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Dr Mask, Doctor
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Hi doctor, I was diagnosed with Graves disease at age 28. I

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Hi doctor, I was diagnosed with Graves disease at age 28. I probably had it much earlier considering all T levels at that point. Reason for not diagnosing earlier may have been less obvious Goiter and no (very little) eye protrusion. I have been med free for +- 12 years, had two healthy children. In last trimester my T-levels were higher though. Now 45 and working full time. Every month around & during menstruation (always perfectly on time but very heavy flow) I feel like I have a bad flu with very sore throats. I always have anaemia, in spite of iron suppliments. Also last week I got to the stage that just looking at food made me ill let alone eating it. Every time I eat a meal I get nausia, headache, weak and terrible reflux, stomach cramps etc etc. All I can do is line down at that stage. Loads of flatulance, runny stomach and haemoroids. Could I have Coeliaki? I started eating gluten free since three days and already feel better. Thanks so much in advance for your answer!

Submitted: 1 year ago.
Category: Medical
Expert:  Dr Mask replied 1 year ago.

Hello,

Welcome to Justanswer

The cause for anemia can be very obvious in your case i.e Heavy menstrual flow, added on top by the fact that you are not good on diet intake.

The symptoms that you have mentioned can be of Celiac, IBS or even IBD.
However for a sure diagnosis an examination and investigations need to be done.

If avoiding gluten free diet has made you feel better, yes it is possible for it to be celiac however it would be best to test for it before going for definite life style and diet modifications.

Hope This Helped

Please remember to leave a positive feedback when prompted for it

Regards
Dr MASK

Customer: replied 1 year ago.

Hi doctor Mask,

Thanks for your answer. I will ask my own doctor for advice and tests for Celiac etc. I actually wanted to know (should have formulated my question better) if my thyroid may be playing up too - Re: Very sore throat and feeling generally rotten, always recurring around the time of menstruation. I havent tested for Graves in 10 years. I am also having problems relaxing/sleeping and have had some mild anxiety attacks too, possibly related to pressure on the work front - I am rather hard on myself, and perfectionist by nature. (We also recently re-located from abroad, moved country and home, so loads of stress etc there too). Because I've been feeling so awful (read stressed and anxious) lately and especially so in the last 3 days (started menstruating 3 days ago) I read up on Graves through internet. It seems that recent studies show there is a direct link between Celiac and Graves (or other thyroid related auto immune disease). Also want to mention that I have a myoma/fibroid the size of a very large grapefruit. It actually protrudes visibly. This increases and decreases in size, sometimes by 3/4 (honestly) depending on where I am in my cycle. I believe this is due to the influence of hormones. It first showed up during my 2nd pregnancy when I was 39 (now 45). It was monitored all the while I was pregnant and the birth was perfect. After birth it decreased in size to 7cm x 4cm but has increased since then. I dont mind it being there (whole other topic) and have always been dead on time with my periods, even when the Graves was at its very worst. Oh and lastly, I stay very slim no matter what I eat. 167 centimeters, 54-55 kilograms. I go from hungry all the time phases, to avoiding food due to the stomach problems I get when eating ANYTHING but particularly breads and pasta which I love. Thanks so much again. I really appretiate your answers, as my own doctor is rather unsympathetic, and vague/non-verbal (though he only ever see's me once a year at very most).

Best regards,

Joyce

Expert:  Dr Mask replied 1 year ago.

You are welcome

Thank you for the additional information and for your patience.

I am sorry to hear of your multiple issues.

Yes you are right in suspecting the fibroid size change being secondary to the hormonal changes during various phases of the cycle. And the fibroid does tend to increase in size with pregnancy and decrease afterward for the same reason i.e hormones.

The inability to gain weight can be there due to hyperthyroidism. The cause graves disease (already proved as you have mentioned in your reply). Graves disease although presents with hyperthyroidism however it can also (in 5 % of the patients) progress to hypothyroidism. Even if it does not, still at least once a year check on Thyroid function tests helps in making sure that the right amount of medication is being provided and hence helps in minimizing discomfort to the patient through prevention of the recurrence of symptoms of hyperthyroidism and the complications thereof. Although the symptoms may suggest so still, the playing up or not of thyroid can only be decided after a latest result for TFTs and not on symptoms alone.

Yes you have read it right about the relationship of graves to celiac. However unless tested (even in the positive finding of getting better with gluten avoidance) one can not give the diagnosis in favor of Celiac.

The anxiety can very well be there due to the increase work pressure and relocation and yet still it can be attributed to non-optimal control of hyperthyroidism, however it would not be wise to blame it on either unless one rules out the inappropriate control of hyperthyroidism.

I am sorry if your treating doctor has not been cooperative, however the way you are interested in your disease process, you must be in knowledge of all lot of things and that is what you can discuss with him/her however if you still feel a lack of interest, then there is always the option of switching to a new doctor with a better caring skills.


Hope This helps

Please remember to leave a positive feedback when prompted for it


Warm wishes
Dr MASK

Customer: replied 1 year ago.

Thanks again doctor! With all respect, there are as many different doctors as there are people - very varied! I subconciously avoid doctors, even though I am in the medical field myself, and deal with them on a daily basis for my work. On a personal level/visit, I am often mildly concerend that they may discover something medicallly wrong with me, and I do not want to knowCool Yes, ostrich with head in the sand; I know...

Obvious is that I will need to have TFT's tested and check for Celliac. As mentioned I have not tested for +-10 years, and have had no meds since then either...

I just needed some extra (un-biased) encouragement which I have now drawn from your answers. Due to the nature of my work on a full time basis, I am concerned that I will not be able to cope with my very busy life (two young children 7 & 10) as my energy levels drop drastically; if I even have just an hour less sleep or don't eat properly. During the weekends I am no fun, and just want to stay home to do household chores and TRY to relax.

Lastly, when diagnosed with Graves at 28 yrs old, I was chased away by the endo/ specialist, and sent out of my GP practice as I refused radioactive iodine. I just wanted to continue with the meds, as I had read conflicting reports about the Iodine. They told me that I did not want any help and did not trust their judgement. I am still glad for the decision, as I have two healthy children, and the Graves was over/gone for +-10 years, during which time i was meds free. Also, I know of people who did go through the radioactive iodine, and now have other serious problems like vision/eye disorders. I think that may be part of the reason for my fear of doctors on a personal levelEmbarassed.

I think the anxiety is also due to the Thyroid, more than likely Graves playing up again. I used to suffer from agoraphobia, which is a huge contrast to the nature of my job which entails talking to many people all day, every day.. It still ocasionally presents a challenge for me, but even more so when (what we presume) Graves is rearing its' head.

Thank you doctor for your advice, it has helped me. Keep up the good work!

Best regards,

Joyce in Europe where its sunny today

Expert:  Dr Mask replied 1 year ago.

You are welcome :)

Sunny here too but not the type one can enjoy since its 35 Celsius.

Best wishes
Dr MASK

Dr Mask, Doctor
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