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Posted on Mon, 9 Nov 2015 in Thyroid Problem and Hormonal Problems
Question: Do you believe a thyroid lobe, can disintegrate?, Went to Endocrinologist back in 2006, history: diagnosed at age of 17 with footer and hypothyroidism, prescribed prednisone, for 3 months, footer gone, hypothyroidism runs in maternal family. On levothyroxin for twenty years , stable, then began to have level problems which was managed by Gyn and then PCP. ENDO tried to stabilize for five years, kept changing mgs, had a cervical open MRI and found growth on parathyroid gland, sent to surgeon, had full blown osteoporosis and Rheumatoid, the surgeon wanted opinion of Endo, relative to size, Endo said no surgery. It had grown three times size and surgeon opened up found on RIGHT lobe a filter and nodules and growth on parathyroid gland, removed entire lobe, no cancer as stated by pathologist.

Then was dealing with spinal disease -deformity, which caused me to have a complete illiostomy. Recovered from that and four months later had deformity spinal surgery along with stem cell transplant. Went back to Endo demanded he ultrasound in office and scan my left lobe, he Saud it disintegrated. I was on 200 mg of levothroxin and recently had tested by PCP and not good, lowered to 175mg daily, lost my PCP, my Rheumatologist does not accept this, I am having trouble recently swallowing, my tongue back in April when on phone would not work, sleepy, dizzy, slept three hours, very TIRED, all the time , no anemia but stressed , depressed, but then not depressed, just tired All the time...blood work, CBC, CMP normal, Calcium levels o.k., but TSH not, so Rheumatologist does not accept disintegration of left lobe, ordered ultrasound in 2 weeks. Could I have Hisimoto Disease or possibly Thyroid Cancer, thank you in advance, XXXXXXX
doctor
Answered by Dr. Binu Parameswaran Pillai 19 minutes later
Brief Answer:
Could you attach the reports please.

Detailed Answer:
Good day,
Noted your concern and sorry to hear about multiple problems.
In long standing thyroid disease, it is common for the thyroid lobes to get destroyed by the immune system. It can fibrosed and become functionless.

It is possible that, depression also is probably adding on to the symptoms.
What is your last Thyroid blood profile? Could you attach a copy of the thyroid ultrasound and blood works? That would further help in coming to a conclusion.

You stated that you are on numerous medications. I must say that some of the medicines also could contribute to tiredness and sleepiness ( especially some pain killers used to treat rheumatoid arthritis).

Could you attach the list of medications and ultrasound as well as blood works if possible?
Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Binu Parameswaran Pillai 10 hours later
First of all, thank you for your concern and interest in my case. Your reply was extremely encouraging due to just losing my PCP and deciding not to return to my Endocrinologist. Felt going five Yeats with a doctor in San XXXXXXX associated with a very large Research institutions as well as Clinic to include a hospital which treats Diabetes and Glandular Diseases. YOU are probably aware we have a large Hispanic population in San XXXXXXX in which there is a hi h amount of Type 2 Diabees amongst the population as well as with Endocrine Diseases associated with Diabetics as well, I am Caucasian, 55, diagnosed with Hypohyroidism at age 17' which runs amongst the maternal side of my family. It was originally discovered that I also had a footer, treated successfully with a regiment of prednisone over a three month period of time. I remained stable for twenty year's treated by my Gynecologist then PVP of Twenty years. However, as .mentioned, full blown osteoporosis, after having several broken bones, which it was recommended I have a Dexa Scan, thus the diagnosis then, I developed these opaque bumps at the bade of my knuckles so I recommended that my PCP run a CBC, CMP, which I had always After I analyzed myself about three Yeats of labs. High SED rates, high platelet counts, very high in both, and my Hypothyroidism became irregular, not steady as it had been over prior twenty years. EARLY, 38 in age, Peri Menopause, stopped mensus at age 40.

It was time to go to both an Endo and a Rheumatologist. The Endo, as mentioned ed was unable to stabilize my Thyroid levels, but just kept changing the strengths of my Levothyroxin medication, which I had bottles of about every kind of dosage available prescribed over a four year timeframe. He treated my osteoporosis, with Foreo injections, finally the infusions in which you should have once every two years but we started with having one each year for so years in a row, then skipped a year, had one more, Then tested this year and I am non osteoporosis or osteoporosis.

