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Diagnosed with hashimoto Thyroiditis. Taking synthroid. Having severe knee pain. Suggestions

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Practicing since : 2007
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My daughter is 24 tomorrow and has been diagnosed with hashimoto Thyroiditis in Nov. 2012 ans was put on 25 mg of synthroid. Since then she has been complaining of severe knee pain. lower back pain, abdominal pain and seems to be getting worse by the day. Now just 1 month ago her blood test showed an increase in her white blood count she has also been complaining of constant urgency to urinate. The Dr. said her Thyroid is already burned out and it is an auto immune disorder and it is now attcking her tissues and wants her to see a rhumetoid Dr. They have put her on prednisone for the inflamation now to find out she has been getting oxycodone off the street and claims that is the only thing that helps with the pain because the Dr.s refuse to give her pain medication. She has been acting out with a tremendous amount of anger towards me and cut up my cloths, cord to my curling irons and is obsessed with my babys death from a premature birth only 13 months after she was born and was also a premature baby of 27 weeks. She is very slow in learning and was diagnosed with adhd at the age of 7 and put her on adderal of which she only took it for a few months because she didnt like it. she has always had sleep issues and was also put on clonidine when she was 8 but was constantly wetting the bed so i took her off of it. She had to graduate from an alternative school because she was flunking special ed classes. She has only had 2 jobs in her life and they only lasted 1 month. She is always having sex with every man she meets pretty much on the first date. She has no friends now and is in a toxic relationship with a 25 yr old man who also does not work and is suffering from depression and only uses her for sex and what ever drugs she can get, I am on oxycodone from a herniated disc and have to lock up my medication or she steals it. She has stolen from everyone in her family very expensive and sentimental jewlery inclusing my wedding rings and lies constantly, she lives in fantacy land and i can not get thru to her. My husband and i are seperated but have a very good relationship. I also have a 20 yr old son and instead of consentrating on her brother that is alive she is always at the cemetary visiting the babys grave and has recently taped all of the babys pictures that passed away. He only liived 42 days he never came home from the hospital. She is violent with me she has hit me and called the police on me 3 times for trying to disciplin her. She refuses any type of treatment and constantly talks about death and she hates her life and wants to die. I dont know what to do i am afraid of her so she is now living with her father and granparents. All she does is yell and scream at me and she twist it around to be my fault she is the way she is. She has no interest in working . all she wants to do is have a baby and can not get pregnant Thank God. I am afraid this disease is attacking her brain. I have had her to the ER 2 times in the last month and each time she gets more angry and depressed because she said she is in so much pain and know one believes her and refuses her pain medicine when she claims that is the only thing that makes her feel better. The whole family has pretty much shunned her because they are afraid to let them in their house because she steals and is on drugs. The only thing that calms her down is marijuana. What do you do when she refuses treatment. I wont let her get her drivers lisence because i am afraid she is going to have a seroius accident she is very slow reac.s at this point. tinf. She can not count money very well and really cant tell distance or even comprehend weeks and months or time. What is wrong with her? She has always had anger issues and throws or hits things and and has hit me in the head with a phone 5 times in a row because i tried to take her lap top away. She does not even know how to fill out an application right, but yet she has a graet memory and is very smart in some areas. She can repeat a whole movie word for word. I dont understand what is wrong with her and neither do the Drs at this point. Please help me?

I can upload her latest blood test results shortly
Posted Sun, 2 Jun 2013 in Mental Health
Answered by Dr. Srikanth Reddy 31 minutes later
Thanks for choosing health care magic for posting your query.
I would like to thank you for providing details extensively and would also like to appreciate you for handling your daughter with patience.
After going though whole of your account in detail, there are three possible diagnosis for your daughter:
1) Attention deficit hyperactivity disorder
2) Conduct disorder
3) Borderline personality disorder
or it could be a combination of all of them. The final diagnosis is possible only after a detailed mental state examination of your daughter.
i understand that you have tried her on adderal and it seems that she has not responded well. But then she can be given a trial of methylphenidate or Bupropion. Its an old concept that ADHD burns out by adulthood, but now it is said that it persists in adulthood as well and leads to lot many other psychological problems as well.
She certainly has some personality disorder, bordering on bordreline or dependent personality disorder. these personality disorders require loads of commitment from the psychiatrist and need extensive psychotherapy. The drugs are not a good treatment though mood stabilizers like carbamazepine may help her.
You can discuss these issue with the treating psychiatrist, who can help you out with the case.
If the outpatient management doesnt help then she should be considered for in-patient care as well.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you can close the discussion and rate the answer accordingly.
In future if you wish to contact me directly, you can use the below mentioned link:

