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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can hypothyroidism cause swelling of the wrists and fingers with joints pain and stiffness?

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Dr. Chobufo Ditah

General & Family Physician

Practicing since :2009

Answered : 6189 Questions

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Posted on Tue, 9 Oct 2018 in Brain and Spine
Question: Hi, I'm a 51 year old female. slightly overweight, but active at 4-6x per week exercise. I work full time. I have had mysterious paresthesias for about 6 years now, mostly affecting my hands and forearms. bilateral and other parts of body affected sometimes. Screenings for autoimmune diseases and other things like MS, etc. are negative. Last week my wrists and fingers swelled considerably with joint pain and stiffness. My knees, neck and ankles were also tight and stiff and ached. It was a progressive episode over about 5 days that ultimately ended in ER with a prescription for Medrol and suggested followup with primary and a rheumatologist. Only "abnormal" findings were slightly elevated ESR and Eosinophil count. WBC and platelet count were low end but within reference ranges. I do not have a history of allergies or asthma. I do not have a parasitic infection. I have hypothyroidism but it is well under control and lab tests from yesterday confirm this. Chemistry panel is perfect. THe Medrol worked very well, but as I step down the dose I'm feeling more pain in my hands and wrists. Doc followup yesterday repeated CRP, ESR, thyroid, and did ANA and RF.
All normal or negative. Waiting to get in to rheumatologist. Newest drug onboard is Singulaire due to cosmetic surgery in January. Otherwise I'm on Escitalopram, levothyroxine, multivitamin, vitamin D, and just finished last dose of Medrol today. Any insight for me? What would be the next step? TIA
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Answered by Dr. Chobufo Ditah 1 hour later
Brief Answer:

Will like your doctor to rule out rheumatoid arthritis!

Detailed Answer:

Hi,

Hypothyroidism, if it is caused by an autoimmune destruction of the thyroid, means you are at increased risk of other autoimmune diseases.

The nature of your joint pain and the symmetric nature raises enormous concern about Rheumatoid arthritis.

True, RF is normal but there are a goof number of persons with this disease condition though with a negative RF screen.

I will recommend you see a rheumatologist as already spelt out by your treating doctor.

If need be to be on steroids for proper pain and inflammation control while the exact cause is identified and addressed, I will do so.

You need to steroids for at least three weeks at high doses before some of the feared side effects set in.

Keep me updated on how this unfolds. I wish you well and look forward to more exchanges as soon as I hear from you.

Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Chobufo Ditah 1 hour later
Thank you for your insight. I will let you know what the rheumatologist determines and in the meantime manage symptoms with my primary care physician.
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Answered by Dr. Chobufo Ditah 3 hours later
Brief Answer:

I look forward to your updates!

Detailed Answer:

Hi,

I look forward to your updates and do wish you well.

Hope I have answered your query.

Take care

Regards,
Dr Chobufo Ditah, General & Family Physician
Above answer was peer-reviewed by : Dr. Nagamani Ng
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