throat pain discomfort

[Holiday12345]

is it possible having high antibodies to cause throat pain made worse by eating. Saw ENT who thought it might be thyroiditis causing my throat symptoms?

[greygoose]

Not the antibodies themselves causing the sore throat, but over-range TPO antibodies means you have Autoimmune Thyroiditis - aka Hashi's - so if your thyroid is swollen, it could cause a sore throat.

Actually, being hypo can cause all sorts of throat problems, because the thyroid is just next door: sore throat, difficulty swallowing, lump in throat, throaty cough, loss of voice, etc.

[Holiday12345 in reply to greygoose]

Thank you for your reply. Would I need to see endocrinologist for this or would GP do? (Mind you if I remember correctly my GP said she didn’t know what high antibodies meant….)

[greygoose in reply to Holiday12345]

Oh dear! That's bad. But, endos can be just as ignorant.

However, what would you expect an endo to do? There is not treatment or cure for Hashi's. The only thing anyone can do is to give you thyroid hormone replacement when you eventually become hypo. Have you had anything else tested, apart from antibodies?

[Holiday12345 in reply to greygoose]

In past 4 years since underactive thyroid been on 50/75 mcg levo last testing I think my tsh was 2.5 I know it should be nearer 1 if medicated but GP asked me to get rechecked in couple of months. Antibodies previously were >950 but last time were around 400. This throat issue is new and affecting swallowing pain etc GP referred me to endoscopy but I just saw ENT they looked at throat with camera up nose thing and it was fine but said I didn’t need endoscopy and thought it was thyroiditis or fostair steroid inhaler I had used that was probably causing the problem. But apart from cutting out gluten and getting ultrasound to check thyroid I’m not sure what else I can do to ease any hashimoto flare up.

[greygoose in reply to Holiday12345]

When on thyroid hormone replacement, TSH should be 1 or under. So, you are under-medicated.

Antibodies fluctuate all the time, it doesn't mean anything.

I know what you mean by ENT! lol I had the same thing. I reeled of all the symptoms I listed above, they shoved a camera up my nose, and told me there was absolutely nothing wrong with me! Obviously oblivious to the fact that the thyroid was right next door! And those were hypo symptoms. Sigh. And, of course, at that time, I didn't know either. Given that GPs are always sending thyroid patients to ENT, you'd think they'd be a bit more clued up, wouldn't you.

What do you mean by a 'Hashimoto flare up'?

[Holiday12345 in reply to greygoose]

When I say flare up … I just mean having these symptoms that might be related to my thyroid (might not be) as haven’t had thyroid symptoms for a long time (I don’t think). I don’t really know much about the autoimmune thyroid/hashimoto and if I would get symptoms from high antibodies

[Holiday12345 in reply to Holiday12345]

I don’t know if it’s acid reflux or just a weird 5?week long sore throat

[greygoose in reply to Holiday12345]

Well, opinions are divided on whether or not antibodies cause symptoms. Myself, I don't see why they would. They have one job, which they do, and then they die down again.

Have a look at this: a brief rundown on Hashi's:

OK, so Hashi's is an autoimmune disease – commonly called by doctors Autoimmune Thyroiditis - where the immune system attacks and slowly destroys the thyroid. It is diagnosed by blood testing Thyroid Peroxidase (TPO) antibodies and Thyroglobulin (Tg) antibodies.

(It's necessary to understand that the blood test to see if your hypothyroidism is autoimmune might not give you any further information, for three reasons:

* What they are testing for are TPO antibodies. Antibodies fluctuate all the time, so one test might be negative, and the next positive. But, if you have one over-range test, it does mean you have Autoimmune Thyroiditis.

* There are two types of Hashi's antibodies: TPOab and TgAB. The NHS only tests TPOab, and they might be negative, but if your TgAB are positive, it means you have Hashi's anyway.

* Some Hashi's people never even have over-range antibodies. They are diagnosed by ultrasound. So, a negative antibodies blood test does not mean you don't really have it.)

There are two types of Autoimmune Thyroiditis: Ord's and Hashimoto's. But, we call them all Hashi's for convenience. The difference is, that with Hashi's, you have a goitre, with Ord's you don't. But, the end result is the same: a dead thyroid.

Contrary to popular belief, it is not the TPO/Tg antibodies themselves that attack the thyroid:

"When lymphocytes infiltrate the thyroid gland, mistakenly taking it for a foreign bacteria invader, they damage the thyroid gland and release thyroid peroxidase &/or thyroglobulin into the blood stream. These don't belong outside of the thyroid gland so antibodies are developed to mop them up.

The antibodies are a result of the attack on the thyroid gland, the antibodies don't cause the attack."

