Sometimes, thyroid patients don’t even know where the inflammation exists in their body, except that their high ferritin reveals it, or their C-Reactive Protein or ESR (erythrocyte sedimentation rate or sed rate) lab tests reveal it. Other times, it’s obvious by the pain they notice in their bodies.
Some ways to deal with inflammation, especially for Hashimotos patients, is removing gluten from the diet. Others have to ascertain if they have Lyme disease that needs treatment. Some have neither problem, but inflammation exists anyway!....
To put it simply, inflammation causes undesirable reactions on the inner lining of blood vessels. The combination of inflammation and circulating lipids is a dangerous recipe that produces something called “foam cells”. Foam cells attach to the endothelial lining of our blood vessels, such as the arteries that feed our heart and brain, and once they mature over months to years form arterial plaques. These plaques narrow the blood vessels making it an eventual challenge for oxygen carrying blood cells to pass. Distal tissues to these narrowing arteries are the ones that suffer. When cells do not get the oxygen they need the result is tissue necrosis in the form of a heart attack or a stroke. Another pathogenesis of inflammation is its impact on maturing plaques. It just happens that inflammation can cause, in a rather short time frame, the rupture of these vessel plaques. In doing so, that plaque can quickly obstruct all blood flow quite abruptly and results in significant damage downstream. One of the biomarkers we shall discuss is FDA-cleared for assessment of plaque rupture and risk of stroke.16 Specific clinically available inflammatory markers are now available for the diagnosis and management of chronic inflammatory states which can impact life and health.
There is a direct inverse correlation between CRP and reduced tissue T3 (112,270), so individuals with elevated CRP (greater than 3 mg/l) or other inflammatory cytokines will have a significant reduction in cellular T3 levels. The suppression of intracellular T3 levels correlates with the degree of elevation of CRP, despite serum thyroid tests being “normal” (112,270). Thus, if any inflammation is present, which is found in numerous clinical and subclinical conditions (as above), the body will have lower cellular T3 levels that are often inadequate for optimal functioning; but the pituitary will have increased levels of T3, resulting in a lowering of the TSH that would potentially be inappropriately interpreted as an indication of “normal” thyroid levels.
It's worth mentioning that high ferritin can be caused by having a cold or virus at the time of testing as iron is dumped into ferritin to 'starve' bacteria and viruses.
I think making people aware of inflammation in the body is very important - how we deal with it is complicated and varied....so we have to find our own journey. Definitely interesting about the connection with CRP and tissue T3.... Keeping the body alkaline is also helpful I believe.
As we know cholesterol in the blood is used to soothe inflammation on the arterial walls - so when raised it is possibly fighting additional inflammation - who knows ?
Thanks for this although it alarms me somewhat as I have a lot of systemic inflammation - high ESR and CRP always. I have a diagnosis of RA and Hashis (for longer) and am currently being investigated for having some form of immune mediated disease afftecting my peripheral nervous system and autonomic nervous system too. I have a gluten free diet and also avoid all refined foods, sugars and caffeine and drink very little alcohol - this has been the case for almost four years now. I try to exercise daily - which I think is key - and take AdCal D3 but no other supplements currently as I believe that most vitamins and minerals should be absorbed through our diet unless we have proven malabsorption issues, ie B12 deficiency - which I dont.
What I'm trying to say is that some people can't actually get on top of inflammation through diet and lifestyle changes alone and require heavy duty drugs or even plasma infusions to get their immune system/ systemic inflammation reduced. My thyroid bloods are currently within normal range as was my T3 last time it was checked. My cholesterol is normal as is ferratin. I know that normal ranges are queried constantly on this site and I respect this but my instincts tell me that taking T3 or changing to NTD privately - my gp has already dismissed this idea - would be a red herring for me - although I sign petitions supporting that people are treated primarilly by their symptoms not their bloods.
But while things are as they are I feel that focussing on keeping up my healthy lifestyle and getting enough rest and fresh air etc are far more key to managing my life and avoiding strokes etc than taking any more tablets or falling out with my medical team by self medicating and stopping my Levothyroxine. We are all stuck with our genes and formative life events and will all die of something so I feel the lifestyle is the one thing we can really have some control over but it may not be enough for everyone and suggesting it is will just lead to those with imflammatory diseases feeling as if they have brought this on themselves.
Hi Twitchytoes, what was your TSH when medicated with Levythyroxine. Mine was 7.5 then up to 8 for 7 years and GP didn't advise at all and wouldn't help. So finally self-medicated with NDT. But still not as much energy as I excpect despite TSH of 1 and T4 of 21 (previously 12) so considering T3, though will see consultant in Jan, having had a FT3 test that he will see. I suspect not converting.
Hi. I'm grateful for the information but find it almost impossible to navigate as a non scientist to be honest.
