Medical Forum / Diseases and Disorders / Breast Cancer / December 2004
Hypothyroidism anyone?
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Erik Friedlander - 14 Jan 2004 14:58 GMT My wife's recent blood test showed elevated liver enzymes which has triggered a lot of research on our part. She has shown a lot of fatigue, slowed speech, puffyness in the face in recent months and it seems these are symptoms of an under active thyroid.
Wondering if anyone has been down this road? any advice?
I understand both radiation, tamoxifen can trigger hypothyroidism....
 Signature Erik Friedlander erikf@_nospam_erikfriedlander.com http://www.erikfriedlander.com
A. P. Thorsen - 14 Jan 2004 16:49 GMT > My wife's recent blood test showed elevated liver > enzymes which has triggered a lot of research on our [quoted text clipped - 6 lines] > I understand both radiation, tamoxifen can trigger > hypothyroidism.... Can't comment on the liver enzymes, but I was diagnosed as hypothyroid after BC treatment. For me, fatigue and joint stiffness in the morning were the main symptoms. I've also read that hypothyroidism is more common for those of us who've had BC. Several besides me on this group are hypothyroid.
I'm not clear; has your wife's TSH level been checked (simple blood test) and you know she's hypothyroid, or are you not sure at this point?
My treatment involved a multi-month titration process where they started me on a small dose of thyroid hormone, tested the result, and adjusted until I was back in the normal range. Now stay on that dose, with blood tests every 6 months or so to make sure nothing's changed.
If there's anything else you would want to know about the hypothyroidism question, please ask.
Ann T. Remove 'dontsendspam' from address to reply by email
Erik Friedlander - 14 Jan 2004 17:23 GMT > I'm not clear; has your wife's TSH level been checked (simple blood > test) and you know she's hypothyroid, or are you not sure at this point? Just this morning. When I read the symptoms I called the nurse at our hospital and asked her to add a thyroid panel to the blood tests we were doing (redoing liver enzymes, hepatitis, cholesterol).
Basically my wife gets very scared when we have to go and get scanned (PET/MRI/CAT whatever) so if I can give her something to hold onto here that is valid she'll be more confident, less terrified.
thanks...
OH, what reason did they give your for your hypothyroidism?
 Signature Erik Friedlander erikf@_nospam_erikfriedlander.com http://www.erikfriedlander.com
A. P. Thorsen - 14 Jan 2004 18:16 GMT > OH, what reason did they give your for your > hypothyroidism? HahaaaaHawhAWW HaaW! Hee Hee! Heh. *Reason*? *Doctors*? Good one!
Seriously: It was treated as "just one of those things" -- it's pretty common, especially in women as we age . . . and I had a near relative (father) who was hypothyroid. I assumed they'd assume that was the cause, so I didn't even ask. I just took my Synthroid gratefully, and started to feel better.
But I suspect something in the BC treatment may have been a trigger -- the first couple weeks after radiation was over, I was starting to get more energy back, and then it was as if I hit a wall . . . I was tired all the time & couldn't seem to improve the situation. Shortly thereafter, I was diagnosed.
Hope your wife turns out to have something as simple as hypothyroidism. I haven't had any side effects from the treatment, other than feeling better!
Take care, and let us know how things come out!
Ann T. Remove 'dontsendspam' from address to reply by eamil
songofruth2002@yahoo.com - 29 Dec 2004 12:50 GMT I know this is an old thread but...
> But I suspect something in the BC treatment may have been a trigger -- > the first couple weeks after radiation was over, I was starting to get > more energy back, and then it was as if I hit a wall . . . I was tired > all the time & couldn't seem to improve the situation. Shortly > thereafter, I was diagnosed. Yah. My last radiation treatment was October 2, 2004. All of October my energy started bouncing back. Terrific! So I started back to work full-time on November 1.
Since then I've just been so tired.
