014)

Thank you so much guys. I feel better and more empowered.

I'm just an emotional guy when it comes to my health and future.


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## Andros (Aug 26, 2009)

It depends but a lot of us here do have more than one autoimmune thing going on. The thing to do is to "clamp down" now. You don't have to get diabetes. However, some autoimmune diseases are like a "speeding train" and there is not much one can do except to live clean. Very clean!

Plenty of exercise, sunshine, water and positive thoughts.

Welcome to the board and when you have time; please tell us how your doctor decided that you have Hashimoto's, what thyroxine replacement are you on, how much and for how long.

Have you had an ultra-sound of your thyroid?


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## CA-Lynn (Apr 29, 2010)

Ksum:

I should have written that "Type II" diabetes is not autoimmune. Type I diabetes typically is diagnosed in childhood, OR very young adulthood. Odds are excellent that if you were predisposed to Type I diabetes that at your age you'd already be seeing increases in your A1C levels. Oh yes, if a father has Type I diabetes, the odds of an offspring having it is only 1 in 17, If both parents have Type I, then the odds are 1 in 10.

There is no "inheritance" in Type II diabetes. Rather this form of diabetes is more of an environmental thing. If the family is sedentary, then odds are you will follow that pattern....UNLESS you make a lifestyle choice to be active and keep your weight in check.

Google "inheritance Type I Diabetes" and information will be available.

People might talk about "established links" between autoimmune diseases, but that's no guarantee that if you have one disease you'll get another., This clustering really refers to certain haplotypes [such as HLA-B27 in Ankylosing Spondylitis, PsA, etc.]., JUST BECAUSE YOU TEST POSITIVE FOR A HAPLOTYPE DOES NOT MEAN YOU WILL GET THE DISEASE. In fact, odds are definitely in your favor that you will not.


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## Ksum (Jun 21, 2014)

Well my doctor just ordered a tsh lab value as part of my blood draw after I was a borderline normal-low for my hemoglobin and hematocrit.

My tsh came back as 8. I forgot the parts per volume, but I started freaking out right away. I've never been so emotional in my life.

I never had a health scare and taking a pill now daily seems like nothing serious. Just the associated autoimmune diseases that I can possibly get, scare me even more.

I am currently subclinical so my doctor has not put me on any replacement medcation. I read somewhere that perhaps early hormone replacement, even at low levels, can help reduce the rate at which hashimotos attacks? Anyone hear of this?

And I really love the support and information you guys are providing. I really do appreciate it.


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## joplin1975 (Jul 21, 2011)

Well, you really want to look at free t4 and free t3 for dosing purposes, but I think in most cases, it's safe to say anyone with a TSH of 8 would benefit from replacement medication. The ATA's revised guidelines suggest your TSH should not be above 3.0.


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## Lovlkn (Dec 20, 2009)

With a TSH of - you are not sub clinical - you are full blown hypo.

You need to find a new doctor or insist the one you have run additional tests - Free T-4 and Free T-3 give an accurate idea of what the "free" thyroid hormones are in your bloodstream.


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## joplin1975 (Jul 21, 2011)

PS -- how were you diagnosed with Hashi's? Did your doctor run antibody tests? Have you had an ultrasound of your thyroid?


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## CA-Lynn (Apr 29, 2010)

Good question, Joplin.

[Ksum: just because you have a high TSH does NOT mean you have the autoimmune version of the disease. Hypothyroidism can be autoimmune or non-autoimmune. No one should assume it's autoimmune unless the antibodies tests were run, and they rarely are at first, and have come back abnormal.]


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## bigfoot (May 13, 2011)

Ksum said:


> I was diagnosed with Hashimoto's a few months ago and I have subclinical hypothyroidism.
> 
> My world came crashing down after this diagnosis just because I never expected to be on a lifelong drug.
> 
> I've since made peace with my diagnosis but now it's my future that concerns me.


 :anim_32:

As a fellow guy who is dealing with this since his 20's, welcome to the club! I agree with others, this sure as heck doesn't sound like "subclinical" anything. You have hypothyroidism. Not really much of a question about it, unless you've been super sick lately, which could result in a skewed TSH value. And as Lynn pointed out, now it's a matter of doing the further proper testing to determine which kind you have.

Taking the medication is the easy part. It just becomes part of your daily routine, and second-nature. Getting doctors to listen to you and advocating for yourself is the hard part. And finding a good doc who is up to speed on the latest info, as well as being open-minded is crucial. Do not fall into the same trap I did, where your doc ignores your signs & symptoms, refuses to run proper tests, and just gives you a handful of drug samples and prescriptions hoping you'll go away. That does nothing to address the root problems and fix them. Meanwhile, you languish. FYI -- thyroid labs are notoriously mis-interpreted by docs; do not accept an answer of, "they're normal" or "they're in range". (Get and keep copies of all your labs and tests.) You want to be optimized. That is the key word. As mentioned above, the AACE recommends a TSH value between 0.3 - 3.0. This is as of a few years ago, too, and is likely conservative at best. Most of us here aim for a goal of a TSH at 1.0 or below, and a FT3 & FT4 at 50-75% of the reference range. That is easier said than done, and may need to be tweaked for you as an individual, but it's a good spot to try for at first.

Your doc should be ordering, at a minimum right now:

* TSH.

* Free T3, Free T4.

* Reverse T3.

* TPO Antibodies and Thyroglobulin Antibodies -- checks for Hashimoto's.

* TRAb (aka Thyroid Receptor Antibodies) or Thyroid Stimulating Immunoglobulin (aka TSI, *not* the same as TSH) -- checks for Graves'.