After every immune system attack on the thyroid, the dying cells release their stock of thyroid hormone into the blood stream, causing the levels of the Frees to shoot up - FT4 to around 30 something, FT3 around 11/12 - and the TSH therefore drops to suppressed.

There is no knowing how long these high levels will persist, but eventually, they will drop by themselves as the excess hormone is used up or excreted, and not only will you become hypo again, but slightly more hypo than before, because there is now less thyroid to make hormone.

(NB: A Hashi's 'hyper' swing is not true hyperthyroidism in that your thyroid is over-producing thyroid hormone. It's physically impossible to 'go hyper' if you are basically hypo. The thyroid cannot regenerate itself to the point of over production of hormones - or even normal production. Very few doctors appear to know that.)

Therefore, it's very important that your doctor does not reduce your prescription, because you’re going to need it again! If you start to feel over-medicated at that point - some do, some don't - the best thing is to stop levo for a few days, then, when you feel hypo again, start taking it again. It's very important to know one's body, and how it reacts.

There is no cure for Hashi's - which is probably one of the reasons that doctors ignore it - apart from the fact that they know nothing about it, of course!

However, between the 'hyper' swing, and the descent back into hypothyroidism, there can be a phase - quite a long one, sometimes - of normality, where the person is neither hypo nor 'hyper'. This is where people sometimes start talking of having 'cured' their Hashi's, by whatever means. But, it doesn't last. Eventually, you will go hypo again.

But, there are things the patient can try for him/herself to help them feel a bit better:

a) adopt a 100% gluten-free diet. Hashi's people are often sensitive to gluten, even if they don't have Coeliac disease, so stopping it can make them feel much better. Worth a try. Some say that going gluten-free will reduce antibodies – I’ve never seen conclusive proof of that, but, you should be aware that even if you were to get rid of the antibodies completely, you would still have Hashi's, because the antibodies are not the disease. It is not the TPO/Tg antibodies that do the attacking.

b) take selenium. This is not only reputed to reduce antibodies, but can also help with conversion of T4 to T3 - something that Hashi's people often find difficult.

c) the best way to even out the swings from hypo to 'hyper' (often called Hashi's Flares, but that doesn't really sum up the way it works) is to keep the TSH suppressed. This is difficult because doctors are terrified of a suppressed TSH, for various false reasons, and because they don't understand the workings of Hashi's. But, TSH - Thyroid Stimulating Hormone (a pituitary hormone) - tries to stimulate the thyroid to make more hormone, which also stimulates the immune system to attack. So, the theory is, the less gland activity there is, the less immune system activity there will be, meaning less attacks, gland destruction slowed down and less swinging from hypo to hyper and back.

[Holiday12345 in reply to greygoose]

Thank you what a great explanation. I’ll try the gluten free diet and I have some selenium just never tried it so I’ll give it a go too. I wish GPs knew half of this thanks again

[greygoose in reply to Holiday12345]

You're very welcome.

[Vsully in reply to Holiday12345]

I have recently had a lump in my throat,and was sent straight to ENT,who then referred me for endo and ultra scan with dye,considering my bro passed away with throat cancer this was all done within a month,so if there really worried best get it checked,many thanks I love this site

[Holiday12345 in reply to Vsully]

sorry about your brother but great you’re being thoroughly check so quickly. Hope everything ok for you.

Turned out mine was a result of my Blood pressure medication (tried 11 so far and they all make me very unwell) this particular one caused the throat problems which cleared up on stopping them . Although docs wouldn’t listen at first.. been through another 5 since and ended up in hospital twice so still on the hunt.

But absolutely agree get anything strange/new with lump or swallowing checks out asap. Best wishes

[Gilbo72]

I have autoimmune thyroid problems. When I have a flare I can feel my the area around my thyroid gland swell on the front of my throat/neck. It hurts just like swollen glands, and can makes swallowing painful and difficult. It often happens along side a viral infection that can cause a normal sore throat. It is very distinct for me. It feels swollen like painful glands and tight, like a scarf is knotted around your neck. It slowly goes down in swelling.

Recently I had bad case of viral laryngitis all in my voice box. It felt similar, but it felt more inside my throat than outside.

The other biggie is post nasal drip, which can cause a chronic, inside, sore (scratchy/sore/raw) throat, and sometimes a cough, with not much other symptoms.

Or it could just be some kind of seasonal allergy...

Try plenty of fluids, humidifier, breathing in steam and perhaps an antihistamine to see if any of that helps for the other causes. Ibuprofen helps with thyroiditis, as it is swelling.

Thats just my experience of sore throats! Hope it helps.

[Holiday12345 in reply to Gilbo72]

That describes what my throats feeling like very well…. I wonder if I have the post nasal drip also. I’ll try antihistamine see if that makes any difference, thanks