Symptoms of a Hashimoto flare

[Itsme_thebeaver]

Dear community

I am wondering if you could share your insights. I was diagnosed with Hashimoto after a Covid infection in 2022. My thyroid levels seem "normal" under substitution (recent lab):

TSH: 171;

fT3: 3.9;

fT4: 13.8.

However, I have flares that seem very clearly to be autoimmune in nature. I have symptoms of connective tissue disease but I'm wondering if they could also be Hashimoto symptoms. I also have a high ANA titer (1:1280). My questions are as follows:

1.) such a high ANA titer is commonly associated with connective tissue disease (tested negative so far); can Hashimoto lead to a ANA titer of 1:1280?

2.) And can a Hashimoto flare lead to the following symptoms?

- low grade fever; swollen lymph nodes; extreme fatigue; muscle pain (burning pain); join pain; photosensitivity; muscle weakness; noise intolerance; neuropathic issues; mild rashes.

My next appointment with my immunologist is soon, and I would like to be informed before meeting him.

Thank you!

[Itsme_thebeaver]

I forgot: I also struggle with dull chest pain during those flares, as well as headaches.

[greygoose]

Hi Itsme_thebeaver, g to the forum.

I think the best way to answer that question is to talk about what exactly a Hashi's 'flare' is, what is happening with your body.

I don't like calling it a 'flare' because I find that confuses people. I prefer to call it a Hashi's 'hyper' swing, because that better describes what it is.

As I'm sure you know, Hashi's is an autoimmune disease, where the immune system attacks the the thyroid, mistaking it for the enemy. During each attack, the dying cells deposit their store of thyroid hormone into the blood, causing levels of FT3 and/or FT4 to rise sharply. This makes you temporarily hyper, so your symptoms would be hyper symptoms.

That said, your levels are so low (guessing here, because you haven't put the ranges) I doubt that even a 'hyper' swing would take you over the top of the range. So, rather than experiencing hyper symptoms, you might just feel better.

None of the symptoms you list are obvious hyper symptoms, but could very well be hypo symptoms, or due to low nutrient levels. Have you had your vit D, vit B12, folate and ferritin tested? Hypos often have low nutrients because being hypo causes low stomach acid, making it difficult to digest food and absorb nutrients. So, if you haven't already, you really should get those tested.

[Itsme_thebeaver in reply to greygoose]

Thank you very much for your reply; this is extremely useful. It's interesting as I don't have symptoms of hyper; i.e. no increased heart rate, sweating, etc. But they also don't really feel like hypo symptoms; I'm not feeling cold. The constipation and fatigue would fit but probably not the rest. I do suspect a second autoimmune disease lurking in the background.

The last time I tested B12 it was high (something over 900) and ferritin was low at 19. But it's a good reminder that I should have them checked again at the next appointment! Folate and Vitamin D have not been checked, will ask for them, thank you.

[greygoose in reply to Itsme_thebeaver]

You're welcome.