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Dr. Andrew Rynne

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Taking thyroxine for hypothyroid. What is the cure for Meniere disease?

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Dr. Shailja Puri

Pathologist and Microbiologist

Practicing since :2006

Answered : 7468 Questions

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Posted on Wed, 11 Dec 2013 in Thyroid Problem and Hormonal Problems
Question: TPO ab levels I have just had my antibodies done for the first time ever in 23 years of being hypothyroid. The result was alarming at least to me 1121 ng/ml. The range was (0.16-20.00) . My anti TG was normal at 24.37 UI/ml (Range 0.24-40). My other thyroid tests were as follows My FT3 is 1.23 pg/ml (Range 2.00-4.00) My FT4 is 0.46 ng/dl (Range 0.70-1.7) and my TSH is 183 uUI/ml. Range is (0.250-5.00) I am now on a whopping dose of thyroxine of 275mcg (yes that is correct)and yet my levels keep getting worse and I just feel worse every day. I also have hyperaldesteronism and hyperparathyroidism. They have found nodules on my thyroid and fibroids in my womb and I have hypertensive heart disease, just had a heart attack 3 weeks ago where they put in a stent and I have Ménière's disease and I am coeliac. I am sleeping 20 hrs a day and feel awful.
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Answered by Dr. Shailja Puri 1 hour later
Brief Answer: All ailments have to be managed separately Detailed Answer: Hello, Thanks for posting your query on XXXXXXX It is evident from your history that you are suffering from a number of ailments and all have to be managed separately. Hypothyroidism has to be managed by appropriate doses of thyroxine (which you are already taking). The nodules on the thyroid gland need to be investigated. An ultrasound followed by aspiration cytology needs to be done. You can consult your doctor for prescription of these investigations. Hyperparathyroidism occurs due to adenoma of single parathyroid gland or due to hyperplasia of all four glands. A sestamibi scan needs to be done to find out the cause of hyperparathyroidism. A single adenoma is removed surgically. In case of hyperplasia, parathyroid tissue is removed leaving behind few grams of the parathyroid tissue for the secretion of parathormone. The cause of hyperaldesteronism also needs to be found out. It could be due to adrenal tumor or hyperplasia of the adrenal gland. Specific investigations need to be done to find the cause of hyperaldosteronism. Management will depend on the result of the investigations. Hypertension needs to be managed by anti-hypertensive drugs. Celiac disease needs to be managed by gluten free diet. Menieres disease is managed by conservative approach (medication). Consult an ENT specialist for the problem. if you have more concerns, feel free to contact me. Thanks Dr Shailja P Wahal
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Shailja Puri 18 minutes later
I have already had the tests you mentioned for both my thyroid gland which the surgeon says has borderline cells and also thyrotoxic cells and my parathyroid glands which tested positive for hyperplasia and was awaiting a date for surgery. They have just started tests for my hyperaldesteronism. However due to both my unstable high blood pressure and my recent heart attack these have now been delayed. I have been on a gluten free diet for 10 years and my coeliac disease is well controlled. I have an ENT but he is treating my Menieres by having me follow a low sodium diet, medication and is also nowtalking about a surgical intervention. My question is although these are separate illnesses many of them are autoimmune in origin. Could there be a common cause as many of them particularly the hormone problems appeared simultaneously on or around 2 years ago, plus although I have been given a huge increase in thyroxine from 150mcg to 250mcg, my antibodies and TSH are still increasing and my T4 and T3 are dropping rapidly. I am exhausted after the heart attack but I have been sleeping more than 20 hrs a day and I am told it can take up to an hour to wake me using water, pinching me, shaking me etc. Is that my heart or is it another one of my conditions.
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Answered by Dr. Shailja Puri 9 minutes later
Brief Answer: MEN 2 syndrome is suspected and sleep study needed Detailed Answer: Hello and welcome again, The endocrine organs are involved simultaneously so there is strong suspicion of syndrome called multiple endocrine neoplasms 2 (MEN 2). This syndrome is caused by mutation of chromosome 10. Chromosomal studies need to be done. The cause for excessive sleep needs to be found out. You need consult a neurologist. This problem is unlikely to be due to cardiac ailment. If you have more queries, i will be glad to answer. Dr Shailja P Wahal
Above answer was peer-reviewed by : Dr. Yogesh D
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