Autoimmune Thyroid Disease

An Unfortunate and Lengthy Adventure in Misdiagnosis

Subacute thyroiditis? Repeatedly?

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I’ve been reading up a little on subacute thyroiditis. There are several different types of subacute thyroiditis. The following two types are of interest to me:

Subacute granulomatous thyroiditis – The most accepted etiology is a viral illness. Viral particles have never been identified within the thyroid, but episodes often follow upper respiratory infections and are associated with falling postconvalescent viral titers of various viruses, including influenza, adenovirus, mumps, and coxsackievirus. This condition is not associated with autoimmune thyroiditis but is associated with HLA (human leukocyte antigen)-B35. A genetic predisposition clearly exists; patients with HLA-Bw35 have a significantly increased risk of developing this condition. Whether the destructive thyroiditis is caused by direct viral infection of the gland or by the host’s response to the viral infection is unclear. Granulomatous thyroiditis is not an autoimmune disease of the thyroid.

Subacute postpartum thyroiditis – This condition is likely autoimmune in nature. Patients develop an autoimmune goiter and permanent hypothyroidism more often than with the painful form of subacute thyroiditis. In iodine-sufficient countries, such as the United States, postpartum thyroiditis occurs in approximately 5-8% of pregnant women. In Japan, nearly 20% of pregnancies are associated with this condition. Patients with positive test results for thyroid autoantibodies either before their pregnancy or during the third trimester are at much higher risk of developing postpartum thyroiditis.

Thyroiditis is basically inflammation of the thyroid gland. Sometimes this can be completely invisible, as in postpartum thyroiditis. The thyroid is under attack, causing die-off of thyroid hormone producing cells. This floods the body with excess thyroid hormone.

The etiology of each of these conditions is different, but all of them follow the same clinical course, including 6-8 weeks of thyrotoxicosis, 2-4 months of mild hypothyroidism, and finally, a return to the euthyroid state in 90-95% or more of the patients. A patient may experience 1 or more of these phases.

After 6-8 weeks of hyperthyroidism, hypothyroidism sets in. In most people, the thyroid function eventually returns to normal. In a small percentage of people, around 5-10%, permanent damage is done to the thyroid. This seems to be particularly true of certain HLA subtypes.

I think I may have had at least three episodes of thyroiditis. I can look back and pinpoint drops in my health.

The first time would be when we were diagnosed with fibromyalgia. I can’t be entirely sure of the timings, but looking back, I think 6 weeks after our nasty infection was roughly right. We would have gone on holiday at the start of the summer break, fallen ill immediately on return, and 6-7 weeks later gone back to school. I don’t think we felt “right” after the infection, but it was at least a couple of weeks after we returned to school that we began to complain of tiredness.

The second time, I believe may have been associated with coming off the pill about six and a half years ago. I think this may have resembled postpartum thyroiditis. Apparently some women do react this way after coming off the pill. I never felt right on the pill, I asked to change my pill because it made me very nauseous, and I was put on the third generation pill. Six months later I had a DVT.

Something was “not right” when I was on the pill. I had a lot of angry insomnia problems and brain fog, compounded by my frustration with my job. I came off the pill on the day I was admitted to hospital. I think it was the third or fourth day after going into hospital that I started having weird weakness and trembling reactions, with increased brainfog. I remember having muscle cramps and twitches and strange sensations in my arms over the next few weeks. I actually felt wired and continued to have insomnia, and I was very panicky. I remember maybe six weeks after I came out of hospital, the doctors had to suddenly adjust my dosage of warfarin upwards for no apparent reason. Thyroid hormones can change clotting speed, and adjusting upwards is necessary if the thyroid slows down. I declined over the following few months, and I think the March, April and May of that year were when things really started to go wrong for me. My hypoglycaemia became much worse, and I put on over a stone in weight in that short time frame, and my menstrual cycle didn’t feel right. I developed a nasty patch of eczema (perioral dermatitis) next to my mouth.

