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Autoimmune Disease

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Rheumatoid Arthritis
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uncompahgre1
New Member
Joined : Nov 2011
Posts : 7
Posted 11/8/2011 9:29 AM (GMT -8)
Just found this group, have lots of questions, but will start with this. I have been diagnosed with Autoimmune Disease-Hashimoto Thyroiditis almost two years ago. Now am having symptoms of RA, going to see my doc next week to see what she has decided is going on. I have bumps under the skin on my arms burning in my hips feet and elbows which sometime hurts so bad I just want to pull the covers over my head and forget!!!! I bruse very easy and itch like crazy on my arms. I know some of the symptoms are related to the Hashi's but is being exhausted part of the RA also, cause I wake up in the am and start thinking what time I can go to bed at night!!!!!! Can anyone tell me about the meds that maybe used for RA and side effects? confused
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wearyRAsufferer
Veteran Member
Joined : Mar 2010
Posts : 2954
Posted 11/9/2011 10:37 AM (GMT -8)
Welcome to the group. Yes- fatigue is a part of RA. The more uncontrolled it is the greater the fatigue.

I hope your doctor is a rheumatologist if you have RA. They understand and treat it best.

When you see them they will explain your med options and you will be fully informed about the side effects. Some sound very scary but the Disease Modifying Drugs that have been on the market for a long time work well and usually without the scary side effects. I know less about the biologics.

I wish you all the best
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Chartreux
Veteran Member
Joined : Aug 2006
Posts : 9664
Posted 11/9/2011 12:28 PM (GMT -8)
Write all this down and take it with you to your doctors appointment, that's about the best
I can offer up, as you should be dx with it before talking about the medicines...
Many many well wishes to you and do keep us posted as to what your doctor thinks is
going on ...
The medicines for RA are very scary and your doctor will talk to you about them first
including the side effects...may well wishes on your appointment.
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uncompahgre1
New Member
Joined : Nov 2011
Posts : 7
Posted 11/9/2011 1:18 PM (GMT -8)
Thank you for your advice, since being diagnosed with Hashi's it seem like everyday something new comes up. Someday's I feel as if people think I am crazy, I have a disease they have never heard of and the only thing they can see that may be wrong with me is how tired I look all the time. So as the song goes, I just keep on keeping on!!!!
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couchtater
Elite Member
Joined : Jul 2009
Posts : 14475
Posted 11/9/2011 2:52 PM (GMT -8)
Have you been checked for Lupus?
Some of your symptoms sound like a type of Lupus where knots develop under the skin (lupus pa...?). Sorry I can't spell it, but if you go to the lupus forum here you'll see it's been recently posted.
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Keah
Veteran Member
Joined : Nov 2003
Posts : 7314
Posted 11/20/2011 12:22 AM (GMT -8)
I also have Hshi and Crohn's. On top of that I have Sponyloarthropathy - a type of autoimmune arthritis and it sounds like that should be a consideration for you. Many of the symptoms are similar to RA and the treatments are the same. I hope you find answers and relief soon.
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Keah
Veteran Member
Joined : Nov 2003
Posts : 7314
Posted 11/20/2011 11:01 AM (GMT -8)
Just one more thing about the Hashi symptoms. How is your Doc managing it? Are they going by your TSH alone or doing the whole thyroid panel and looking at your T3 & T4 too? It's possible to have your TSH in the normal range and still have T3 or T4 be low. Even if these are in the normal range, having a borderline normal might be too low for someone with Hashi. The only reason I was tested for Hashi was because I had an MRI of my neck to evaluate my arthritis and they saw a calcification on my thyroid. My sister had Hashi's for several years so I knew enough to demand they run a thyroid panel and antibodies. My T3 & T4 levels were literally on the border, but in the normal range but my TSH was in the mid normal range. Both sets of antibodies were at the highest level they count but because my levels were 'normal' my PCP was unsure of how to proceed. When I saw the Endo she said i was literally in the verge of thyroid failure and needed replacement therapy immediately. So, if I had been evaluated based on my TSH alone, I would not have ever been treated.

Most Labs & Docs consider normal TSH levels to be between 0.5 and 4.5 or 5.0. However, more recent research indicates that these parameters should be lowered to 0.3 and 3.0. Additionally, since Hashimoto's is an autoimmune disease, research indicates that it benefits patients to keep their TSH at the lowest possible level . Remember, our thyroids are constantly under attack by the antbodies that our immune system creates. Using Levothyroxine or Armour Thyroid only supplements the normal production of the thyroid and using a higher dose eliminates the need for our thyroid to try and function.

After the Endo started me on rLevothyroxine, my PCP was not concerned about my numbers at all. He said "I treat patients, not lab reports" and didn't have any problem bumping my script up by 25mgs when I felt that I was having symptoms. He has since retired and my new Primary is also an Endocrinologist. It's been a little harder to get her to bump me, but in all fairness, when I really pushed for it, I was having a terrible Crohn's flare and it's possible that my low T3 & T4 levels were from something called Euthyroid Sick Syndrome.

Are you being treated for all this by your Primary or have you seen an endocrin and Rheumy? Your Primary can certainly run some blood tests including an entire thyroid panel, RF (Rheumatoid Factor) and ANA (Lupus). Having these results in hand when you see the specialists will at least give them a starting point.

You also mentioned burning in your extremities. You should have this evaluated to determine if you've got some peripheral neuropathy vs. pinched nerves. Either can cause burning, tingling and numbness and there are several things that can help. Massage can really help if the cause is from muscle spasms pinching the nerve(s) that run through that muscle and there are many meds used to successfully treat peripheral neuropathy such as Neurontin (gabapentin), Lyrica & Cymbalta are meds that my Mom and I have both used to relieve the symptoms of neuropathy with good success. It might be a good idea to consult a Neurologist if the problem is bad enough.

Like you, I also have had terrible problems with itching, hives and unusual bumps. These are allergic type reactions, but it is our immune system which regulates our reaction to allergies and our immune systems are malfunctioning. With treatment, I've had significantly fewer episodes of these annoying things. I hope the same will happen for you.

It's nice to have just one Primary Care Doc to handle all of our care but it's been my experience that once someone has the types of problems you are describing, a specialist is necessary. As I mentioned, my PCP is also an Endo, but I still need a Pain Doc, Rheumatologist, Gastroenterologist,  Dermatologist, Psychiatrist, Hematologist, Cardiologist and a GYN. Each of these Docs addresses the specific problems that I have in their area of expertise. Once I've gotten on a stable regimen with them, I let my PCP manage my continued care and then only go back to the specialists if something changes. I know this might all sound overwhelming to some but before I had this list of Docs involved in my care, I was suffering with all sorets of problems that nobody was addressing. Although I am still sick and probably always will be, I am getting the appropriate care and can manage my symptoms well.

I hope that your Doc is willing to work with you to get you evaluated by the appropriate specialists to ensure you get the best care and relief of your symptoms soon.

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