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I have been diagnosed with Hashimoto's thyroiditis, but I am worried about lupus. Please help.

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At February 12, 2021
Reviewed AtJuly 20, 2023

Patient's Query

Hi doctor,

I recently had some blood work come up abnormal after going to my PCP for extreme fatigue (as well as a myriad of other symptoms). My WBC and platelets were both a little low. He said something was destroying my platelets, so he wanted to run some more tests. Here are my abnormal results- My thyroid peroxidase was 179 (0-34 is normal), and my thyroglobulin antibody was 2.5 (normal 0.0-0.9) but I think those are both Hashimoto's thyroiditis. My FANA (fluorescent antinuclear antibody) staining pattern results say 1:1280 with homogeneous patterns. The hematologist said it seemed likely that I had lupus and referred me to a rheumatologist, but I cannot get in until the fall. I cannot stop wondering if I have lupus or if it could be something else. Here is a little bit of background to help. My symptoms include extreme fatigue, headaches, short episodes of feeling almost like I am drunk (I feel like I m moving slower, brain fog or cannot remember what I am trying to say, cannot think of the right words, I feel like I kind of stumble or off-balanced), chest pain, the sun makes me very exhausted, dry skin, puffy eyes, petechiae, occasional knee pain, pretty severe anxiety, and this is probably not related to anything but can't hurt to mention. Still, I get this weird wiggly or tingly feeling under my nose and on my ankle sometimes, different than anything I have ever felt. I also get this feeling like warm water is running down my ankle occasionally. I have also been diagnosed with quite a few things- Hashimoto's (no medication as my thyroid is always in the normal range), von Willebrand disease type 1, lichen sclerosis, POTS (postural orthostatic tachycardia syndrome), recently developed pulmonary, tricuspid, and mitral regurgitation (it was not there when I last checked about three to four years ago, I have had quite a few heart tests due to the pain), as well as asthma, unicornuate uterus, and hearing impairment due to my inner ear not forming right. My family has some history of MS (multiple sclerosis), Graves's disease, psoriasis, Raynaud's, and some other rheumatic disease I cannot think of. I would also like to mention my platelets and WBC were fine, and previously they were slightly below normal and now even more below normal. I know this is a lot so please know how appreciative I am if you look at this, but my question is, do you think it is likely that I have lupus, or could it be something else? Just my Hashimoto's, Multiple sclerosis? Thank you so much.

Hi,

Welcome to icliniq.com.

There are multiple problems but do not worry, there are solutions to all these problems, but we have to step by step first; you told me Hashimoto's thyroiditis, so most of the symptoms you are mentioning are related to that only so for controlling that I would require your fresh FT3 (free triiodothyronine), FT4 and TSH (thyroid-stimulating factor) levels. You have to get tests done for SLE (systemic lupus erythematosus) - anti dsDNA, anti-histone antibody, complete ANA (antinuclear antibody)profile. Complete Blood Picture with ESR (erythrocyte sedimentation rate), anti -CCP antibodies, kidney function tests. Complete sugar profile with HBA 1C. With all these tests, we can narrow down our diagnosis and start a complete treatment, but till then, you can start

1. Tablet Tryptomer 25 mg (Amitriptyline) in the night for ten days (excessive sedation is a side effect)

2. Tablet Wysolone 20 mg (Predsisolone) after food for seven days (do not stop abruptly)

3. TabletZerodol-SP (Aceclofenac,Paracetamol and Serratiopeptidase) one tablet twice daily for five days.

The rest of the management strictly depends upon your reports.

Thanks

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Kusumakar Srivastava
Dr. Kusumakar Srivastava

Diabetology

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