Autoimmune Mechanism and conditions Archives

Desperate patient needs advice

Dear Doctor Stoll

My name is Mark.

I recently found your website and would like to briefly describe to you my symptoms and ask for your opinion if it could be related to thyroid problems.
During the last 3.5 years I have seen numerous doctors without much success and am still trying to find out the cause of my problems.
I am 30-year-old man. I do not drink or smoke. My energy level is good as well as my sleep patterns (no insomnia). I have not noticed any difference in these two since the start of my problem. My weight has not changed.

Recent Blood test results:
High ANA (ANA titer 1:320), Speckled pattern
High Anti thyroid peroxidase (microsomal) antibody test, was done 2 times: 188 and 199
(normal range 0-35)
TSH varies from 2.6 (most recent) to 3.7
Free T4 is 17
All other antibody tests such as ENA panel and Anti DNA test for connective tissue disease are normal

My problems started suddenly 3 years ago with sharp acute pain in my left foot (the center of the pain was in the second toe and the bone/tendon, which leads to the second toe). For about 1 month I could not literally walk. The pain became worse with walking and even light physical activity in a gym. I felt as if needles were put in my foot near the second toe. MRI and CT Scan did not show any abnormalities. I had 2 cortisone injections with no improvement. With time the foot pain became more manageable and I learned what not to do to provoke pain. It gets worse if I were to do some weight exercises in the gym which I avoid for the moment.

2 year ago, I started to have backache. The onset was also sudden. It gets much worse with the weight exercises, even very light ones like bench press. MRI of L-Spine showed no abnormalities, no compression on adjacent neural structures. CT Scan showed minimal increases uptake in the SI joints compatible with sacroiliatis. I was told that CT scan was in the normal range.

My biggest problem started 1.5 year ago during my first full-time employment as an accountant after finishing University studies. The first symptoms started 3 months after the beginning of the employment. During my work I was supposed to use computer but these were not considered heavy computer related responsibilities. I developed very acute shooting type of pain in both hands. The pain was so strong that I had to take several weeks off in hopes that the pain would stop. It did get better ~50% but when I came back to work I got worse again. Even when I was holding a newspaper I often felt sharp electric shock type of pain in my hands. The pain was going from my wrist to the fingers, on top of the hand. My nerve conduction, EMG tests were normal.

Because of the pain in my hands I had to leave my work and have not been working since January 2002.
I read that muscle pain can be due to abnormal thyroid function.
Since March of 2002 I have had recurrent colds every month, often twice per month. These colds can be characterized as flu type symptoms. I have hot flashes all the time when i have these colds, feel feverish as well as stuffy nose and sore throat.

I am in a very desperate situation, as I can not perform computer work if I am employed. Also the colds and flu like symptoms are extremely exhausting.
My rheumatologist downplays my increased thyroid peroxidase (microsomal) antibody test and said that my TSH test is within norms. He suggested that it might be a connective tissue disease.

In your opinion, could thyroid malfunction be the cause of my problems given the fact that my TSH test is within the norms however my thyroid antibody are greatly elevated.

I read that some doctors think that elevated thyroid antibody is a problem that needs to be treated even if TSH is normal.

I really appreciate your response.

Thanks a million,

Mark

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