Question
oh  one  more thing when this happened the second time a few years back I showed that I had low estrogin levels and nothing was done about it could this have anything to do with it?
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The text above is a follow-up to ...

-----Question-----
Hi thank you for reading my question...I'm a 25 year old female that has three boys 4, 2, and 3 months.  My family has a history of none spisific cancers, heart deases, MS, Graves, and Lupus.  

My issue right now is...haha...I mean issues are...
Tingling, buring, nubness all over my body extrimities scalp and ribs...muscle spasims...extrame bone pain in large bones and ribs and skull...upper abdominal pain (bloating and acking)...really bad headaches in the back of my head...stiffness of spine...and my junuller vein on the right side is getting larger (from what a doctor says)...goiter... loss of short term memory...hair loss...extrime fatige and hopefully last but not least mouth infections (constintly) Help all tests resently preformed (CBC, kidney function, liver functone, and calcuim were all normal, exept the thyriod showed a cold defect...but it was biopsied and it was (-)...for that they put me on 3 months of synthriod to shrick the gioter.  Help I'm so tired of this and everyone saying your fine you look great and your so young...I'm at the end of my rope and I can't keep up with my family any more...and they don't like that much!

Thank you!!!!!!!!!!!  Hopeless:(


PS: I went through  somthing similer 3 years ago when my face went numb and my right side droped along with tigling in my face and hands for about a month...
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Dear Melissa,

Wow, you have quite a bit going on, the firts step is to try and think about a central cause for the problems.  When you have symptoms that are all of the place there is usually a common source or related sources.

Obviously the thyroid is a contributing factor, but I do not believe that it is the casue of all your symptoms. With Synthroid the goiter will start to show improvement, you should see some improvement in the hair loss and extreme fatigue, but these are symptoms you can get from the other conditions as well.  Conversely, I don't know if you know this, but Graves disease is actually similar to the goiter problem (Hypo-thyroid)...it is considered a Hyper-thyroid condition.

Other complicating factors are that your family history is quite extensive. In addition to the Grave's Disease, you have Lupus and Multiple Sclerosis as possible factors in your genetic make-up.  All of these conditions have symptoms that are similar to what you are describing.

Considering Lupus, it is an autoimmune disease. Your body抯 immune system is like an army with hundreds of soldiers. The immune system抯 job is to fight foreign substances in the body, like germs and viruses. But in autoimmune diseases, the immune system is out of control. It actually attacks healthy tissues (normal cells).

Lupus is a disease that can affect many parts of the body. Everyone reacts differently. One person with lupus may have swollen knees and fever. Another person may be tired all the time or have kidney trouble. Someone else may have rashes. Lupus can involve the joints, the skin, the kidneys, the lungs, the heart and/or the brain. If you have lupus, it may affect two or three parts of your body.

There are three main types of lupus: SYSTEMIC LUPUS ERYTHMATOSIS (SLE) is the most common form. The word 搒ystemic?means that the disease can involve many parts of the body such as the heart, lungs, kidneys, and brain. SLE symptoms can be mild or serious.  DISCOID LUPUS ERYTHMATOSIS mainly affects the skin. A red rash may appear, or the skin on the face, scalp, or elsewhere may change color. DRUG-INDUCED LUPUS is triggered by a few medicines. It抯 like SLE, but symptoms are usually milder. Most of the time, the disease goes away when the medicine is stopped. More men develop drug-induced lupus because the drugs that cause it, hydralazine and procainamide, are used to treat heart conditions that are more common in men.

SIGNS/SYMPTOMS:  Lupus may be hard to diagnose. It抯 often mistaken for other diseases. For this reason, lupus has been called the 揼reat imitator.?The signs of lupus differ from person to person. Some people have just a few signs; others have more.  1.Red rash or color change on the face, often in the shape of a butterfly across the nose and cheeks, 2.Painful or swollen joints, 3.Unexplained fever, 4.Chest pain with deep breathing, 5. Swollen glands, 5.Extreme fatigue (feeling tired all the time), 6.Unusual hair loss (mainly on the scalp), 7.Pale or purple fingers or toes from cold or stress, 8.Sensitivity to the sun, 9.Low blood count, 10.Depression, trouble thinking, and/or memory problems, 11.Other signs are mouth sores, unexplained seizures (convulsions), 搒eeing things?(hallucinations), repeated miscarriages, and unexplained kidney problems.

We don抰 know what causes lupus. There is no cure, but in most cases lupus can be managed. Lupus seems to run in families, which suggests the disease may be hereditary, and is woth exploring considering your family history. Having the genes isn抰 the whole story, though. The environment, sunlight, stress, and certain medicines may trigger symptoms in some people. Anyone can get lupus. But 9 out of 10 people who have it are women.

SLE should be explored further by your doctor or a specialist. Telling a doctor about your symptoms and other problems you have had can help him/her understand your situation. Your history can provide clues to your disease. Use the checklist of symptoms above to keep track of your symptoms. Share this checklist with your doctor. Ask your family or friends to help you with the checklist or come up with questions for your doctor.

DIAGNOSIS: 1.Complete physical exam桾he doctor will look for rashes and other signs that something is wrong. 2.Laboratory testing of blood and urine samples桞lood and urine samples often show if your immune system is overactive. 3.Skin or kidney biopsy桰n a biopsy, tissue that is removed by a minor surgical procedure is examined under a microscope. Skin or kidney tissue examined in this way can show signs of an autoimmune disease.

Lupus is most common in women between the ages of 15 and 44. These are roughly the years when most women are able to have babies. Scientists think a woman抯 hormones may have something to do with getting lupus...you fit the profilee.

