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Archive for July, 2014

So I have gained a fair amount of weight since my Graves went into remission (still have antibodies). My TSH is normal but I have Thyroid Peroxidase (TPO) Antibodies (TPOAb) / Antithyroid Peroxidase Antibodies  levels of 198.

I don’t know what this means exactly, except that it’s associated with Hashimotos and my doctor never told me this (even though I asked specifically). I found it on my medical records. It’s also associated with pernicious anemia, and even before I had Graves, my B12 level is 170 (doctor never thought it was an issue, never told before, I found it on my records).

For the last 3.5 years I have had HORRIBLE digestive symptoms and low levels of iron, b12, magnesium, calcium and D.  Not sure if there is a link, but something is off and my old doctor outright lied when I asked her about Hashimoto’s antibodies.  And as I just checked, my Graves Disease antibodies Thyroglobin AB was NEGATIVE!!! Never knew this.

  • Free T4 is 10.
  • Free T3 is 4.7.
  • TPO is 198.
  • TSH 0.98
  • Triglycerides 2.66!
  • Albumin 41
  • Thyroblobin AB – negative

I have come off gluten for 4 days and have a great improvement in my gut symptoms, and it makes sense now since Hashimoto’s is associated with gluten problems.  So confused, but this makes more sense with the symptoms I’ve been having: VERY dry hair and skin, eczema, digestive issues, numbness and tingling, low ferritn, calcium, b12, magnesium and vitamin D, not to mention weight gain.

 

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I recently switched doctors, which gave me access to my medical records. I found out some surprising things that my doctor never told me. Apparently, I have high triglycerides 2.66 MMOL/L (I’m mid 30s female). This happened as soon as my Graves disease started going into remission. I wonder if I’ve been having mild bouts of acute pancreatitis or papillary stenosis ( a disturbance of the sphincter of Oddi, a muscular valve, that prevents the opening and release of bile or pancreatic fluids into the duodenum in response to food entering the duodenum.)

I also had a colonoscopy and and upper GI scope, and she told me it was normal, but the report said that I had proximal small bowel mucosa with minimal focal intraepithelial lymphocytes, without specific pathology. “It may be nothing noteworthy, but it comes up with inflammatory bowel disease and says can be seen with early gluten sensitive enteropathy.”  So, am I gluten sensitive? Will going gluten free help? I tested negative for Celiacs, but..I have heard gut dysbiosis can make you sensitive to foods you normally can eat. Going to try it for a little while to see if it helps.

t-IgA = 5 KEU/L

 

Update July 27, 2014

So, I have given up gluten for only 4 days now and have noticed a big improvement in my gas and bloating, and believe me, I am/was the world’s biggest skeptic. Two things made me give this a try: a) my daughter has terrible, eczema on her hands and green, mucousy poops, and b) and upper GI scope that says small bowel inflammation, but not Celiacs.  So, I was desperate and gave it a try – half-hearted at first, but after seeing a difference, I’ve been getting stricter, until today…at a bridal shower. I had half a sandwich and BOOM!  My stomach is in agony.  Now, whether it’s gluten, or wheat, it’s the first time I’ve had it in days and boy did it react with me.  Doubled over with stomach pains and gas. It doesn’t last forever, but when I was eating Mini Wheats twice a day, breakfast and afternoon, I felt like every food was bothering my stomach.  I can NOT believe it could be gluten, but my daughter’s poop is already back to a brown colour and her hand eczema is 80% better (until today, when her father, a non-believer, fed her TimBits and a hamburger with a regular bun). Her hand is already more red and she’s been farting and burping. It sucks.

I really don’t want either of us to have this condition, but the gas pains are just too much for me, and I hate to see my daughter face similar symptoms.  Throughout my life my symptoms have waxed and waned and it seems my thyroid has been the breaking point for me – the second it started going into remission my problems with food/gas began.  As a baby I was always constipated (like my daughter), and have had horrible gas my whole life, which was worse during puberty and during University. It was not bad after my first daughter, in fact, I felt great! When my Graves was at it’s worst, my digestion was at it’s best, ironically.  Now, with Graves in remission (but with anti-bodies which haven’t changed from 198), my stomach is a disaster!