I've thought - I started back full-time too soon. - I'm trying to do too much. - I'm not getting enough sleep. - I go to bed too late. - I get up too early. - I'm not eating right. - I should get more exercise.
It just doesn't seem to take much for me to be absolutely dog-tired. But none of the stuff I keep thinking might be it really explains it. The most recent thing to wonder is that my MUGA shows 61% whereas it was 65% before chemo.
I started looking for support groups because I was hoping for possible explanations for still being so tired almost 3 months post-radiation. I'll ask my doc (if I can remember) to check into this. Take care, Melody
A. P. Thorsen - 29 Dec 2004 14:14 GMT > Yah. My last radiation treatment was October 2, 2004. All of October > my energy started bouncing back. Terrific! So I started back to work > full-time on November 1. > > Since then I've just been so tired. To confirm our counter your suspicions, you might want to consider whether you have other hypothyroid symptoms, too. There are lots of sources for lists of symptoms, such as:
http://www.mayoclinic.com/invoke.cfm?objectid=021FF7E0-FECE-4FE8-B7EBF6632546B11 6&dsection=2
(That URL may line-wrap & you'll have to use cut & paste to get it into your browser.)
Morning stiffness was a big symptom for me.
> I started looking for support groups because I was hoping for possible > explanations for still being so tired almost 3 months post-radiation. > I'll ask my doc (if I can remember) to check into this. It's just a simple blood test. There are other things your doc may consider as explanations, too.
Oh -- and I'd recommend the "more exercise" idea, too -- getting my thyroid hormones under control was a biggie in getting my energy back, but it's the "more exercise" thing that's gotten me to the point where I feel physically better & more energetic than I have in *decades* . . . .
Hope you find a solution (and soon) -- let us know how it comes out, OK?
Ann T. Remove 'dontsendspam' from address to reply by email
SongOfRuth - 29 Dec 2004 15:01 GMT > To confirm our counter your suspicions, you might want to consider > whether you have other hypothyroid symptoms, too. There are lots of > sources for lists of symptoms, such as: http://www.mayoclinic.com/invoke.cfm?objectid=021FF7E0-FECE-4FE8-B7EBF6632546B11 6&dsection=2
So many things could be symptoms or just life.
"increased sensitivity to cold" - can this be off and on? cause that's how it seems to go but then is that the early menopause or the just the fluctuations of the heating system since it's winter now.
"pale dry skin" - yep, but then again it's winter with it's drier air.
"muscle aches, tenderness, stiffness, esp in shoulders and hips" - I have been getting soreness right below my shoulders, but is that just because I'm also experiencing a right breast that feels 1-1/2 times normal size?
"pain & stiffness in joints, swelling in knees or small joints of hands & feet" - yes, but again can be put down to either happened pre-cancer or the weather
But I'll write it all down and start trying to take better note. One place said that brain fog is also a symptom. Got that in spades - is it hypoT or chemo brain. But like you say below...
> It's just a simple blood test. I have a call into the nurse to see about getting the test ASAP so that the doc will have the results for next week's appt. I once looked into this long ago (relating to infertility) and know that there are a couple of things that need to be looked at. And also that on one test the bounds of "normal" were reduced from 5 to 3.
> There are other things your doc may > consider as explanations, too. That's just the thing... the docs seem very willing to put it all down to "that's just the way it is".
> Oh -- and I'd recommend the "more exercise" idea, too -- getting my > thyroid hormones under control was a biggie in getting my energy back, > but it's the "more exercise" thing that's gotten me to the point where I > feel physically better & more energetic than I have in *decades* . . . . Exercise is one of the things that counts as "doing too much" that is guaranteed to make me really super tired the next day. But I'll give it another go and start with lower amounts (was trying to do 1 mile every day on the treadmill).
Thanks for the reply. Now to go find just exactly what tests to request.