I take 100mcg Levo and have done for years. My TSH was 0.4 a few weeks ago and my FT4 was 12.1 - can't recall the exact normal ranges by heart but TSH is a bit suppressed and has been for a few years while FT4 is lower end of normal and my FT3 was bang in the centre of normal when last taken 11 months ago. My ESR was 55 five a month go (normal range 0-10) and my CRP was 30 a year ago when last taken. My ESR was taken regularly and I'm told that the fact it is always high is proof of autoimmunity but that's all. I don't agree as it happens because it fluctuates according to how well I feel or don't with my autoimmunity so I can predict it perfectly. This time last year it got down to 17 while on Hydroxichloraquine and I felt great! Unfortunately my skin went bonkers though so I had to stop taking this disease modifying drug after a year and a bit.
But as I don't appear to have active RA presently - despite being off all immune suppressant meds for six months now - I don't know what is causing it to be always high. My PVC is always high too and so is my total protein. My GPs and rheumatologist maintain it doesn't matter - "we treat your symptoms not your blood" - where they seem to say the opposite about my thyroid! I think if it weren't for my high ESR and CRP they would tell me it was all Fibro or ME so in a way I'm very grateful to my blood for supporting the fact that something autoimmune is going on at least.
I certainly see what you mean, in that feeling rough with normal ranges GP's offer no support at all, so you almost want to be REALLY ill with some ranges, any ranges, too high/low in order to be taken seriously. They certainly do say the opposite on Thyroid, in fact GP seem very unknowledgable. My GP telling me I had to decrease dose of NDT as TSH below 1, FT4: 21, saying that lab will refuse to test FT3. I said in that case I will start taking T3. Then I asked her if she would refer me to specialist and realising she was over her head, agreed to do so. Then also sent letter offering a FT3 test as well.
I'm the same with trying to understand the science, so I try to glean a little then ask questions/research on here, and luckily some kind and much more intelligent/experienced members help me to understand better, but sure takes a lot of effort.
Your CRP and ESR ar certainly very high, so even a GP would be able to diagnose autoimmune problems.
I like the "even a GP" bit!! Mine is pretty full of himself (very good looking and doesn't half know it!) I have to say and in some ways he is very good and more knowledgeable than many from what I've gathered on here.
The neurologist I saw in October commented on my fluctuating ESR levels and I explained that I can almost predict what it will be now from the way I'm feeling. I have two specialists involved in my care now but I'm not sure they are the right ones for me - although I live in a remote place so will not be able to get any others and I was impressed by the thoroughness of the neurologist at least. I would like to see a good immunologist or a rheumatologist who knows much more about the immune system and isn't completely preoccupied by arthritis as mine seems to be!
Your thyroid bloods sound pretty healthy but if you aren't feeling that way then this should count for something I feel.
My GP won't hear of me switching to NTD and there's no way he will refer me to an endo either. He says my thyroid is well controlled with my present dose of Levo 100mcg and believes Levo is fine as a synthetic substitute for thyroxine.
He is adamant that my problems are rheumatic/ neurological not endocrine. He won't take my CRP because he maintains it is unreliable for RA but this is rubbish as I know rather a lot about RA/ rheumatic diseases now and have been told by specialists that the CRP is the more reliable method of assessing disease activity with RA and Lupus. It is more expensive to take than the ESR though - call me cynical but I'm sure that's why he won't use it anymore! The other GPs are no more knowledgeable than him - if anything less. I think I've chosen to navigate the science of rheumatology and immunology rather than the thyroid/ endocrine system because of my GP and because of the relatively normal ranges. I know it's all interconnected and that my thyroid antibodies were raised (but not soaring - I think my TPA was about 52 - about 20 over the top of normal range a year ago when I got it tested privately). But my brain just won't take too much in - I studied art and did no sciences and I fear I'll become a total health obsessive if I get preoccupied by the thyroid as well as all the rheumatic stuff!
You are becoming a health obsessive, like me and the rest of us on here because the medics have not helped us and/or dismiss what we are telling them. 7 years I was feeling awful with my GP telling me everything was normal. It was only when I got my blood test over 10 years printed and posted on here that I started to go in the right direction, and finally am seeing an endo in Jan, selected from the list of good NHS endos that louise (administrator) sent to me.
So you're TSH was 52. I see. I would advise your posting individual questions in all the areas you would like info/advice on, until you get a clearer picture.
You could just 'try' another GP, saying needed an emergency appt and couldn't see usual one, to see if any better once all explained. And if that GP is no better, go back to original, or try yet another. I swapped 3 times before got referral to consultant, and again that was only cause I questioned what she was advising, going from the info I received here.
I am self-medicating with NDT for 7 months, but as iron still very low and ferritin high, want help with this and prescription for T3, though I know where I can get it without prescription.
