Thyroid issues and PA

[Raven_Cat]

Well just over 6 months into being diagnosed with PA/AIG my thyroid is playing up and I'm feeling really crap again, fatigue!

My normal doctor is on leave for two months, thankfully monthly injections are set in concreate for now, 3 monthly didn't work and balance issues and pins and needles came back 2 months in (even with taking active B12 sublingual's, which was only admitted to my DR before she took leave, her response was, well if you go over 1,400 again you will need to go back down with less frequent injections).

Considering the 1400 reading was 2 days after the last loading dose I received, I'm not worried about having my monthly injections reduced any time soon. One fight won for now, monthly injections! I would prefer 2 weekly, that could be my next mission, but without knowing when the thyroid problems kicked in, not even I am sure when and why I started going down hill again (apart from the 3 monthly shot bullshit when neuro symptoms came back).

Anyway, while my doctor is on leave for two months I am seeing another doctor from the practise and he is dealing with my current bloodwork which in his opinion relates to primary hyperparathyroidism. I have been taking 50mcg of Levothyroxine daily for a week now and can see some improvement already.

I am getting I believe a Sestamibi Scan to test for tumours on my thyroid glands on Monday, no harm there, I could be incredibly unlucky and have some. I know Hashimoto's is the most often the thyroid issue found in unison with PA. I have read somewhere that 50% - 60% of PA peoples have thyroid problems, 80% Hashimoto's.

My questions to my most learned and wise folk on this forum are:

What should I make of my blood work, if known?

Have you been diagnosed with primary hyperparathyroidism and legit, or initially primary hyperparathyroidism then resolved as Hashimoto's?

What have been your experiences, if appropriate to me?

I have included my recent bloodwork results with lab comments, BTW, my Vit D, ferritin and folate are stable, as is B12, I believe.

Thanks for reading this and sharing any potential insights you may have, I think I have sufficient energy to get back to people this time, surely nothing else should crop up and relegate me back to zombie survival mode (pre b12 shots and now Levothyroxine).

THYROID PROFILE

Date Collected................1 Feb 23.....6 Sep 24...........14 Mar 25........31 Mar 25

Time Collected................2:48.............10:20...................08:20.................09:45

Specimen Type: Serum

TSH (0.5-4.0) mIU/L.......3...................3.4........................6.5 H...................4.8 H

FT4 (10-20) pmol/L ............................................................................................14

FT3 (3.5-6.5) pmol/L ........................................................................................4.2

Specimen Type: Serum

Date Collected 31 Mar 25

Anti-Thyroglobulin Abs (aTGII) IU/mL (< 4.5) < 1.3

Anti-Thyroidal Peroxidase Abs IU/mL (< 60) < 28

Over 90% of patients with autoimmune thyroiditis show moderate to high levels of Anti-Thyroidal Peroxidase Abs (anti-TPO) with Anti-Thyroglobulin Abs (anti-Tg) also present in about 90% of such patients. Up to 75% of patients with Graves' hyperthyroidism show increased anti-TPO with anti-Tg present in 50-60%. Low levels of both anti-TPO and anti-Tg may be found in up to 10% of "normal" asymptomatic adults. In most cases of autoimmune thyroid disease increased anti-TPO is the predominant finding although a small proportion of patients show a predominant increase in anti-Tg.

PARATHYROID HORMONE

Date Collected.................. 24 Oct 24 .............. 31 Mar 25

Time Collected.................. 08:48 ...................... 09:45

iPTH (1.5-9.9) pmol/L..... .14.8 H ..................... 15.6 H

Notes:

A raised PTH in the context of hypercalcaemia, as evidenced by the high ionised calcium, is consistent with primary hyperparathyroidism. The effect of lithium and familial hypocalciuric hypercalcaemia may be other diagnostic considerations

Ionised Calcium

Date Collected 31 Mar 25

Time Collected 09:45

Ionised Calcium mmol/L (1.15-1.29) 1.42 H

Calicium Levels in my blood serum

Date Collected............................. 10 Oct 24 ..........24 Oct 24.....14 Mar 25 .......... 31-Mar-25

Ca (2.10-2.60) mmol/L ..................2.62H .................. 2.47 ............ 2.64 H ..................... ??

Corr Ca (2.10-2.60) mmol/L .......2.62H .................. 2.51 ............ 2.68 H ................... ??

[yorkshiregirl4]

Hello Raven_Cat, You are very fortunate indeed to receive your B12 injections so frequently. I am in the UK and that would be, and is, completely out of the question at my GP practice irrespective of symptoms. I have PA and also hypothyroidism and as you have already realised this combination is not unusual. Did you have the correct amount of B12 injections for your loading doses based on the type of symptoms you were experiencing?

In terms of you having blood tests to check B12 levels now that you are having treatment this is unnecessary and extremely unhelpful, as many others on this forum will tell you. They are not at all helpful as they measure the level of B12 in your blood but at this stage the B12 is unlikely to be available for the cells in your body and therefore the blood test is not representative of recovery and should not be undertaken at all as others on this forum will tell you.

It can be difficult to differentiate symptoms between both conditions as there is overlapping of symptoms. I suggest you post your thyroid blood test results on the thyroid forum of Health Unblocked to receive helpful advice specifically about these. The recommendations regarding blood tests for thyroid problems are very specific to ensure reliability and this will also be commented upon that other forum. Best wishes for your health improvement.

[Iheartb12]

I can't really answer your questions but I wanted to share that I have hashimotos and have steadily seen my tsh increase and in turn levothyroxine dose increase every few years for the past 25ish years. I was on 150 mcg levo. I went hyper thyroid for the first time ever not long after starting b12 injections and my anemia resolving. I was anemic for over 20 years. For the first time my levothyroxine does has been decreased several times and I'm not on 125mcg of levothyroxine and feeling much better. I've been on b12 injections for 2 years and most PA symptoms have resolved. I have not had my parathyroid checked as my symptoms and tsh are stable. It is in the back of my mind to have parathyroid checked if my thyroid levels become unstable again. In my case? Going hyperthyroid could be many things from a separate autoimmune disorder yet to be diagnosed, to graves to just hashi swings. Not sure. But I can't help but feel there is a link between treating my PA and my thyroid working better. Only Time will tell.