When I went to the doctor to complain that there seemed to be something wrong with my hormones and I’d put on a lot of weight in a short amount of time, she laughed and told me to go on a diet, and there was only something wrong with my sex hormones if I wasn’t having a period. She sent me to the hospital for a fasting blood sugar test. I never bothered to go, because I knew they wouldn’t find anything of use. I went on the Atkins diet and lost all that weight. I remember a few weeks in, I started making soy pancakes for breakfast. I immediately stopped losing weight and started getting headaches. No wonder! Fortunately I figured it out very quickly and returned to eating eggs.

I was still very hypoglycaemic and taking a lot of vitamins in the hopes that they would fix me for all of that year. Six months after I went on Atkins, we moved to Nice, France. I felt great in Nice. I was very high all of the time. I still wasn’t right, but I felt so much better. Things began to slide again during the last couple of months of our six month stay. I was quite stressed by all of the visitors we had from the UK, my diet lapsed somewhat and I began including things like yoghurt and lots of nuts, and I started taking silly, dangerous supplements like quercetin (for allergies) and PABA (to protect against sunburn).

My parents came to visit us shortly before we were due to return to the UK. I requested that they bring a bottle of cod liver oil with them, as I had been reading on the WAPF website about the wonders of vitamin A. I had tested every other vitamin, and I hoped it might help to cure my hypoglycaemia after hearing about how wonderful it was. I took some quite large doses. I think that this, in combination with that dreadful quercetin and PABA provoked a serious respiratory infection by messing up my immune system. This was the third time I think I had subacute thyroiditis.

I haven’t been that ill in a long time. I developed bronchitis and throat problems. I’m sure I did feel as though I had a lump in my throat. Adenoviruses are common causes of bronchitis, and they’re also common causes of subacute thyroiditis. Weird, weird stuff was happening to my body. I had muscle cramps and twitches, and massive palpitations and skipping heart beat. I felt incredibly overheated and kept waking up sweating. I was very, very scared, but there was nothing I could do because I was in France, and I couldn’t speak the language well enough to go to a doctor. I thought I must have messed up my electrolytes. I realised that milk drinking seemed to help calm my symptoms down, and decided to blame the cod liver oil. I stopped taking the stupid supplements and tried to get plenty of calcium. Calcium has regulatory effects on the thyroid.

I got better, but I didn’t feel right. I felt wired, stressed, and hyper. We returned to the UK two weeks later. I must have spent a week charging around madly getting the new flat sorted out with basics like plates, cutlery and kettles. I bought some scales too, and was surprised to see that I’d put on about half a stone in the six months I was in France. I immediately went back on Atkins. I lost the weight again incredibly quickly and was really pleased with the speed. But I had all these strange jaw pains and wondered if I was about to grow some more wisdom teeth. Jaw pains are also associated with subacute thyroiditis.

About a month after we arrived in the UK, I remember looking at my face in the mirror and noticing that I had developed a new patch of eczema. My skin had been perfect for almost a year, since shortly after I started Atkins the previous summer, so I was pretty disappointed that doing the same thing wasn’t having the same effect any longer.

I started to feel very tired and run down. I started to experiment with vitamins. We started buying organic meat that was shipped overnight by carrier, and I think the meat probably contained amines and made things worse. Nothing seemed to work. My brain was in a fog. As autumn came around, I became very moody and weepy and a bit nuts. I just dragged along and dragged along, doing stupid vitamin experiments in the hopes that something would eventually work. Vitamin A, C, and E seemed to help, but their effects only lasted for about a week before they wore off. A lot of things made me worse. One of my many theories was that I had a thyroid problem, because I knew that eczema could be caused by thyroid problems. I tried eating coconut oil, which made me retch. It did indeed make me very energetic for a few hours, but it seemed to have a dreadful rebound effect on me. I started having strange, inexplicable weight gains every time I went out for a meal, despite eating a normal calorie count.