So, I will keep you updated on how the gluten-free thing works out. At the very least, my very picky-eater daughter is trying more foods. She actually has latched on quite positively to this gluten-free kick, which was a humongous surprise to me, since she really is a very picky eater.  Maybe it’s not the worst thing in the world, this gluten-intolerance thing.

Good bye, my beloved fresh buns. I will miss you!

 

Update July 31

1 week off gluten and I realize there is more going on than just a gluten sensitivity. I know milk is an issue for me, so I tried soy milk in my coffee and my nose instantly started running.  I had a reaction after dinner last night and I can’t figure out what caused it: I had chicken (I baked myself), potatoes, and a bowl of gluten-free Chex with coconut milk.  I also had a green tea and a iced-tea.  So, maybe tea doesn’t agree with me? Weird.

I used to swell up – go all red and puffy after eating and would sweat. That has stopped!  My thyroid is still not controlled (T4s are the the bottom of the normal range at 10 pmol/l or .777 ng) and I wonder if that was corrected if I’d be less sensitive.

My “allergies” or “sensitivities” started all of a sudden – basically in January 2011 I could no longer eat what I wanted. This is also when my t4 was at 9.7 pmol/l, the lowest it’s been.  So, I think there is a hypothyroid connection here.  In fact, six months later my t4 was at the same level and I was in really bad shape. I was 5 months pregnant at this point and was swollen like I was 9 months pregnant. I started taking lots of supplements for the remainder of my pregnancy, and not sure if that helped, but when I was 9 months pregnant I felt the best I had the whole pregnancy. After my daughter was born, things quickly spiraled back to where they were, although I didn’t realize the food connection because it wasn’t immediate and because I couldn’t figure out which foods bothered me.  But I finally realized that eating made me sweat, in between my shoulder blades and up the right side of my face. Weird, I know.

Just curious what other reactions to food people have had while being hypothyroid and what your free t4 levels are!

Read the comments in the link below. Some of these stories resonate so much with me!!

http://glutenfreegirl.com/2011/05/symptoms-of-celiac-and-gluten-sensitivity/

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For the past 3.5 years, as soon as my Graves disease went into remission, I’ve been dealing with bloating, stomach pain, edema, muscle aches, low b12 and anemia.  My doctor told me I had fibromyalgia and stress, despite blood irregularities (low b12, calcium, magnesium, ferritin, vitamin D).

I had be constipated my whole life. When I had Graves disease, I was regular for the first time ever. As soon as it started going in remission I got this terrible, tight pain in my back, and then watery dirrhea. I have no gallstones, but I suspect my gallbladder is not functioning very well. Over the next six months I was extremely tired, and had extreme edema (my albumin levels were below the normal level 46 and I believe the bottom of the range is 52).  Still, my doctor didn’t think much of it.

Three and a half years later, I’m still battling these symptoms. I’ve gained 30 pounds, but I’m pretty sure it’s mostly water since when I move I literally feel it sloshing around in me, especially when I run! I’m trying a water fast/ low FODMAPs diet for as long as I can and seeing if that helps.

As a background, I believe this runs in my family. Childbirth seems to bring it out in us. I think my Graves disease also made it worse…

Symptoms of protein malabsorption:

http://www.endonurse.com/articles/2006/04/malabsorption-syndrome.aspx

Malabsorption causes weight loss, glossitis, carpopedal spasms, absent tendon reflexes, cutaneous bruising, flatulence and abdominal distention, bloating or discomfort resulting from increased intestinal bulk and gas production.

