Discussions By Condition: I cannot get a diagnosis.

Migraines, Sleep Apnea, Graves-> Hypothyroid + Hot Nodule, Low T and Low Vit D :)

Posted In: I cannot get a diagnosis. 2 Replies
  • Posted By: sparkinson
  • July 18, 2009
  • 01:46 AM

These are all the conditions I have been diagnosed with and am being actively treated for. Are these part of a bigger problem, or am I really that unlucky to have all these separate, chronic, illnesses?

I have been tested for a myriad of diseases, including Lupus, Rheumatoid factor etc. I had an MRI that showed a potential tiny lump in some not very important part of my head - if such a place exists :) - neither the Endo nor the Neurologist seemed bothered by it. (I have a followup in a couple of months to see if it has grown that will include a more detailed scan of the pituitary) I will have blood tests for prolactin and one for the genetic disorder hemochromatosis to figure out why my Testosterone is low.

So, can anyone put these problems together into one disease / condition, or am I just plain unlucky with a lot of illness'? It's so hard to balance all these hormones whilst trying to avoid the persistent continual headaches, the occasional once per week migraine (now they are mostly under control) and the extreme fatigue and brain fog that goes along with all of these conditions.

FWIW, I am taking 20mg Nortiptyline and 20 mg Citalopram for the Migraines (I don't have any depression - I was sent to a psychiatrist and psychologist who both thought I was in remarkable good spirits considering all my illnesses and I also don't notice any mood changes on them) these generally seems to help a lot without much in the way of side effects.

Up to 3000MG Gabbapentin (Neurontin) per day when the headaches are bad- that stuff is an absolute marvel, but it makes you eat like a moose and sleep like a bear.

The usual 100 MG Immitrex if I catch a Migraine coming on.

180 MG Armour Thyroid (just upped from 120 and possibly responsible for my current 3 day headache)

5MG Androgen for the Low T, just started a few days ago and also possibly responsible for this headache.

CPAP for the Sleep Apnea.

Just finished 25000 IU Vit D supplement once per week.

Also take Migralef (lots of Magnesium) for the migraines too.


Thanks in advance for any insight anyone may have,

Simon.

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2 Replies:

  • Graves disease is an autoimmune disorder due to antibodies which stimulate the thyroid gland. This can be associated with various other autoimmune disorders such as SLE (lupus), rheumatoid arthritis, or vitiligo among others. This is the likely explanation for your being tested for myriad diseases (i.e. your doctors may be trying to rule out other autoimmune disorders). Rarely, Graves disease may be a part of an autoimmune polyglandular syndrome. Treatment of Graves disease frequently results in iatrogenic hypothyroidism which may manifest with various symptoms including fatigue, weight gain, and "brain fog." Thyroid replacement, usually for life, is necessary to treat hypothyroidism. Hypothyroidism can cause elevation in TSH and TRH levels because the secretion of these hormones is no longer inhibited by thyroid hormones. Elevated levels of TRH can cause increased secretion of prolactin. Elevated prolactin levels reduce the secretion of LHRH, which results in decreased testosterone levels. Of course, elevated prolactin levels can also be due to a pituitary adenoma (prolactinoma), which may be seen on a pituitary MRI. Hyperprolactinemia can cause decreased libido (low testosterone) and headache. Migraine is a fairly common condition and can exist independent of other disorders. Obstructive sleep apnea is associated with excess weight, and weight loss (in addition to CPAP) may be helpful. Hypovitaminosis D can be due to decreased intake, reduced exposure to sunlight, malabsorption, or kidney problems. There isn't sufficient information to comment on the intracranial lesion on MRI (although it may be a pituitary adenoma) or symptoms necessitating evaluation for hemochromatosis. Age is an important factor in tying symptoms together. In general, physicians tend to look for a common disorder to explain various symptoms in younger patients, whereas older patients tend to have more than one disorder. This is not a hard and fast rule, and evaluation depends on each individual patient.
    m3dh31p 69 Replies Flag this Response
  • Thanks for the reply.I am 39, currently 210 lbs. I was under 170 lbs when the Migraines started 2.5 years ago- the weight gain could obviously be causing / aggravating the sleep apnea which was only diagnosed last year, and I was around 30 yrs old when I was diagnosed with Graves disease- later treated with RAI when block and replace therapy failed to work. A hot nodule was discovered 2 years ago that necessitated a second dose of RAI, something my Endo said was rare.Thanks,Simon
    sparkinson 2 Replies Flag this Response
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