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Friday, March 7, 2014
Arthritis and Rheumatism
I was just diagnosed two weeks ago with hashimotos thyroiditis. TSH 10.7. Autoantibodies 785.0 I am extremely tired and i have dry gritty eye and a feeling of thick tongue and thick saliva. I had plugs put in my eyelids for the dry eye and they are still really dry. I was tested for Sjogrens and every test came back negative. i am considering a lip biopsy. Can Hashimotos thyroiditis cause dry eye symptoms? I started on Levoxyl 50 mcgs. two weeks ago. How long does it take to help relieve the symptoms of fatigue and dry eyes if these are related it? thank you
I think it is very likely that you have Sjogren`s syndrome. Blood tests are not a reliable way to detect that disorder. Before getting a lip biopsy, I would check to make sure that you are not taking any medications that may be causing dry eyes/dry mouth, such as some antidepressants, antihistamines, medications for diarrhea or abdominal cramps, and diuretics. You may also want to see an opthalmologist, who can look for objective evidence that you are not producing a sufficient amount of tears, and a dentist, who can check to make sure that decreased production of saliva is not causing tooth problems. If the diagnosis of Sjogren`s syndrome is not certain after that, a lip biopsy would be a good idea. As you probably already know, Sjogren`s syndrome and Hashimoto`s thyroiditis frequently occur together. Other disorders, such as rheumatoid arthritis, pernicious anemia (vitamin B12 deficiency), and lupus also occur with increased frequency in patients who have Sjogren`s syndrome. Any of these diseases could make you feel tired. Although hypothyroidism, caused by Hashimoto`s thyroiditis, can produce tiredness, which can last for weeks after you are started on thyroid replacement therapy, and severe hypothyroidism can be associated with a thick tongue and dry mouth, the relatively mild hypothyroidism that you probably have (judging from your mildly elevated TSH) probably does not account for these symptoms by itself. A rheumatologist would probably be the specialist who is best trained to look at the additional possibilities. There is no cure for Sjogren`s syndrome, but there are therapies that can help with some of the problems. Again, a rheumatologist would probably have the best training and most experience to help. Good luck with your problem.
Fred Finkelman, MD
Director, Division of Immunology
College of Medicine
University of Cincinnati