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Old 05-26-2011, 04:36 PM #1
Stellatum Stellatum is offline
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Default hyperthyroidism and MG

So I had my thyroid checked by my endo, and I'm slightly hyper (TSH=0.2. I've had Graves for years, and have been on and off PTU, most recently off). All MG patients should have their thyroids checked (simple blood test) since so many of us have Graves, by the way.

It is tempting to think of hyperthyroid periodic paralysis to explain these sudden episodes of extreme weakness I've been having, only I had my thyroid levels checked three months ago, just before I got so weak I went to the ER, and it was fine (TSH around 1).

Meanwhile, my neuro did mention that hyperthyroidism can make MG much worse--he told me to make sure I see my endo periodically. However, a little googling reveals that treating hyperthyroidism seems to sometimes make MG worse, and sometimes make it better.* So, I don't know what to think. My endo, who knows nothing about MG, left a message for me to simply be rechecked in two months, but I am going to ask him to start me on the suppressant again, because my hyperthyroidism has never gone away by itself--I think it's only going to get worse if I don't treat it. And who knows what that will do to me. But I will be watching for possible effects on the MG.

Abby
*One of the articles I read was a frustrating case from the 1960s. Woman presents with MG and Graves. They give her Mestinon--she gets weaker. They up the dose--she gets weaker. They up the dose even more--she's still getting weaker. They up it again, and what do you know, she has a colinergic crisis. They take her off the Mestinon. She gets better. They start her up on it, and then for some reason the whole thing happens again--they increase the dose until she goes into another cholinergic crisis.
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Old 05-28-2011, 10:23 AM #2
AnnieB3 AnnieB3 is offline
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Abby, Are you trying to make yourself nuts?

They should have little blood testers/monitors for TSH like they do for glucose and INR.

Do some more research on hormones. Estrogen dominance causes all kinds of hills and valleys in hormones. Have you tried a progesterone cream?

I'm sorry, I'm too tired out to put up much more right now. But, you're right, all MGers need to keep an eye out for thyroid symptoms or any other new symptoms.

Annie
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Old 05-28-2011, 12:08 PM #3
Stellatum Stellatum is offline
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Annie, I have Graves disease that flared up a couple of years ago. Since then I've been having my blood tested every three months. I treated the flare-up two years ago with PTU, but went off it as soon as I could--since then I've been watching my TSH creep down again. So this is no mystery. It's just the Graves disease slipping out of control again. I will suppress my thyroid with a low dose of the drug for a few months, and monitor it with lab work.

I did try progesterone supplementation last February. It made me so nauseous and tired that I quit after six days--which was really stupid, because I know that my normal drop in progesterone triggers my MG symptoms. Because I was supplementing, I dropped from a much higher level. That's how I ended up in the hospital for a week!

Thanks--get some rest!

Abby
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Old 06-01-2011, 07:47 PM #4
AnnieB3 AnnieB3 is offline
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Abby, Thanks for the reminder.

I was wondering, when was the last time you had a chest CT? Has anyone actually LOOKED at your thymus, thyroid and parathyroid lately? Have you had any of the paraneoplastic antibodies done? Not that I'm thinking about cancer or anything but with some MG (and LEMS) patients, it is a concern.

What about a 24-hour urine looking at potassium/sodium, etc.? And don't forget about magnesium. Is your kidney function good?

http://www.mayomedicallaboratories.c...Overview/83380

What I meant about driving yourself nuts is your doubt about your MG diagnosis. As I'm sure you can tell, I'm in quite a grief funk at the moment and not my normal, detailed self.

I hope you can figure out what is going on.
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Old 06-01-2011, 08:02 PM #5
Stellatum Stellatum is offline
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Thanks, Annie. I hope you will take some time off of everything that you can take time off of...

I had a chest CT about six months ago, and my yearly thyroid ultrasound a couple of months ago (I have a big nodule, which was biopsied and is now followed with yearly ultrasounds). I have been having lots of standard metabolic panels and such.

I really think that what I'm experiencing is just some sort of MG surge. These spells always hit during the "down" phase of my MG ups and downs.

I am slightly hyperthyroid, which makes me sort of over-react to things. I get carried away. Thanks for caring.

Abby

Quote:
Originally Posted by AnnieB3 View Post
Abby, Thanks for the reminder.

I was wondering, when was the last time you had a chest CT? Has anyone actually LOOKED at your thymus, thyroid and parathyroid lately? Have you had any of the paraneoplastic antibodies done? Not that I'm thinking about cancer or anything but with some MG (and LEMS) patients, it is a concern.

What about a 24-hour urine looking at potassium/sodium, etc.? And don't forget about magnesium. Is your kidney function good?

http://www.mayomedicallaboratories.c...Overview/83380

What I meant about driving yourself nuts is your doubt about your MG diagnosis. As I'm sure you can tell, I'm in quite a grief funk at the moment and not my normal, detailed self.

I hope you can figure out what is going on.
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Old 06-05-2011, 03:35 PM #6
Christel Jackson Christel Jackson is offline
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Quote:
Originally Posted by AnnieB3 View Post
Abby, Are you trying to make yourself nuts?

They should have little blood testers/monitors for TSH like they do for glucose and INR.

Do some more research on hormones. Estrogen dominance causes all kinds of hills and valleys in hormones. Have you tried a progesterone cream?

I'm sorry, I'm too tired out to put up much more right now. But, you're right, all MGers need to keep an eye out for thyroid symptoms or any other new symptoms.

Annie
Annie,

I am currently reading a lot about hormones and I am on Progesterone cream! I have only been on for about a month, but I believe I feel better. Have you had any luck? I know that my hormones have to have something to do with my MG. I have had flare-up after flare-up since giving birth to my daughter almost 5 years ago. I have read a lot about estrogen dominance and I fit almost every symptom. Please respond, I am excited to see your post.

Christel
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Old 06-05-2011, 10:13 PM #7
AnnieB3 AnnieB3 is offline
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Christel, Welcome. I hope you will do a new post introducing yourself to everyone.

The best thing to do is to get a very good endocrinologist. I have no personal experience to offer you on this topic. Sorry.

Annie
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