We moved house at Christmas time into our cottage in the countryside. I was scraping rock bottom. I really thought I had a thyroid problem then, but I had nothing to go on because every time I took a basal body temperature test, it was in the normal range. Low, but normal. In the space of the six months since I had returned to the UK, I had lost a lot of lean body mass, and gained a stone in weight, despite working hard to keep my weight under control. I started eating big breakfasts in the hope of stimulating my thyroid, eating things like sausages. I think the sulphites in the sausages made me feel worse. I tried all kinds of herbal teas. Ginger is supposed to help the thyroid. Ginger made me feel like I was dead, and always set my eczema itching.

Then in the spring I discovered Kwasniewski’s Optimal Diet. I completely changed what I was eating. I started drinking more milk and cream, cut out the sausages, started eating foods that were much more bland, and eating much more fat and less carbohydrate and protein. I really rallied that summer. I felt really great and energetic again, and I actually lost weight in the first couple of weeks despite eating huge amounts of calories.

I tried doing a fat fast in the autumn with the aide of coffee and aspirin, because I couldn’t figure out how to lose all the weight I’d gained, nothing seemed to work. I felt dreadful! I blamed the fat fast. It may have been the aspirin. Then I started mucking around removing sulphurous vegetables from my diet because I thought I had a problem with sulphites, and taking big doses of B12. I rallied again for a while.

Shortly after Christmas, I discovered the failsafe diet. Within a couple of weeks, 90% of my symptoms were gone, and within a couple of months, I felt like a normal person again, better than I had done in many, many years. That was back in the spring of 2006.

About a year in to the failsafe diet, I noticed that I was starting to feel a bit groggy, and I cut out my calcium and magnesium citrate tablets, because I realised I was reacting to the citrate, and possibly to the magnesium. Later, I started feeling groggy again and I cut out failsafe vegetables like cabbage and Brussels sprouts. Later still, I realised I was having chronic upper back pain again, and I cut out opioid-like peptides in gluten and cow’s casein. This left me with a very limited diet, but one that I was very stable on.

Last autumn I had a few flaky patches emotional front. I had a lot of environmental stress come into play and there were times when I couldn’t eat. I started drinking slightly more goat’s milk because it was the only thing I could stomach. This seemed to make me feel more clear-headed, so I kept it in my diet. Then just before Christmas there was that Yersinia-like stomach bug. I remember losing weight and being surprised about it. I kept thinking to myself that maybe the extra calcium was helping.

A couple of months later, I lost my appetite. This was the start of the progression of my hypothyroidism again.

Over the last few years I’ve repeatedly noticed weird reactions to calcium and magnesium. During the last three or four months, I’ve realised that I absolutely need three cups of milk a day, or I will feel sub-optimal. I had been supplementing magnesium to help keep my cal:mag ratio in balance, but back in February, I realised the magnesium was making me feel worse. Even small doses began to make my heart skip beats. I remember a couple of months ago, I tried taking a 125mg tablet at night. I developed a strange feeling of doom, a weird heartbeat, and I had so much squeezing pain in my left arm that I felt like I was having a heart attack. After a couple of hours of trying to ride this through, I went and drank another cup of milk, and the symptoms eased right off. I’ve said before that I never had any heart problems before that bout of bronchitis in Nice.

I’ve getting more and more backed into a corner with my diet. Currently, I’m only able to hold off heart problems by ensuring I get those three cups of milk every day. When you are hypothyroid, you lose calcium and retain magnesium. Thyroid hormones regulate your calcium ion channels, and if you don’t have enough thyroid hormones, you can’t keep enough calcium inside your cells. I’ve been losing the stuff like nobody’s business. 75mg of magnesium is enough to mess with my heartbeat and make me groggy the next day, because it opposes calcium on so many metabolic levels.

I’ve told this story a number of times before. I’ve talked about how low-carbing has helped me, I’ve talked about developing severe food intolerances, and I’ve talked about how failsafe helped me overcome them. I’ve never been able to explain why I got ill in all this time. Now I think I know why.


Written by alienrobotgirl

24 May, 2009 at 12:19 am

Posted in Thyroid

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