I don't think we are health obsessives because that implies it is all in our heads. I think we are just trying to navigate a path that helps us live a normal life again. I'm too busy and too keen to get back to working full time again to be able to afford to read and read about it all anymore than I do already.
Sorry if I was unclear. My TSH was fine at 0.4 - it was my TPA (antibodies) that were 56 or 52 - 20 over the range anyhow. This just shows I have Hashimoto's I believe - not that my thyroid is seriously out of whack. Many people here have antibodies that are far far higher than mine.
I can't try another GP - I live in a remote place and the practice is the only one for people in my area and there are three of them and he's the senior partner. The other two know less and tend to fall into line. I won't self medicate because I also have other autoimmune problems and two specialists already so can't risk it. I wouldn't feel comfortable with this route - not yet anyhow. I don't think my thyroid or my diet are responsible for my high ESR or CRP.
I only commented on this post because I sometimes think people don't always see the bigger picture with the immune system and inflammation and think that tweaking supplements or thyroxine or diet are all it takes to address this for everyone. From my experience of autoimmune diseases I don't think it is but I do think the gut is a huge player. I just wish doctors were so much more knowledgeable and enquiring.
I believe I do have a rare autoimmune syndrome and would consider moving somewhere to be nearer to a good immunologist who could take a look at the bigger picture with me. Will see how it all pans out.
I don't think health obsessed is tantamount to hypo contraria. I think we have to become health obsessed to find out enough about our own health condtions to give ourselves a fighting chance not to be fobbed of by a GP who relies on our ignorance. Do continue to research, then perhaps you will know what specialist consultant you can shoot for.
My GP doesn't rely on my ignorance - but he knows I'm not medically trained or a scientist and he only has so much time to discuss things with me in a 15 minute slot.
I can see from his perspective that it's frustrating having patients who are knowledgeable to a certain extent but haven't spent years and years training to be medical professionals.
I send him links sometimes, including my favourite one about the device being trialled to attack inflammation through the Vagus nerve - which he had already listened to and agreed it was exciting. He always looks at them and comments in reply - even if it's to disagree as he did about NDT.
These people are just as fallible as anyone else and can become arrogant of course. But personally I prefer being able to share and discuss my research with my doctor rather than go in all guns blazing and piss them off by making them feel useless.
I think the term obsessive is actually right for many of us, including me, but I don't think it's particularly healthy. We should be able to become expert patients and self manage our conditions without becoming obsessed in an ideal world. There's a very fine line between being obsessed and becoming a hypochondriac I believe. Hypochondria can be an illness in itself of course.
My GP relied on my ignorance for over 7 years. I only discovered TSH elevated when insisted on print outs. Sounds like you have a better than average GP, open to your research. The GP who misdiagnosed me for 7 years, always seemed far to busy to allow me to talk through my symptoms, so wouldn't have dreamt of offering her stuff to read.
For 'obsessive' read ' trying to clue oneself up on one's health issues, so we don't have to rely on GP's diagnosis, when we just know we're not feeling right' : )
I do agree with you about getting clued up and trusting our instincts and I do get frustrated by my GP too as he is quite controlling. But I was diagnosed with hypothyroidism about 12 years ago by a different GP who I sometimes see too. I was actually seeing her about being overweight and had severe eczema and dramatic hairloss (bald patches) so she must have tested me for thyroid problems and just said I was borderline and would I like to try Levothyroxine as it might help me to lose weight. I agreed with great enthusiasm - had no idea what it meant and never questioned it at all! I'd seen my dad become obsessed with his health problems and felt I didn't want to become like this myself so I just took the pills and had blood tests yearly.
One time I had a phone call from the practice nurse saying my thyroid bloods were really bad and how was I feeling. I just laughed and said "just as rubbish, tired, fat and unhealthy as I always have!" and she put up my dose by a lot I think. It never made much difference although after RA was diagnosed nearly four years ago my GP phoned and lowered my dose from 125 down to 100 I did feel rather less well for ages and tried to persuade him to raise it again. But I've never really taken my thyroid problems as seriously as I have my inflammatory problems or researched them much as I'm very bad with numbers and find my brain just doesn't take thyroid stuff in well at all. Nowadays my hair is thick, I'm four stone lighter and I exercise daily and live a very healthy lifestyle and have no eczema at all. I think we can take control of our health a lot but not entirely as I would wish - and I need my GP to help me do the rest.
Hormonal changes/ menopause I think. The cat of many years died and I stopped working with oil paint so these probably helped too!
I think a lot of health problems are to do with hormonal changes and also to do events that have shaped us from birth onwards. But although, in theory I'm quite ill these days, I'm so much healthier in how I approach my health and gut. Because of all the health problems and the drug intolerences I have NHS counseling now and this has really helped me too.
