The Perfect Storm of Hashimoto’s and Lupus

When Lupus and Thyroid Problems Co-Exist

I am in a full-blown flare, which I have just learned can mask other health issues/autoimmune diseases. It seems these autoimmune diseases travel in packs — just like a wolf. It should not be surprising, yet that is the best way to describe my feelings right now. In my head all I can think is, "You have got to be kidding me."

I just underwent more blood tests for my rheumatologist, rechecking on the severity of my lupus (he feels the disease is progressing) and to look at other possible issues. I really had no idea what he was looking for, but I gave the lab 11 vials of blood and went on my way with an increased dose of Plaquenil as my new prescription.

Then, three days later, I got a phone call from my doctor (himself) at 6:45 p.m. When a doctor calls at dinner time, after hours, you just brace yourself.

He said my lupus is still in a full flare, but that I also have Hashimoto's thyroiditis, an additional autoimmune disease. It sounded like a menu item to me and I had no idea what it might entail.

Basically, he described it as an autoimmune disease in which the immune system turns against the body's own tissues (wow, sounds familiar), in this case the thyroid specifically.

“What does that mean for my health?" I asked him. He said it can lead to hypothyroidism, a condition in which the thyroid does not make enough hormones for the body's needs.

Eventually, he said, it can completely destroy your thyroid.

Located in the front of your neck, the thyroid gland makes hormones that control your metabolism. This includes your heart rate and how quickly your body uses calories from the foods you eat.

This, according to my cardiologist, may be the cause of the recent fluttering/irregular heartbeat I have been experiencing ( I will know more after she sends me home with a 24-hour heart monitor attached to me).

Symptoms of a Thyroid Problem

So, it appears that these autoimmune diseases are related in that if you have one, you are more likely to develop another — or several. As if one is not enough to deal with!

And the symptoms overlap, so I did not even think about the symptoms I was having, because I just assumed lupus was the cause.

Hashimoto's symptoms may be mild at first or take years to develop. The first sign of the disease is often an enlarged thyroid, called a goiter. I did not have this, but I did have a nodule on my thyroid for the last three years that must be biopsied and monitored annually and I feel a pressure in the front of my neck.

An actual goiter may cause the front of your neck to look swollen and may make swallowing difficult.

Other symptoms of an underactive thyroid due to Hashimoto's may include:

  • Weight gain
  • Fatigue
  • Paleness or puffiness of the face
  • Joint and muscle pain
  • Constipation
  • Inability to get warm
  • Difficulty getting pregnant
  • Hair loss or thinning, brittle hair
  • Irregular or heavy menstrual periods
  • Depression
  • Slowed heart rate
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Basically, all the things lupus can also cause. Who knew?

So, I am seeing my endocrinologist next week to determine if I need thyroid medications to slow the damage and regulate the disease as much as possible.

Because the symptoms of Hashimoto's may be similar to those for other medical conditions, like lupus, it is important to see your doctor for a test if you suspect it. My advice is to have your rheumatologist test for it even if you have not experienced all the symptoms or you think they are just lupus.

The more you know, the earlier you know, the better informed decisions you can make about treatment.

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