The Rheumatoid was treated with Methotrexate only over a period of three months, at times, flare ups, meaning Sed rates high and platelet counts up as well as joint pain and stiffness in hips, knees, ankles, and of course hands. However I have been also on a regiment of pharmaceutical Omega 3 only, as well as Limberal, Pensede, Voltaren Gel, and Flechtor patches. Please keep in mind that with the growth discovered on my parathyroid, explained fractures in my spine, as well as ribs, feet, both one month a par from each other and dress fracture on the anterior side of my fe""?.oral neck of my left hip, broken tibia, which casted for three months, then developed Refex Sympathetic Dystrophy in. Both legs, very painful, put on Pletyl for several years by PCP. Had developed Sciatica when I began travelling for business via car at age , 37. First year very conservative treatment, Chiropractor, acupuncture, Tylenol 3 , along with NSAIDES but developing peptic ulcers so no more oral Nsaides. Exercise, stretching, walking but activity exacerbated the pain and developed neuropathy and sent to Spinal Orho and Chronic Pain Specialist. Had every study done, mylograms, etc, could not see any problem, but the pain then excruciating....Spinal ORTH went in as exploratory, just at L4 level, bone .not seen on CT, was hitting nerve root, a XXXXXXX rotor rooted job done but still awoke from surgery in pain, we went 8 months, decided to go back in at L4/L5,L5/S1 did non hardware fusion, used bone from this level, osteoarthritis or spondiothosis, and fusion did not take. Pain Specialist implanted Dorsal Column Stimulator, leads fell down twice plus, stimulator exacerbated nerve pain. I turned off, was on Amitriptyline, Oxycontin and Robaxin or XXXXXXX at times. Also Neurontin and decided to go to Neurosurgeon. Had ESIs in between. NEURO decided to do a two level fusion with HARDWARE, more ESIs, then L3/L4, fused as well as Laminectomy, took stimulator out per my required. Then complication, development of a huge Sedona, required surgery, Gall Bladder and Pancreatitis developed, Gall Bladder removed, then L3 fractured, fused L 2/L3, went home, 3 weeks later, all fell apart, osteoporosis, plus Lumbar fell deep down into pelvis, Will created, Emergency surgery, New Neurosurgeon. He felt with putting it back together, I had a Medtronic Pain Pump implanted with Buvivocaine, Clonidine, Baclofen, 30percent concentration of morphine...rotated now not to exceed 10mg of compounded meds over 24 hours.

Had vertebral pleural fracture, then, Kyphoplasty experimental, but used twice, another new pump installed, Neuro took leads out from previous Stimulator and in 2006 after 17 or so back to include pumps, lead revisions ex, and now L2/l3 fused, called it quits and All the Endocrine issues began, and Osteoarthritis, Rheumatoid, knee surgeries, illiostomy, Development of Cherote Syndrome (French) developed, bent forward 90degrees forward for nine years, diaphragm moved up, encompassing lower lungs, sleep apnea, etc. Last two years the illiostomy done, bleeding out, went back in are separates from small intestine, no inertia for stool to move up and around then down, Causa Eqina Syndrome, no L5, vertebra or disc, deformity surgery with stem cell transplant and then developed drop foot fell shattered left knee, ER surgery...Cervical, Rt shoulder and left knee needs to be 're done and braces for drop foot, peripheral nerd damage, both XXXXXXX but still here, lives alone, changed to Humana Choice PPO, fighting with them due to denials, paid off on filing grievance with Medicare, now have a RN assigned to me, will see face to Face every week, No additional costs due to acutely Lon term Chronically ill Disabled Medicare recipient.

But, tired All the time, eating small bits a day and blending organically, so far o.k. but neurogenesis bladder, take bethnecol to urinate. DEPRESSION comes and goes, been on Prozac for twenty years and added Welbuterion XL, take Reglan as needed as well sometimes Lomotil and Dexilant. Take Probiotics, Cinnamon, honey, Tumeric in my organic smoothies. DRINK BOOST HIGH PROTEIN, HIGH CALORIE,

Just diagnosed with Connective Issue Disease. TSH A's you said off, When I get the Ultrasound and New Labs to test for Hisumoto, etc, I will get scanned as ,pdf files and upload. Trouble swallowing, C3 , disc, is going and Sponiothosis from C3-C7, also Scoliosis in Cervical and upper Thoracic.

You now have a good history...what do you think? Morbidity rate not great..but I try to take one day at a time and I know I no way am physically ready for another surgery till another six months. Hope this helps I just lost my PCP and need an Endo but Rheumatologist is acting PCP for nose.

I really need some help or 2nd opinion till I can get new doctors, of course agree to your TCs, respectively, XXXXXXX
doctor
Answered by Dr. Binu Parameswaran Pillai 18 hours later
Brief Answer:
Can help you dealing with hormonal issues

Detailed Answer:
Hi Dear,
Sorry for the late reply. It was a very lengthy history and in detail indeed . Hmm, you seems to have multiple issues and i am sorry to hear about them.

From the history, it unfolded that you have hyperparathyroidism as well which is linked to osteoporosis, fractures as well as depression.
With the multitude of problems, yiu seriously need a multi disciplinary team which should include a PCP, endocrinologist and rheumatologist.

There are several issues
1) Hypothyroidism
2) Hyperparathyroidism and osteoporosis associated with it.
3) Joint pains and conective tissue issues.

I am unable to provide you with all the answers , but look, i can help you dealing with hypothyroidism and hyperparathyroidism.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Binu Parameswaran Pillai 7 days later
Sent another more specific, questions on Thyroid, and immune.

Also rated 5 star, thank you so much, XXXXXXX
doctor
Answered by Dr. Binu Parameswaran Pillai 1 hour later
Brief Answer:
Thank you

Detailed Answer:
Thank you. . Please feel free to ask further if you have more questions. If there are no other questions, you may close the query.

Wish you good health.

Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
Dr.
Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1418 Questions

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