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HASHIMOTO'S CAN COME WITH OTHER AUTOIMMUNE DISEASES
THIS NEWSLETTER IS FOR INFORMATIONAL PURPOSES ONLY. NOTHING IN THIS CONTENT CONSTITUTES MEDICAL, PSYCHOLOGICAL, OR PROFESSIONAL ADVICE. ALWAYS CONSULT A QUALIFIED HEALTHCARE PROFESSIONAL BEFORE MAKING ANY HEALTH RELATED DECISIONS.
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OKAY BACK FROM THE GI CLINIC 🩻
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A THYROID DIAGNOSIS THAT MISSED SOMETHING ELSE 📉
A 33 Year Old Man Went To His Doctor For Severe Fatigue
He Had Lost About 20 Kilograms Over The Previous Three Months
His Doctor Tested His Thyroid Function First
The Test Found Positive Thyroid Peroxidase Antibodies
His TSH Reading Measured 44 Confirming An Underactive Thyroid
Doctors Diagnosed Him With Autoimmune Hypothyroidism
He Had Lived With Vitiligo Since Childhood
Otherwise He Reported Being In Good Health
His Father Had Vitiligo Too
Both His Mother And Half Sister Had Rheumatoid Arthritis
None Of His Relatives Had Thyroid Disease Though
Doctors Suspected Cancer After That Much Weight Loss
He Was Referred To A Specialist Center To Check
His Chest X-Ray Came Back Normal
An Abdominal Ultrasound Showed Only Slight Fatty Liver
No Tumor Or Swollen Lymph Node Appeared On Exam
Doctors Then Looked For Other Autoimmune Diseases
He Was Sent To Both A Gastrointestinal And An Endocrine Unit
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A STOMACH SCOPE AND A SEVERE ADRENAL CRISIS 🩺
The Gastrointestinal Unit Performed A Gastroscopy On Him
That Scope Revealed Signs Of Autoimmune Gastritis
Biopsies Of His Stomach Lining Later Confirmed The Finding
In The Days After The Scope He Could Not Get Out Of Bed
He Felt Extremely Tired Nauseous And Unable To Eat Or Drink
Three Days After The Scope He Was Brought To The Endocrine Clinic
The Clinic Ran A Hormone Test Called A Synacthen Test
A 30 Minute Cortisol Reading Registered Only 33 nmol/L
Normal Is 420 nmol/L Or Higher
Doctors Admitted Him Immediately And Treated Him For Addison's Crisis
In Addison's Disease The Adrenal Glands Make Too Few Hormones
His Blood Pressure On Admission Was 74 Over 69
Sodium Levels On Admission Measured Only 124 mmol/L
His TSH On The Same Day Measured 62 mIU/L
White Patches From His Vitiligo Marked His Skin
Darker Patches Came From Too Much Of A Hormone Called ACTH
ACTH Is Released By The Pituitary Gland At The Base Of The Brain
Even Slight Activity Left Him Breathless
Intravenous Hydrocortisone And Saline Stabilized Him
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FOUR DISEASES TIED TO ONE SYNDROME 🧩
The Case Authors Say Autoimmune Thyroid Disease Is Often Overlooked
It Can Appear Alongside Other Autoimmune Diseases
They Say That Happens Particularly In Men
His Case Fit That Pattern
Doctors Settled On Four Final Diagnoses For Him
The List Included Hashimoto's Thyroiditis And Addison's Disease
It Also Included Vitiligo And Pernicious Anemia
Doctors Named It Autoimmune Polyglandular Syndrome Type II
A Doctor Named Martin Benno Schmidt Described It In 1926
He Linked Addison's Disease To Chronic Thyroid Inflammation
Today The Syndrome Is Defined By Addison's Disease
It Must Come With Type I Diabetes Or Autoimmune Thyroid Disease
The Syndrome Occurs In About 1 Person In Every 20,000
His Genome Was Sequenced To Look For A Cause
That Search Found No Gene Change Behind His Disease
His Immune System Markers Showed A Known Risk Pattern Instead
He Carried DR3 DR4 DQ8 And DQ2 Variants On Chromosome 6
That Combination Is Linked To The Syndrome
Doctors Treated Him With Hydrocortisone Fludrocortisone And B12
He Also Took Levothyroxine For His Thyroid
Over The Following Year His Health Steadily Improved
He Returned To His Job Within A Couple Of Months
