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Can Degenerative Spine Changes And Hypothyroidism Be Related?
Question: Here is what has gone on:
Had neck pain for almost 2 weeks. Started having right sided facial numbness as well as problems with writing, numbness in right thumb, slow thinking, and visual disturbances. Went to doctor and after she found out I fall over backwards when I stand with eyes closed she sent me to ED. I spent 3 days in hospital. Normal EKG, head CT, Brain MRI, and EEG. Only labs abnormal was low calcium and high triglycerides (they started me on rosuvastatin and ASA while in hospital). Since out of hospital I went to eye doctor who said eyes normal except that "the normal hole" in the optic nerve was smaller than it was before (had yearly exam 1 1/2 months ago) but the optic nerve itself was not swelling. Said can sometimes be caused by increased CSF pressure. Had Cortisol levels checked - reference range for the lab is 6.7 to 22.6 - at 8am was 6.2 and at 4pm was 1.2. Had MRI of neck which showed "C5-6 and C6-7 have prominent degenerative annular bulging narrowing the AP dimension of the spinal canal to 10mm at C5-6 and 9mm at C6-7.
I guess my questions are 1. Can all these be related? 2. Any idea what is going on with me?
I forgot to put in that after testing TSH they upped my Synthroid. (I always forget which way the TSH shows hypo or hyper)
Had neck pain for almost 2 weeks. Started having right sided facial numbness as well as problems with writing, numbness in right thumb, slow thinking, and visual disturbances. Went to doctor and after she found out I fall over backwards when I stand with eyes closed she sent me to ED. I spent 3 days in hospital. Normal EKG, head CT, Brain MRI, and EEG. Only labs abnormal was low calcium and high triglycerides (they started me on rosuvastatin and ASA while in hospital). Since out of hospital I went to eye doctor who said eyes normal except that "the normal hole" in the optic nerve was smaller than it was before (had yearly exam 1 1/2 months ago) but the optic nerve itself was not swelling. Said can sometimes be caused by increased CSF pressure. Had Cortisol levels checked - reference range for the lab is 6.7 to 22.6 - at 8am was 6.2 and at 4pm was 1.2. Had MRI of neck which showed "C5-6 and C6-7 have prominent degenerative annular bulging narrowing the AP dimension of the spinal canal to 10mm at C5-6 and 9mm at C6-7.
I guess my questions are 1. Can all these be related? 2. Any idea what is going on with me?
I forgot to put in that after testing TSH they upped my Synthroid. (I always forget which way the TSH shows hypo or hyper)
Brief Answer:
Cup to disc ratio/ Degenerative spine changes/ hypothyroidism
Detailed Answer:
Hello and welcome,
I appreciate your concern...
The focal neurological deficit with the history of fall prompted the brain imaging to rule out especially a possible bleed or space occupying lesion.
Most likely the ophthalmologist was referring to the optic disc, cup to disc ratio. If the fundus was normal and there was no papilledema then there is unlikely to be a cause for concern.
The cervical spine MRI report shows degenerative spine changes at the levels described. If there are any symptoms associated with pain and numbness in the extremities then nerve conduction studies should be done. Symptomatic control at this stage would suffice as no surgical intervention is required at this juncture.
NSAIDs, muscle relaxants, Pregabalin, physiotherapy and in severe cases prescription based stronger pain-killer like Tramadol can be added.
The TSH would be high as you are hypothyroid so the Synthroid dose is increased accordingly.
In my opinion, the issues you described are mostly unrelated to each other. There isn't one single disease entity or explanation to describe the root of all these symptoms.
Wishing you best of health. Feel free to ask further.
Thanks.
Cup to disc ratio/ Degenerative spine changes/ hypothyroidism
Detailed Answer:
Hello and welcome,
I appreciate your concern...
The focal neurological deficit with the history of fall prompted the brain imaging to rule out especially a possible bleed or space occupying lesion.
Most likely the ophthalmologist was referring to the optic disc, cup to disc ratio. If the fundus was normal and there was no papilledema then there is unlikely to be a cause for concern.
The cervical spine MRI report shows degenerative spine changes at the levels described. If there are any symptoms associated with pain and numbness in the extremities then nerve conduction studies should be done. Symptomatic control at this stage would suffice as no surgical intervention is required at this juncture.
NSAIDs, muscle relaxants, Pregabalin, physiotherapy and in severe cases prescription based stronger pain-killer like Tramadol can be added.
The TSH would be high as you are hypothyroid so the Synthroid dose is increased accordingly.
In my opinion, the issues you described are mostly unrelated to each other. There isn't one single disease entity or explanation to describe the root of all these symptoms.
Wishing you best of health. Feel free to ask further.
Thanks.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Answered by
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