The most common symptoms of malabsorption include:

  • anemia, with weakness and fatigue due to inadequate absorption of vitamin B-12, iron, and folic acid
  • diarrhea, steatorrhea (excessive amount of fat in the stool), and abdominal distention with cramps, bloating, and gas due to impaired water and carbohydrate absorption and irritation from unabsorbed fatty acids. The individual may also report explosive diarrhea with greasy, foul-smelling stools
  • edema from decreased protein absorption
  • malnutrition and weight loss due to decreased fat, carbohydrate, and protein absorption
  • muscle cramping from decreased vitamin D, calcium, and potassium levels
  • muscle wasting and atrophy due to decreased protein absorption and metabolism
  • perianal skin burning, itching or soreness due to frequent loose stools

Irregular heart rhythms may also result from inadequate levels of potassium and other electrolytes. Blood clotting disorders may occur due to a vitamin K deficiency.

Secondary nutritional deficiencies develop in proportion to the severity of the primary disease and the area of the GI tract involved. Many patients with malabsorption are anemic, usually because of deficiencies of iron (microcytic anemia) and folic acid (megaloblastic anemia) but also from the B vitamins, calcium, vitamin D, vitamin K (mainly fat-soluble), and niacin.

Protein malabsorption may lead to hypoproteinemic edema, usually of the lower limbs, and secondary endocrine deficiencies may result from malnutrition due to the high risk of polyunsaturated fatty acid (PUFA) deficiency. Moreover, patients with malabsorption will become immunosuppressed due to the nutritional deficiencies.

Fluid and nutrient monitoring and replacement is essential for any individual with malabsorption syndrome. Hospital-ization may be required to treat severe fluid and electrolyte imbalances. Consultation with a dietitian to assist with nutritional support and meal planning is helpful. If the patient is able to eat, the diet and supplements should provide bulk and be rich in carbohydrates, proteins, fats, minerals, and vitamins. It is often recommended that those suffering from malabsorption syndrome eat foods as close to already digested form as possible, and eat several small, frequent meals throughout the day, avoiding fluids and foods that promote diarrhea. Intake and output should be monitored, along with the number, color, and consistency of stools.

Vitamin and mineral supplements are advised. Other helpful supplements may include probiotics and prebiotics.

“There is no doubt that a healthy digestive system is critical for proper nutrient absorption,” says Tim Gamble, vice president of sales and marketing for Nutraceutix, Inc. “A healthy gut to some extent means that there is a healthy, naturally occurring population of probiotic bacteria present in the intestines. Research indicates that viable, properly delivered probiotics can play a key role in strengthening the function of the intestines from digestion of food to prohibiting pathogenic bacterial growth to immune system stimulation. If one is hoping to gain weight by manipulating or supplementing one’s diet, perhaps beyond that which is considered normal or routine, a healthy gut is critical to allowing one to do so without digestive discomfort or dysfunction. Probiotic supplementation is probably a wise choice before and during a weight gain regimen.”

Medical management for malabsorption syndrome is dependent upon the cause. (Treatment for tropical sprue consists of folic acid supplements and long-term antibiotics. Whipple’s disease also may require long-term use of antibiotics, such as tetracycline). Management of some individuals may require injections of vitamin B-12 and oral iron supplements. The doctor may also prescribe enzymes to replace missing intestinal enzymes, or antispasmodics to reduce abdominal cramping and associated diarrhea. People with cystic fibrosis and chronic pancreatitis require pancreatic supplements. Those with lactose intolerance or gluten enteropathy will have to modify their diets to avoid foods that they cannot properly digest.

 

 

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I’ve been in remission from Graves Disease for over 3 years.  Since that time I have gained 30 pounds!  My TSH is normal, but I feel like I am super duper bloated all the time. Every cell in my body – my legs, my stomach, my face, my arms, are all watery and jiggly.  I’ve never ate less in my life. In fact, I have two bowls of cereal a day and a normal dinner.  I am so frustrated.

I also think I have gallbladder issues, but no gallstones as I can’t eat any fatty food without getting pain in my right-upper quadrant area and severe headaches followed by diarrhea.

I have muscle weakness and cramping and very dry skin and hair.  All signs point to thyroid issues, but my normal TSH makes my doctor think it’s just stress. I tell her my only stress is weight gain and an inability to eat normally. Gah!

Interestingly, even when I had Graves disease my t3 was high, but t4 was at the bottom level of normal.

 

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