A. P. Thorsen - 29 Dec 2004 17:55 GMT >>It's just a simple blood test.
> I have a call into the nurse to see about getting the test ASAP so that > the doc will have the results for next week's appt. I once looked into > this long ago (relating to infertility) and know that there are a > couple of things that need to be looked at. And also that on one test > the bounds of "normal" were reduced from 5 to 3. I think there's a standard "thyroid panel" or something . . . a set of tests that are routinely done together for thyroid function. The nurse will probably know. I don't have the test results here with me, but the key test is TSH (thyroid stimulating hormone) with related tests for T3, T4 (thyroid hormones), and maybe some others.
>>There are other things your doc may >>consider as explanations, too. > > That's just the thing... the docs seem very willing to put it all down > to "that's just the way it is". One thing I've learned from my BC, my late husband's esophageal cancer, my late father's various heart and other problems, is that sometimes I have to be emphatic with doctors about what I want. Polite, very clear, *very* emphatic, *very* persistent. "These symptoms are not acceptable. They're impairing my daily life. What can we do?"
> Exercise is one of the things that counts as "doing too much" that is > guaranteed to make me really super tired the next day. But I'll give > it another go and start with lower amounts (was trying to do 1 mile > every day on the treadmill). I started even more slowly, with yoga -- a class once a week, and maybe 10 minutes a day in between. Then 20 minutes daily, then up to an hour on weekends. Then I started weight training twice a week. Months later, I added half an hour or so of aerobics 2-3 times per week.
Then I started rowing, first once a week for maybe 6 months, then 3-4 times/week. Slacking off some on the weight training & yoga, I started swimming 2-3 times/week in the rowing off-season. In rowing season, I've done some racing . . . and I never *dreamed* of athletic competition before BC.
My emotional energy & stamina can still be lacking at times, but my physical energy is excellent (for my age & weight, anyway).
You'll get there!
Take care,
Ann T. Remove 'dontsendspam' from address to reply by email
marilyn@historica.ac - 29 Dec 2004 19:10 GMT Melody wrote:
>> Exercise is one of the things that counts as "doing too much" that is >> guaranteed to make me really super tired the next day. But I'll give >> it another go and start with lower amounts (was trying to do 1 mile >> every day on the treadmill). I went for a walk after my first chemo, thinking it would make me feel better. At the time I was walking about 3 ks a day. On the way back I got so tired I thought I was going to have to flag down a police car to take me the final two blocks. I was standing on the street crying wondering what to do. (I made it, barely)
After that a short walk around the block or to the grocery store to feed my sudden raging sugar addiction was all I did.
I joined a gym last October and can now do 40 minutes on the eliptical machine. I've started to do better at housework too. It was 18 months after I finished all treatment before I felt like me again.
Marilyn
SongOfRuth - 29 Dec 2004 19:13 GMT I found some references (from tracing down the one you gave me) that confirm what I was thinking re TSH levels. Although I don't have muscle weakness (that I can tell) I have been getting muscle cramps, which I've never had in my life. Really! The only muscle cramps I've ever had were occassional foot cramps in my left foot only. But now I get them in both feet and in my lower legs - got a nasty one in my shin the other day and it was hard to work the muscle to get it out.
I'll start with 5 minutes on the treadmill. We've booked Disney in March and I don't want to join my 71yo mom in needing a motorized wheelchair just to keep up.
A. P. Thorsen - 29 Dec 2004 19:37 GMT > I found some references (from tracing down the one you gave me) that > confirm what I was thinking re TSH levels. Although I don't have [quoted text clipped - 7 lines] > March and I don't want to join my 71yo mom in needing a motorized > wheelchair just to keep up. Be forewarned that if you are hypothyroid, you'll probably go through a period of dosage titration for the prescription thyroid meds -- they start you on a dose, wait a while (a month or six weeks, I think it was), re-do the blood tests, adjust the dosage if necessary, wait . . . .
Don't panic, though: There seems to be symptomatic improvement even at the suboptimal dosage. They just don't want to go too far, and make you hyperthyroid instead (and I'm sure you don't want that either). I guess the reponse is quite individualized.
