Dry eyes

[Zelda5]

Recently, I had an ANA speckled pattern 1:640. They ran all the little subtests and all came out negative. My eyes are so dry that I was thinking I might have sjogrens. Also, I have bad constipation that I take Linzess for. Optician said when I was getting tested for glasses that my glands were blocked up and not due to allergies. I also have been breaking out in rashes. They said this is probably related to my Hashimotos but my numbers are actually pretty good. The lowest they've been in awhile. I think its all related, but may be early signs of something else.

[helvella Administrator]

I hope you are regularly using some form of eye drops?

Regardless the cause, you need to making things more comfortable and avoid causing damage from dryness.

It's important to use preservative-free eye drops. Many can tolerate the preservatives used for a while but eventually become intolerant so they no longer work properly.

Others will probably come along with some suggestions of specific products. I'm a bit out of touch as I have improved since getting adequate thyroid treatment.

[Buddy195 Administrator]

I recommend both HycoSan and Hyloforte for dry eyes; use liberally so your eyes are well lubricated. If you have any eye pain, swelling or double vision I recommend seeing a specialist ophthalmologist to rule out Thyroid Eye Disease. I have TED with Hashimotos even though it is more common with Graves.

[SlowDragon Administrator]

what are your most recent thyroid and vitamin results?

Are you on gluten free diet or dairy free diet

[Zelda5 in reply to SlowDragon]

No, I thought about it when my son was diagnosed with autism years ago. Some folks believed in doing a gf/cf diet. I decided not to try it then because the pediatric gastro said if he had an issue with gluten I would know. Because he'd be crapping through a screen door, 'his words'

[Zelda5 in reply to SlowDragon]

my tsh was like 2.57 my peroxidase was 127, so not too bad. It had been in 300's some years ago. I try to take vitamin D when I remember. My D had been in the past pretty low, but I had that hyperparathyroid then too. And it wreaked alot of havoc on me at the time.

[pennyannie]

Hello Jean and welcome to the forum :

There are tests for Sjogren's Syndrome - it is another auto immune disease.

Dry gritty eyes, and watering eyes, are also a common thyroid issues :

Are you using any lotions, potions, spray or drops - if so, just make sure that any OTC product or prescribed medication is Preservative Free.

Your lash base could be blocked - so use a damp hottish flannel across your closed eyes and gently massage down and around the lash base to remove any build up of debris.

[Zelda5 in reply to pennyannie]

Right now Im just using a generic eye drop that I picked up at Wal Mart. I bought some baby clothes to use as warm compresses. I probably dont use that enough. I got some johnsons baby soap I could probably use too. Someone on another forum mentioned a sjo test by bausch and lomb that is more sensitive than the usual blood work. My vision was blurry the better part of the day. Its so annoying.

[pennyannie in reply to Zelda5]

Well just make sure the product has written on it " Preservative Free" - it not do not use

A old clean flannel works well, it holds the dampness and folded down into an oblong to lay over your eyes.

[Zelda5 in reply to pennyannie]

oh it does have a preservative in it. I guess I will look for something better.

[pennyannie in reply to Zelda5]

Bin it :

[Caesard]

few thoughts from my side as well:

1. A speckled 1:640 dilution ANA result can't really be negative, unless it's a false positive, and therefore should be repeated. I'm thinking the immunofluourescence (IFA) test has been used.

1:640 is considered a high titer, it means it reacts to something, unless, again, it's a false positive

2. Speckled pattern usually means antibodies are present and could point to Sjorgren.

Thats why they perform the exploratory, antibody specific tests to confirm the type of antibodies present (little tests)

But if all the specific came back negative, as far as I can understand its either ANA was flawed (technical or human error) or exploratory tests failed to identify the existing antibodies (ANA reacts to more than 100 of them)

3. You can be ANA positive and not have an autoimmune or rheumatologic or other issues. And the other way around...

This per se doesn't point out to a (specific) disease, there is a % of healthy people carrying antinuclear antibodies, especially after 60-65 years of age.

Also vital infection can trigger transient ANA antobodies that can show positive results. (COVID?)

4. Besides ANA result, that can by itself point out to Sjorgren (and so it does in your case) there is a specific Sjorgren test to help physiologically determine the lack of functionality - the Schirmer test that uses test strips to determine the volume of lubrification the gland can provide in a determiend period of time.

5. The (intermittent) rash could very well be related to a positive ANA pattern. In which way...there is not enough data to even speculate about it.

6 Hashimoto antobodies, if present, might be the culprit, though there is no specific ANA rectivity to it. But its not uncommon thyroid antibodies to bring more (not specific to thyroid) antibodies to the table.

Finally, my thoughts is to thoroughly explore this, as it my herald another immune disorder, though definitely this is not necessarily true.

But I would stay on it, to get to the bottom of it.

I also have a 1:640 fine speckled pattern with DFS70 (dense fine speckled) some dsDNA Ab and a failed Schirmer test with dry eyes with a history of Basedow-Graves and TED oftalmopathy. Key point here its that my ANA pattern and titre do correlate with presence of antibodies. DFS70 in my case.

medlineplus.gov/lab-tests/a...

[Zelda5 in reply to Caesard]

Thank you, Caesard that was very informative. The ANA test was repeated twice. They said that the speckled pattern is the most common type and can be seen in healthy people. But, I do feel like there's more something going on. They said my rash was eczema. But it didnt look like those bumpy rashes. It was more oval shape with a slight ring and smooth and just shade or two darker than my skin . Now its like plaquey dry patch and it has shrunk. I probably shouldve waited to see the dermatologist and not the nurse practitioner. It honestly looked like the early scleroderma morphea pics that I found online. However, they are starting to disappear now. I needed to have them looked at when they first appeared and asked for a biopsy, I suppose.

[Caesard in reply to Zelda5]

it's probably not too late to see a dermatologist and possibly a rheumtologist too - just to be on the safe side - but shrinking is a good sign.

Where is the eczema located? Pre-tibial might be explained via thyroid connection (pre-tibial mixoedema)

And I would repeat ANA, to exclude a false positive. If confirmed positive, i would repeat ANA and the detailed ANA workup, after 6 months.

It may be the effect of a viraviral infection. But you should notice the drip and even clear of the antibodies response.

What I cant comprehend is how there is a positive ANA and no confirmed antibodies found. It reacts to what?!