* Thyroid Ultrasound to get a baseline.

Anything less than the above, or if they refuse, look elsewhere for your medical care ASAP. You need someone who is an outside the box thinker, and that could be an MD, DO, ND, Endo, or other specialist. The plaque hanging on the wall is great, but that's not the whole story. Trust me, doing all of this up front will save you years of spinning your wheels down the road.


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## Ksum (Jun 21, 2014)

I'm so sorry, I forgot to mention a few labs.

These are all the labs I have had I regards to my thyroid.

Here are my lab results. 
11/19/2013 TSH 8.66 mclU/mL
11/19/2013 Free T4 1.1 ng/dL
11/23/2013 Thyroperoxidase antibody 437.8 IU/mL
02/25/2014 TSH 5.79 mclU/mL
02/25/2014 Free T4 1.0 ng/dL

The reason why I was told I'm subclinical is because I have normal levels of free t4 with a high tsh.

My doctor is a joke really. I'm gonna find another doctor for sure. Hopefully one that is more aware of Hashimoto's. 
With him I have to be adamant about a certain lab blood draw or test. He also has horrible bedside manner. I'm with Kaiser Permanente , not sure if anyone is aware of them, but the feeling I get is that they tell their doctors to be conservative with their orders of tests and labs. I'm gonna see who's taking patients.

This disease seems like a gateway disease!

So most people don't just take meds for the rest of their life, instead they also have other diseases along with their Hashimoto's?


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## bigfoot (May 13, 2011)

Ugh. Kaiser. Yep, they're not exactly forthcoming with ordering tests. I think I've read on here where others had trouble even getting them to run a simple FT3.

It's entirely possible that someone could have only Hashi's. But as Lynn mentioned, a lot of times *if* there is something else, your odds are better that it gets caught. Hang in there, man. Once you find a good doc you'll be in a better position to address everything. This stuff isn't that hard if you have a game plan.  If you have any specific questions, hit me with a PM.

Keep us posted!


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## shafree (May 8, 2014)

It wouldn't be accurate to say that most people with Hashimoto's will end up with other diseases, so don't drive yourself crazy worrying about that. One of the bigger studies on the subject, which I'll link to below, came to this conclusion: "The frequency of another autoimmune disorder was 9.67% in Graves' disease and 14.3% in Hashimoto's thyroiditis index cases."

http://www.ncbi.nlm.nih.gov/pubmed/20103030

That's a lower number than you'll find with quite a few other autoimmune diseases, which makes sense: Hashimoto's is very common. If everyone with Hashimoto's was running around with a million other diseases, you'd hear all about it.

I can't speak for the others here who are in similar situations, but I've had three autoimmune diseases so far and I'm barely into my thirties. (This is a rarity in my family; most of them stopped at one.) The first two ran on different sides of the family, and they have a known association anyway so that was doubly unlucky. Hashimoto's was a surprise because I didn't know of any relative who has it and my endocrinologist was confident it's probably genetic. Later I learned that a grandmother was hypothyroid for decades, so it's possible she had it without knowing.

Is it optimal? Of course not. But it's hardly the end of the world. I'm alive. I'm more health-conscious than I might've otherwise been and eat a much cleaner diet and exercise a lot more than many "healthy" people I know. My doctors are often more preoccupied or aloof than I'd like (I get the feeling they can't wait for appointments to be over so they can return to their offices and play Fruit Ninja), but they generally do their jobs well and if they don't, they're fired.

And I have to tell you, Hashimoto's is a freaking walk in the park compared to most autoimmune diseases. It certainly sucks when it's raging and the doctor hasn't helped you feel better yet. (Or when you're undiagnosed for years, which is the case for all too many of us.) But you will feel better, and that's what is important. Having to take a daily pill isn't a big deal. Swallowing a Synthroid every morning isn't as much fun as chewing a Flinstone vitamin was every morning years ago, but it makes me feel much better than a Barney Rubble ever did.

This will sound bonkers to you given the way your world is currently spinning (and given the fact that your TSH isn't where it should be, which might make you more emotional than usual), but if you had to be sick with something, you could've done a heck of a lot worse than Hashimoto's! I wish you much success in finding a better doctor - you deserve the best.


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## CA-Lynn (Apr 29, 2010)

Shafree hit the nail on the head: Hashimoto's is a walk in the park compared to so many other diseases [if not ALL of them] out there.

And let me repeat: there is no solid evidence that shows that because you have one autoimmune disease that you're doomed for others. Read my stats in an earlier post.

I think, Ksum, that you're worrying this to death and in the end you're going to kick yourself in the butt for spending that much energy on it. It's easily treatable. Sure, you might have to adjust med doses over the years, but that's no big deal. Right now, at your age, it should be framed as an "annoyance" you have to periodically deal with.

I don't mean to trash your feelings, but I really want to put this in perspective. Remember this: for the few people on this forum who can't seem to get a handle on their disease, there are at least 1000 times as many out there with thyroid disease, enjoying a normal life.


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## visc (Feb 22, 2014)

I actually think the best thing that has ever happened to me was being forced to wake up at the same time every day.

I have a new routine and its only been positive on my health.

For diabetes fear:

As long as you have a negative A1C test than you have nothing to worry about. Just get it done every year or so.


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## Ksum (Jun 21, 2014)

Thanks again everyone! I changed my doctor and will schedule an appointment soon to address my concerns.


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## bigfoot (May 13, 2011)

BOOYAH! That is good news bro! :anim_32:


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