Autoimmune Thyroid Disease

An Unfortunate and Lengthy Adventure in Misdiagnosis

Some insights from Doctor Skinner

with 2 comments

Last night my brain fog was so bad that I took some B12. The ole’ B12 and I have a tempestuous relationship, as I seem to need a little now and then to clear up symptoms, but it frequently makes me irritable, gives me insomnia, and mucks around with my heartbeat. One interesting thing I’ve found is that B12 increases my confidence. I’ve often taken it before going out to socialise with people for this reason. Apparently I needed some B12, because this morning I woke up clear-headed, cheerful, and I actually felt confident enough to phone the office of the great Scottish thyroid doctor, Dr Gordon Skinner, to enquire about his fees, consultation times, and how to get a referral. If you know me, then you know I don’t make phone calls. B12 deficiency is very common in hypothyroidism. This could well explain my curious reactions to methylation cycle vitamins.

Also, amazingly (and I don’t attribute the mood changes to this at all), I got my period this evening. I was expecting at least three more days of torture and temperature fluctuations. The thyroxine must be working better than I thought (though, alas, my carpal-leg-syndrome continues). I also spent the day sitting in the garden deliberately (though unsuccessfully) trying to overheat myself, which might have helped. The last time I got surprised by my period was just after Christmas, shortly after that Yersinia-like food poisoning. I also had a spell of very good skin and easy weight regulation back then. I really do suspect that that food poisoning damaged my thyroid again and gave me a short period of high or normal T4, before plunging me into my current state. In a way I’m quite thankful it happened as I’ve been balancing on a knife-edge for so long now.

To my delight, the good Doctor Skinner’s book about hypothyroidism arrived in the post today. Hopefully, if I can get my heel-dragging, skeptical family doctor to give me a referral, I would like to go and see Doctor Skinner. Without quoting his entire book, here are a few insightful extracts:

In my experience the most common identifiable precipitating cause is infection and the most frequent by far is a history of infectious mononucleosis or an infectious ‘mononucleosis like’ or ‘glandular fever like’ illness while the highest proportion of hypothyroid patients follow adult chicken pox which is less common in absolute terms than glandular fever. […] A history of influenza and particularly influenza B is common and a notable number of patients developed hypothyroidism following an outbreak of influenza B in 1989 in Birmingham, UK.

Other infections can often be identified as precipitating causes, most commonly streptococcal sore throat, food poisoning and often an ill defined ‘viral’ illness where many patients report an acute illness associated with ‘utter fatigue’, fever, diarrhoea and ‘collapse’ and I have never resolved the nature of this problem…

Doctor Skinner later describes how non-surgical trauma such as car accidents appear to trigger a problem in some people, while others appear to develop hypothyroidism after an emotional upset such as a death or a divorce. This is very interesting, as a number of failsafers report that their food intolerance was triggered after a major life event like this too. Apparently four of his patients attribute their hypothyroidism onset to the physical trauma of running in a full marathon. I have a number of friends who have been doing this marathon nonsense. You heard it here first: it’s stupid and dangerous, and making £200 for your favourite charity just isn’t worth ending up like me.

Doctor Skinner describes how many of his hypothyroid patients can be identified by their demeanour.

Hypothyroid patients tend to come into the consulting room in a fearful or ‘quietly agitated’ state probably because they’ve had multiple rejections and been given the big DMO [depressive, menopausal, overweight] tag [by their doctor] which can include a reprimand for the greatest sin of all which is presuming or even suggesting that thyroid replacement might help them lose weight. The patient will often plonk themselves down […] slumped as if she can hardly hold up her head or her back can hardly support her […] She frequently has a badly-written-out list of clinical features […] Basically she has such a poor memory and is usually so lacking in confidence that she does not trust herself to ‘remember everything’ and her memory can be so fraught for recent events that she depends entirely on the list. […] [A] significant number have not opened and read the referral letter […] It’s all back to a lack of confidence, fear of confrontation and general fear of establishment and of being out of line which is a feature of many hypothyroid patients.

This made me hoot with laughter, as it is a perfect description of me, two weeks ago, walking into the doctors’ office, with my scrawled list of symptoms, which I did indeed have to refer to as my memory is so poor right now. I have indeed been given the big DMO, though in my case “depressive, premenstrual, overweight” on at least three separate occasions when I have complained of these symptoms. I am very nervous of doctors, afraid of confrontation, and over the last few months I have lost so much of my already low self-confidence that I’ve become a virtual recluse.

It is not, for example, uncommon for patients to believe they are being poisoned by their partner, relatives or friends. This is actually within the bounds of reasonable thinking in that for no accountable reason – and in spite of all medical attention – the patient is becoming more and more ill and additionally her food tastes ‘strange’, it’s not that crazy to imagine that food has been tampered with in some adverse way. […]

This had never crossed my mind before, but when I was very ill before failsafe, I knew it had something to do with food but I didn’t know what, and everything I ate seemed to make me ill almost instantaneously. I can see how a hypothyroid person who spots a food intolerance connection could well come to the conclusion that they are being poisoned! In fact, I know of (a relative of a relative), a middle-aged, overweight woman who went mad a couple of years ago and started accusing her poor innocent husband of poisoning her. I wonder!

Intolerance to all things great and small is a characteristic feature of hypothyroidism […] and arises from the inability of the hypothyroid patient to modulate, modify, control or buffer physiological response to an array of physical and psychological phenomena. […]

This all leads to a curious intolerance of (mainly) people where patients get cross if somebody touches them in a nonsexual way or even comes into the room when they are watching television or – which is sad – grandchildren become a bit of a nuisance…

That sounds like autism to me. Something I have discovered is a feature of hypothyroidism, is low dopamine levels, indeed, dopamine is so low that it tends to cause hyperprolactinaemia, a feature it shares with celiac disease. Is it possible that my asperger’s syndrome is induced by chronically low thyroid function from birth onwards?

Doctor Skinner does mention food intolerance.

[T]he patient is usually deemed to have irritable bowel syndrome (IBS) and indeed has this as the problem except that it will go away on thyroid replacement. The other explanation, which is frequently offered by the patient herself, is ‘food intolerance’ is often to a bewildering array of foods including water in several patients which is usually attributed to bad things in modern water. I believe the ‘intolerance’ is essentially intestinal sluggishness with bloating of the stomach and constipation followed by fermentation with further abdominal distention and sometimes diarrhoea. The problem is compounded by less efficient absorption and inefficient detoxification of intermediate metabolites by the liver.

Eureka! I would like to clue up Doctor Skinner to the failsafe diet to expand his understanding of food intolerance in hypothyroidism, fibromyalgia, and that funny old syndrome ‘multiple chemical sensitivity’.

This is as far as I’ve read. I recommend anyone who suspects hypothyroidism to get a copy of this book.


Written by alienrobotgirl

29 May, 2009 at 1:17 am

Posted in Thyroid

2 Responses

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  1. What are your blood sodium levels? I’m wondering if you’re suffering from a mild case of hyponatremia. Hypothyroidism has been known to affect blood sodium levels, and a low sodium concentration in the blood may lead to the manifestation of fatigue, hallucinations, impaired concentration, etc. Of course, this is just a shot in the dark.


    30 May, 2009 at 10:40 pm

  2. I have no idea.


    31 May, 2009 at 11:57 pm

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