Melissa, many people have lupus for a long time before they find out they have it. It抯 important that you tell the doctor or nurse about your symptoms. This information, along with a physical examination and the results of laboratory tests, helps the doctor decide whether you have lupus or something else.

Concerening the specialist I mentioned above, A rheumatologist is a doctor who specializes in treating diseases that affect the joints and muscles, like lupus. You may want to ask your regular doctor for a referral to a rheumatologist.No single test can show that you have lupus. Your doctor may have to run several tests and study your medical history. It may take time for the doctor to diagnose lupus.

Now, MS is thought to be an autoimmune disease that affects the central nervous system (CNS). The CNS consists of the brain, spinal cord, and the optic nerves. Surrounding and protecting the nerve fibers of the CNS is a fatty tissue called myelin, which helps nerve fibers conduct electrical impulses. In MS, myelin is lost in multiple areas, leaving scar tissue called sclerosis or plaques. Sometimes the nerve fiber itself is damaged or broken.  Myelin not only protects nerve fibers, but makes their job possible. When myelin or the nerve fiber is destroyed or damaged, the ability of the nerves to conduct electrical impulses to and from the brain is disrupted, and this produces the various symptoms of MS.

While the exact cause of MS is unknown, most researchers believe that the damage to myelin results from an abnormal response by the body抯 immune system. Normally, the immune system defends the body against foreign invaders such as viruses or bacteria. In autoimmune diseases, the body attacks its own tissue. It is believed that MS is an autoimmune disease. In the case of MS, myelin is attacked.

Scientists do not yet know what triggers the immune system to do this. Most agree that several factors are involved, including:  Genetics, Gender, Environmental Triggers[Possibilities include viruses, trauma, and heavy metals ( toxicology)]

Anyone may develop MS, but there are some patterns.  Most people with MS are diagnosed between the ages of 20 and 50. Two-three times as many women as men have MS.
Studies indicate that genetic factors make certain individuals more susceptible than others, but there is no evidence that MS is directly inherited. MS occurs more commonly among people with northern European ancestry, but people of African, Asian, and Hispanic backgrounds are not immune. Approximately 400,000 Americans acknowledge having MS, and every week about 200 people are diagnosed. Worldwide, MS may affect 2.5 million individuals.

Symptoms of MS are unpredictable and vary from person to person and from time to time in the same person. For example, one person may experience abnormal fatigue, while another might have severe vision problems. A person with MS could have loss of balance and muscle coordination making walking difficult; another person with MS could have slurred speech, tremors, stiffness, and bladder problems. While some symptoms will come and go over the course of the disease, others may be more lasting.

Most Common Symptoms:  Bowel Dysfunction Bowel Dysfunction, Changes in Cognitive Function, including problems with memory, attention, and problem-solving. Dizziness and Vertigo,Depression and other Emotional Changes. Fatigue (also called MS lassitude), Difficulty in Walking and/or Balance or Coordination. Abnormal sensations such as Numbness or 損ins and needles?Numbness, and pain. Sexual Dysfunction, spasticity, and visual symptoms are also reported.

At this time, no single test is available to identify or rule out MS. Several tests and procedures are needed. These are likely to include:

Complete Medical History: Healthcare providers need an overall view of the individual's health picture, including symptoms and when they began.

Nervous System Functioning: Testing of reflexes, balance, coordination, and vision?as well as checking for areas of numbness.

Diagnostic Tests such as:  1.MRI scan, which gives detailed view of the brain, 2. Evoked potential tests, which measure how quickly and accurately a person's nervous system responds to certain stimulation, and 3.  Spinal tap, which checks spinal fluid for signs of the disease.

Two Basic Signs are Required to Confirm MS:  1. Signs of disease in different parts of the nervous system, 2. Signs of at least two separate flare-ups (also called relapses or exacerbations) of the disease.

As you can see Melissa, there is overlap, and the diagnosis is complicated.  You are not crazy...monitor your symptoms and pay attention to any changes, document them, and follow up on this.  Do not let your doctor brush you off with not knowing.  Press them to test for these conditions...and explore the possibilities outside these diagnoses as well.

Good luck, I wish you all the best in your quest for answers.
Respectfully,
Dr. J. Shawn Leatherman  

Answer
Dear Melissa:

The question of estrogen levels is a bit out of my expertise, but My wife is also a doctor and this lies within her area of expertise.  Below are some key points she relayed to me.  

Post-pregnancy hypothryoidism common and may be made worse with multiple pregnancies.

One time Low estrogen blood work is not clinically significant since blood chemistries fluctuate continuously.  For instance your estrogen levels are always reduce in the second half of the monthly cycle when progesterone levels increase.

She recommends doing a saliva test over multiple days during the cycle so that estrogen levels may be charted and compared to the normal fluctuations of a menstruation cycle.  She also recommends reading a book titled "Adrenal Fatigue" by Dr. James Wilson.

it is also common for auto-immune disorders to go into remission during pregnancy and then to have flare ups post-partum. Examples include Rheumatoid arthritis.

Another possible explanation for the low estrogen is if you were breastfeeding (suppressed by Prolactin), your milk-producing hormone. Lower estrogen suppresses libido, so that you focus on your baby and their survival and provides for natural child spacing.  This is a normal physiological swing in endocrine functioning.

In addition, multiple, back to back pregnancies is hard on body and may create havoc on the endocrine function due to the increased demand for hormone production to create an environment for the growth and maintenance of the fetus.

Respectfully,
Dr. J. Shawn Leatherman