Between whatever help your docs can give you on the medical front, and consistent exercise (don't be afraid to push yourself *a little*), I predict you'll do great at Disney in March. I'll bet it'll be a nice treat!
Take care,
Ann T. Remove 'dontsendspam' from address to reply by email
SongOfRuth - 29 Dec 2004 19:53 GMT Well, if I end up with hypothyroidism, at least I'm already going to the doc once a month already, lol. At least until they'll let me take this dang port out. And I can live with monthly doc visits so long as I have a plan and know what's going on.
Kaye301 - 31 Dec 2004 15:46 GMT << Well, if I end up with hypothyroidism, at least I'm already going to the doc once a month already, lol. >><BR><BR>
I am being treated by the endocrinologist and only need to see her once a year, if that much, I think?
Kaye301 - 31 Dec 2004 15:50 GMT << Although I don't have muscle weakness (that I can tell) I have been getting muscle cramps, which I've never had in my life. >><BR><BR>
At time of dx I experienced a fatigue in my legs like I had never had before although it did remind me a bit of the fatigue and achiness I felt during AC treatment but it was worse
<< I'll start with 5 minutes on the treadmill. We've booked Disney in March and I don't want to join my 71yo mom in needing a motorized wheelchair just to keep up. >><BR><BR>
Sounds like fun and sounds like it would be good to build up your strength--enjoy!
Kaye301 - 14 Jan 2004 17:57 GMT http://my.webmd.com/content/article/63/72044.htm Statins: Breast Cancer Treatment? Cholesterol Drugs Stop Breast Cancer Growth in Test Tube By Daniel DeNoon WebMD Medical News Reviewed By Michael Smith, MD on Thursday, April 10, 2003 April 10, 2003 -- A widely used family of cholesterol-lowering drugs is being looked at as a potential breast cancer treatment. And findings from a new, preliminary study suggest researchers may be onto something. The drugs are known as statins. Earlier studies by Khandan Keyomarsi, PhD, at the University of Texas M.D. Anderson Cancer Center looked at breast cancer cells in the lab. When researchers added the statin drug Mevacor, the cancer cells stopped growing. Was it a fluke? Ekem Efuet, PhD, one of Keyomarsi's postdoctoral students, took a closer look. One reason cancer cells grow so fast is that they lack biochemical brakes that slow cell growth. Efuet found that Mevacor -- and, likely, other statins -- lets these growth-brakes build up inside cancer cells -- making them a potentially useful breast cancer treatment down the road. The current findings are published in the Proceedings for the 2003 Annual Meeting of the American Association for Cancer Research. "We have found out how a well-known and widely used class of drugs exhibits anti-cancer activities. That's an exciting finding," Efuet says in a news release. Other statin drugs that could potentially have some role in breast cancer treatment include Lescol, Lipitor, Pravachol, and Zocor. The idea of making cancer cells accumulate growth brakes isn't new. Several labs are working hard to develop new drugs to do this. But even if they work, such drugs would be years away from human tests. The finding that statins can do the same thing could shorten the process -- and hopefully make them available sooner for breast cancer treatment if research pans out. Interestingly, statins have to be processed in the liver before they can fight cholesterol. But it's the unprocessed drug that fights cancer growth. It may be that new forms of statins may be needed for breast cancer treatment. But Keyomarsi's lab is now testing existing statin drugs to see if they fight cancer in lab animals. ------------------------------------------------------------------------ SOURCES: Proceedings for the 2003 Annual Meeting of the American Association for Cancer Research. News release, University of Texas M.D. Anderson Cancer Center.
