Hyperthyroidism Addsions

[Jul2020]

Hi I have been majorly unwell for 6 weeks with high temp and pulse rate eventually saw GP and was diagnosed following undetectable TSH and raised T4 to have Thyrotoxicitosis. (Commened on propanalol and carbimazole) Unfortunately I was admitted to hospital sunday night due to high temp and high heart rate. They are querying Graves, Throiditis or a nodule. But also they did a cortisol test and have said this is borderline so I have to go for a slow synacthen test. I have had major stress going on, since the end of last year and became then really unwell initially I thought it was Covid-19 as flu like symptoms. But these have continued, I have lost 1½ stone since beginning of May and of late is averaging between 2-4 lbs a week. Can anyone advise if they have had similar symptoms and if they have been diagnosed with Addisons along with hyperthyroidism as I thought this tends to be the case for hypothyroidism? I am due for a thyroid uptake scan this Tuesday and the slow synacthen test waiting for appointment letter

[Valarian]

Poor you ! Feeling over-heated, a rapid heart-rate and weight loss are pretty common symptoms of any hyperthyroid disorder, including Graves’. There can also be some overlap with Addison’s symptoms. Although hypothyroidism may be more common, having any autoimmune disease, including Graves’, is a risk factor for Addisons, but at least they are doing all the tests. healthline.com/health/addis...

Although the exact cause isn’t well-understood,the start of Graves’ is often associated with a period of unusual stress.

The thyroid uptake test should identify the cause of your hyperthyroidism (there are distinct patterns) and the slow synacthen test will check out your adrenal glands.

You can see some example thyroid uptake test images here, showing the distinctions between Graves’, thyroiditis, mutinodular goitre and an autonomous module racgp.org.au/afp/2012/augus...

[Hidden]

Do you know what your cortisol result was? The short synacthen test is done to see how well your adrenal glands respond to the artificial ACTH, a base level blood test is done & the idea is that the result after 30mins should be over 450nmol/Ls. It is important that they measure your ACTH levels at the start of the test, this needs to go on ice straight away, this shows if the issues is with your pituitary gland rather than your adrenal glands. High levels of stress will cause your cortisol levels to rise, plus the weight loss points more to adrenal insufficiency. If the issues is with your adrenal glands then it will be primary adrenal insufficiency, also known as Addison's. if it is due to your pituitary gland then it is secondary adrenal insufficiency, both are treated with steroids. Hope that helps?

[GAG68]

I was diagnosed with Graves’ disease as a child aged 9 , corrected with surgery and Addisons amongst others in late 30’s