Each community I am a member of on HU claims my symptoms for it's own so I have learned to take a very ginger approach to advice I'm given about supplements/ diet and medication as we know nothing about people here or what their own agendas are. A few people do appear to know masses about their own conditions but often very little about those of others. I've learned loads about what people have to cope with health-wise by just reading and researching each condition. If you span many autoimmune diseases as I do then you learn to be very careful about taking advice. In fact most communities do not allow their members to give any.
I also think medicine and our understanding about the immune system is really still in it's infancy in many ways so I am quite wary of all drugs and all doctors and of alternative therapists too/ naturopaths too. So much depends on the individual and their tolerences and intolerences and their own history from conception onwards. No one rule fits all and I hope this applies to inflammation levels too.
It is a mystery why the immune system turns against itself, I guess. In my case the inflammation is stopping my iron levels rising, iron going into stored (ferritin), which more than doubled whilst active iron reduced. And low iron blocks T4 to T3 conversion.
Not medically trained but have been told that Adcal is not at all good for you. Its a minefield trying to find a calcium supplement which is really beneficial. Through high doses of thyroxine I lost bone and had to have a hip replacement at a relatively young age. However my GP pushes Adcal but having done my research I would not take it myself as according to a site dealing with osteoporosis the calcium is not going to the make the bones improve at all and could have quite the opposite effect. Milk and certain other 'beneficial' foods are not good either because they are acidic. I did heal myself of a nasty auto immune disease (ulcerative colitis) through diet and herbs but don't think that diet helped my bones a great deal. Trying to get the correct balance of diet and/or supplements which are beneficial, is not easy!
That is intetesting about AdCal D3. My GP recently retested my calcium levels, which had been low a year ago but he was concerned that I didn't need the AdCal D3 anymore now. Calcium came back bang on range so I'm still taking it.
However if what you say is right I might stop and replace it with D3 capsules only though as I get my calcium through almond milk, nuts and seeds and plenty of dark leafy veg. Interesting that you found you addressed your ulcerative colitis through dietry changes. I feel that ive addressed my RA in this way and even more so through regular exercise too. And yet as soon as I stop taking immune suppressant medication my ESR and CRP soar again - been off all RA drugs for six months now due to drug intolerences but my neuropathic symptoms still rage on alongside high inflammation markers. It is most frustrating and IT does worry me when I read a post such as this because I'm scared of having a stroke.
So sorry did not mean to alarm and everyone must do what they think is right and do their own research. Just thought I would mention what I had found out. I take cod liver oil (peppermint flavour) and a little flax seed oil but truly don't know if that is the best. Wish someone could give me advice on this calcium minefield.
Yes although none of these articles excite me a fraction as much as the programme about the Vagus Neve device being fitted in to send electrical signals through this key nerve. This is truly groundbreaking medical science and could perhaps help people with inflammatory thyroid diseases too at some stage. bbc.co.uk/programmes/b04pv6kq
That's a very low CRP cc120 I'd be on air if mine was that low - I wouldn't call that inflammation. My CRP has never been below 19 yet. But people like me with inflammatory autoimmune diseases are in a different category and have a different normal range to those who don't have inflammatory disease so it isn't just about pain - it's about fatigue, depression and flu like symptoms as well as severe nerve pain and loss of sensation and drying up of the mucous/ sweat producing glands throughout the body and circulation issues. Presently all my pain is caused by small fiber neuropathy - probably immune mediated - and so my inflammatory markers are still high despite no joint pain or swelling from my rheumatoid arthritis. I am told that my high inflammation levels are a clear sign of autoimmunity rather than active disease but I haven't quite got my head round this yet!
Yes I suspected my CRP range is a lot lower than people with auto immune issues. But as the article above states:
'There is a direct inverse correlation between CRP and reduced tissue T3 (112,270), so individuals with elevated CRP (greater than 3 mg/l) or other inflammatory cytokines will have a significant reduction in cellular T3 levels.'
So therefore must be contributing to my lack of energy. I wonder if its high enough to create the Foam cells as reported in the first article?
Well I guess that trying to reduce inflammation further is always a good idea. Things like singing in a choir (stimulating the vagus nerve naturally) , regular exercise, avoiding certain foods (gluten/ carbs/ saturated fats/ refined sugars/ dairy) can only be good- mainly because being at the right weight for your BMI impacts on your inflammation levels a lot too.
I was previously eating 'healthily' which didn't seem to help with energy levels and I must admit to now not being so strict with myself, in regards chocs/sweets/deserts, but I've never smoked nor drank and note overweight. Find I can't exercise as become breathless and dizzy but I do stretch instead.
guess not but I assume mine is to do with my thyroid hormone level and trying to get it right...and whilst the pain is acute my tissues will be aggravated...I need to research more...an' I done loads....
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