Wish you good health,
Dr. Srikanth Reddy M.D.
Above answer was peer-reviewed by
Follow-up: Diagnosed with hashimoto Thyroiditis. Taking synthroid. Having severe knee pain. Suggestions 1 hour later
Thank You Your answer is pretty much what i was leading towards and i will look into the recommended medication you have mentioned. Do you think it is a good idea to put her back on suboxone for her opiod addiction. She was on it for 4 months last year and she was much more manageable but now with the hashimotos i dont know if it is a good idea. I know the best thing is nothing but she said without it she experiences uncontiollable and dibilitating anxiety. I dont know if she is acting, exagerating or what. i do know we went to mexico in Feb of this year and she was off of evrything for 12 days but waas full of anxiety. What is your opinion?
Answered by Dr. Srikanth Reddy 35 minutes later
Hello again,
Thanks for the follow-up question.
Suboxone has buprenorphine and naloxone , and is supposed to be taken sublingually (keeping below the tongue).
It will not interfere with her thyroid treatment. Anxiety is sure to occur if the opiods are withheld abruptly. She should be back on Soboxone as advised by your treating doctor and the dose can be increased gradually, looking at her tolerance.
As far as her anxiety is considered, she should take propranolol or a short course of benzodiazepines. That will help her in reducing the anxiety.
Thanks and regards,
Dr. Srikanth Reddy
Above answer was peer-reviewed by
Follow-up: Diagnosed with hashimoto Thyroiditis. Taking synthroid. Having severe knee pain. Suggestions 9 minutes later
Should i just wait until i get her evaluated by a psychiatrist? It is advisable to use the suboxone along with 1 of the other medications you had mentioned or is it 1 or the other or a combination of both. Not sure will the suboxone interfere with 1 or more of the other medications you had suggested or should i get her on the suboxone immediatly to just get her started back in the right direction and then let the psychiatrist take it from there and let him decide what to do from there on? Thanks
Answered by Dr. Srikanth Reddy 9 minutes later
Hello again,
You should start her on suboxone and let her get somewhat better. All the medications for her ADHD and possible depression and personality disorder can be started after her initial symptoms of opiod withdrawal have subsided.
If she doesnt co-operate in outpatient basis, then a possibility of inpatient care should be considered.
Also one thing I missed out mentioning was that she has indulged in lot many sexual encounters and drug abuse as well. Some of them might be even unprotected. If she is willing get her also tested for HIV and cousel her by an expert about the safe sexual practice and explain her that even a condom is not a 100% garuntee that HIV will not spread.
Thanks and regards,
Dr. Srikanth Reddy MD'
Addiction Specialist
Above answer was peer-reviewed by
Follow-up: Diagnosed with hashimoto Thyroiditis. Taking synthroid. Having severe knee pain. Suggestions 5 minutes later
Yes i agree I think the Dr did test her for stds and hiv recently i have to check and make sure and i have had several discussions with her about that but she has a very low self esteem but also claims she was using condoms until this boyfriend that she is seeing now. Your advise has helped me tremendously and i appreciate it as you can see this is keeping me up at night worrying about what to do. Thank You!
Answered by Dr. Srikanth Reddy 10 minutes later
Its our pleasure to be of help to you.
When you take her for cognitive behavioral therapy, some of the sessions can be reserved for motivating her to follow safe sexual practice.
Along with your daughter, do take care of your self. In such conditions, the caregivers burden is huge and that causes burnout.
Maintain a positive life with regular exercise and good diet and keep socializing.
If you are healthy, you can take care of your daughter. Its your responsibility to help her but its not your responsibility to get er best of the results.
Wish you good health.
Dr. Srikanth Reddy MD
Addiction Specialist
Above answer was peer-reviewed by
Follow-up: Diagnosed with hashimoto Thyroiditis. Taking synthroid. Having severe knee pain. Suggestions 15 minutes later
I am in the process of scheduling laser surgery as well i have weaned myself off of it before and i can handle it but she cant because i dont want to take it anymore either but i have get my back fixed because i am in too much pain and that will help her to know i stopped and its not in the house and that will help her because your right i am so stressed its making me sick and i have to fix me to be strong for her. Thanks again i have alot of work to do but again you have given me more answers then i have been getting all in 1 night. thank god for this website!!
Answered by Dr. Srikanth Reddy 1 hour later
Hope your back problem settles soon. Then you will be in better position to take care of your daughter. Unavailability of opioids will surely help in reducing your daughter problems.
I am glad I could be of help to you.
Thanks and regards.
Dr. Srikanth Reddy M.D.
Above answer was peer-reviewed by
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