I had an appointment with the doctor last night to look at my latest blood test results, only testing for iron levels though as he seems to be adamant I don't need thyroid levels checked until July. Whatever.
He did mention that since I started having my blood tests (April 2013) I have had a consistently low platelet count which as ranged from 109 to 149 (normal range I think 150-400) and has now gone back down to 108. He mentioned it could be another autoimmune disease and he is going to write to a haematologist (who will probably just tell him just to monitor me).
Has any one had/heard of this before??
Thanks in advance and happy Friday
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SJaggs
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Hi as we know the thyroid tests are rubbish. He will be looking into possible thrombocytopenia and thrombopenia, (causes of low platelet counts), often related to Systemic Lupus and Hughes Syndrome, I have both and my thyroid tests always look fine, however one of my consultants in London noticed my physically obvious symptoms including the reflex in my feet being very sluggish. I see Dr BDP due to the expertise. At least your GP is on the right track. Autoimmune disease normally has thyroid troubles trotting alongside.
It might be neither of the two things mentioned above, but is indicative of your autoimmune problems, which of course Hashimotos is! the MaryF
Thanks, it will be interesting to see what the haematologist says. I was surprised as my gp said he would usually wait until the platelets where down to under 100. He did say with one autoimmune issue, usually comes more! How lucky we are!
"It might be neither of the two things mentioned above, but is indicative of your autoimmune problems, which of course Hashimotos is!"
Yes: is it quite unforgettable when you mentioned Prof H commenting on "trio of diseases"? Thyroid, Hugh (?) & Lupus? Sorry, my memory is quite dicky this morning x
.....and a fairly typical blog from Professor Hughes two years ago!
Which clearly shows the overlap of autoimmune symptoms and why things should always be investigated carefully.
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Three interesting meetings to report, the third being the annual Hughes Syndrome Foundation Patients’ Day earlier this week.
One meeting was an ‘emergency’ gathering of lupus doctors from a number of European countries, to discuss the new lupus drug ‘Benlysta’. This medicine, the first ever to be ratified for lupus treatment was developed after very extensive worldwide trials and found to meet strict medical requirements. It is now available in most European countries – but not England! NICE have turned it down on (I’m told) cost reasons. One unfortunate knock-on effect of this decision is that British lupus experts will have to rely on other countries such as Germany for experience in its usage.
The second meeting, the eighth international congress on autoimmunity was held in Granada, Spain. Although I was only there for 24 hours, it really was one of the most stimulating meetings ever. The world of autoimmunity covers the whole of medicine, from thyroid disease to Hughes syndrome, from vaccination to cancer treatment. And the scope gets wider and wider with, on this occasion, insights into autism, sleep disturbance, epilepsy, loss of smell, multiple sclerosis and pregnancy loss. Thanks to the leadership and energy of Professor Yehuda Shoenfeld, the presentations are all available online and in print.
The third meeting, the annual Hughes Syndrome Foundation Patients’ Day, held at St Thomas’ hospital was packed. After the short talks, there was a truly lively Q&A session, which covered topics ranging from sero-negative APS to the brain in APS, from life and travel insurance to newer anticoagulants, from genetics to when (if ever) to stop warfarin. Congratulations to Kate Hindle and Lynne Kirwin and their team of volunteers for arranging such as successful afternoon.
Case of the Month
Mrs DL, aged 52, complained of recurring headaches, ‘cold’ circulation, two previous leg clots, and more recently, memory problems and balance difficulties. She had a long history of ‘fibromyalgia’ – aches and pains. She had put on some weight, had ‘pins and needles’ in the fingers of both hands, and finally – the problem which brought her to my clinic – a TIA (mini stroke).
Investigations showed a blotchy skin rash (livedo reticularis) on the arms and legs, slightly tender muscles, and sluggish tendon reflexes – a sign of a possibly underactive thyroid.
Blood tests showed positive anti-nuclear and anti-thyroid antibiotics and moderately positive anticardiolipin antibodies (aCL).
A possible diagnosis of lupus was made – subsequently changed to Sjogrens syndrome (dry eyes, dry mouth, aches and pains), together with underactive thyroid and probable Hughes syndrome.
What is this patient teaching us?
For a lupus doctor, a fairly common set of problems – Sjogrens syndrome (masquerading as ‘fibromyalgia’), hypothyroidism (sluggish metabolism and sluggish reflexes) and Hughes syndrome (features including DVTs, mini stroke, livedo and positive antibodies). Treatment with Plaquenil and baby aspirin. Thyroid replacement.
And yet so often missed. A common medical triad, but each with symptoms which have, it might appear, few obvious diagnostic clues.
The very first lesson in medicine is ‘listen to the patient’ – and in this patient’s case, the bigger picture came with the family history.
“Anything similar in your family history?”
Mother – low thyroid
Aunt – low thyroid
Mother, aunt, three sisters – migraine
One sister, one aunt – multiple sclerosis
One cousin – lupus and epilepsy
Two cousins – DVT
Five female close relatives – recurrent pregnancy loss
At the Patients’ Day this week, the question was once again asked – is this a genetic disease?
Again, the answer seems to be – possibly. But in any genetic study, the right questions need to be asked. Not ‘anyone with thrombosis or pregnancy loss in your family’ – but … MS, migraine, thyroid, epilepsy, balance problems, memory loss, infertility, heart valve disease, low platelets – and even, as the ripples of Hughes syndrome spread – more. Only in this detailed way will we realise the full clinical implications of this syndrome.
Yes, it's a beautiful morning. It lift's our spirits.
I cannot answer your question, but if you get a copy from the surgery of your latest thyroid gland blood test results, with the ranges, and post for members to comment on them. Usually, when we are eventually on an optimum dose of meds we are looked upon as 'stable' with yearly blood tests. If your GP is one who believes that 'within range' means patient is well - that can be a problem. If you are symptom free there is probably no need for a thyroid gland check-up but if you still have symptoms he should do a blood test.
My last TSH was 0.64 (0.34- 4.5) which was July last year having only been diagnosed in April last year. I though they might squeeze another one in before July this year, but it seems not even though they are testing my iron anyway!
Hi SJags. The only thing that echoes with your case and mine, are the side effects of a drig called Carbimazole which is an anti thyroid med. I ended up with "Agranulocytosis which is the destruction of some whie cells called granulocytes. Have you checked any of your meds for their possible side effects or even drug interractions between all you prescribed meds? Just a thought x
Have you had an antibody test. If you have hypo and antibodies then you have autoimmune disease. I have this and am about to start Paleo diet. No gluten or dairy as these cause the antibodies.
The related autoimmune disease which your doctor was probably referring to was Thrombocytapenia - your body destroys your own platelets so you cannot clot as quickly. Very important to check you don't have it before having children .etc as birth is more risky due to blood loss. My Mum has it and she didn't know this but was very lucky; it gave my brother and I a higher likelihood of developing a related autoimmune disease, and I developed Hashimotos. In general, once you have one form of autoimmunity, you have around a 60% chance of developing another one. endocrineweb.com/conditions...
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