Barb - 14 Jan 2004 21:33 GMT > Wondering if anyone has been down this road? any advice? > > I understand both radiation, tamoxifen can trigger > hypothyroidism.... Hi Erik I am also hypothyroid. Was diagnosed a number of years after my mastectomy and chemo, but the numbers were so far out of whack that I could have been affected for years and didn't realize it. I was also very fatigued, lots of muscle weakness, dry skin, and depressed. They synthroid made a world of difference. Hope all goes well with your wife's blood tests and it's something as simple as hypothyroidism. The treatment is convenient and inexpensive.
Best wishes. Barb
Kaye301 - 15 Jan 2004 15:46 GMT Hi Erik, I am not sure what happened--perhaps I fell asleep again while posting ;-) or only part of my post came through. I feel a little embarrassed that an article only on statins appeared in response to your post re. hypothyroidism. I remember writing something directly related (unless I'm dreaming). Seriously, I also developed hypothyroidism 16 mos after my dx and about 11 months after I finished radiation. I suppose the radiation may have been the prime trigger but there were other events that may have also contributed. I wonder if the effects of the Arimidex (lowered estrogen) had anything to do with it. As I posted here--there were several things that happened soon after I began taking it. The first thing that developed (about 7 weeks later) was benign paroxysmal positional vertigo--caused by calcium depositis break loose in the middle ear and result in imbalance. A month after that I had a series of 3 separate attacks of pancreatitis of unknown cause. The pancreatitis may have contributed to the development of the hypothyroidism. One week after my last pancreatitis attack (about 11 weeks after starting the Arimidex) all standard blood tests taken were within normal limits. About 5 weeks later I began to feel very weak and exhausted. New blood levels were drawn and I was found to have several tests 'off' which included hypothyroidism. In addition to being hypothyroid, my tumor markers began to elevate, my testosterone level became double normal and then a few weeks later was 6 times normal (unless that was a lab error since same order for that test also had an order for a sperm count--and tech thought something had to be 'wrong' and falsified results--just guessing on that one). In addition my SGOT (one of the liver function tests) was above normal, the bilirubin went from .6 to 1.0 (highest normal level), and alkaline phosphatase levels rose to the 90's (from the 70's) although still 'normal.' During this time I also had a cholesterol count and lipid panel done and my cholesterol level and triglycerides were found to be too high. Tumor markers also rose--CEA went from 2.2 to 3.6 and then 4.5; CA 27.29 although still normal rose about 8 pts and a few weeks after that an additional 3 pts. I was put on Thyroid medication--Levothroid (syntrhoid) and basic blood levels returned to normal. I also had a complete hysterectomy and Salpingo--oopherectomy. My cholesterol/lipid levels remained high. A year after that I started a statin drug. I don't know if that can help thyroid function but high lipid levels could have contributed to the pancreatitis. I then began taking a statin drug--which I subsequently learned may also be helpful in control of breast cancer--which is why I posted the related article. I believe I recall reading that high lipids may also be related to hypothyroidism--and was wondering if your wife had been tested. There is no way to know for sure if anyone of the 'events' caused the hypothyroidism alone or if they all had a cumulative effect.
cussot - 19 Jan 2004 10:19 GMT Add me to the list: about 18 months after treatment for br ca (CMFx8 and radiation) I was diagnosed with hypothyroidism. TSH was 23 or something, way out of whack. I thought the fatigue was just due to the chemo/rads, so I dragged around for a long time feeling like a dishrag. Synthroid took a while to perk me up, but it helped eventually.
> My wife's recent blood test showed elevated liver > enzymes which has triggered a lot of research on our [quoted text clipped - 6 lines] > I understand both radiation, tamoxifen can trigger > hypothyroidism.... Kaye301 - 21 Jan 2004 17:49 GMT cussot wrote: << treatment for br ca (CMFx8 and radiation) I was diagnosed with hypothyroidism...<< I dragged around for a long time feeling like a dishrag. Synthroid took a while to perk me up, but it helped eventually >>
Same here...but think synthoid helped in about 10 ddays. I had thought it was the cancer or that I was having an M.S. (multiple sclerosis) attack. O wasm t even that tired with the chemo
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