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Diagnosed with Hashimotos thyroiditis and primary biliary cirrhosis. Taking synthroid. Abdominal pain and acid reflux. Cure for symptoms?

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I had been diagnosed with autoimmune diseases. I have Hashimotos thyroiditis and primary biliary cirrhosis and have been taking synthroid and ursodiol for treatment of same. I was hospitalized in April, 2012 due to pleural effusion and pericardial effusion. I had a cardiocentisis and thorancentecis (sorry for the spelling) and was subsequently treated with prednisone and colchicine over a period of 8 months. During this hospitalization, they ran tests on the fluid and found a "non-specific" cause. They also checked for cancer, lupus with negative results. I started feeling abdominal pain, (acid reflux) and consulted with my gastroenterologist and had an endoscopy which confirmed hiatal hernia and acid reflux. Was on pantaprazole and now on dexilant. This year, I was put on imuran for rheumatoid issues and to treat my chest pain. Stopped the Imuran because my hair was falling out. For over a month, I have felt chest pain, upper back pain, left neck pain, a suffocating sensation, along with extreme acid reflux and my face is constantly flushed. Both my cardiologist and pulmonologist don't see any effusions or issues of concern in my heart and lungs. My rheumatogist put me on medrol (2mg) and cymbalta (30mg). Cannot tolerate the cymbalta after one pill. I am very distressed over this as the symptoms continue but I have no resolution.
Posted Wed, 13 Nov 2013 in Lung and Chest disorders
Answered by Dr. Shashi Dangwal 8 hours later
Brief Answer:
Pain could be due to rheumatoid arthritis.

Detailed Answer:
Hello XXXX,

Thanks for posting your query on XXXXXXX

All your ailments seem to be of autoimmune nature. Generally a person having autoimmune disorder has involvement of more than one system as is in your case also. You have been put on correct line of treatment which you must take regularly under supervision of your treating physician.

Coming to the chest and back pain, since heart and lung causes have been ruled out by your doctor, it could be because of rheumatoid arthritis or it could be musculoskeletal pain. Medrol that you are taking may help in relieving the pain and has to be taken regularly.

Acid reflux should be well controlled as sometimes it may also cause this kind of pain and may also mimic pain due to heart and lung disease.

Since you are already taking treatment for all your problems, i suggest you do some physical exercises. Start with walking short distance gradually increasing it to build up your stamina and then enrolling yourself with a trained physiotherapist. Pl take care of your diet ensuring that it does not worsen your acid reflux. Take calcium, vit D and vitamin supplements. You may take pain killers as short courses when the pain is aggravated after consulting your doctor.

If you are not tolerating cymbalta, ask your doctor to prescribe you a substitue. You may try Pregabalin or Gabapentin but only after consulting your doctor.

Take care.
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