Alan- Fatigue was the most debilitating symptom I experienced with Hashimoto’s. It actually started 8 years before I was finally diagnosed in 2009, after I got Mono (Epstein-Barr Virus) in college. I needed to sleep for 12 hours each night to be able to function, and by “function” I mean after hitting the snooze button on my alarm clock for two hours (ask my poor husband), I would drag myself out of bed and then had to drink 4-6 cups of caffeine everyday to keep myself awake. I often had Red Bull and Pepsi for breakfast, and was the epitome of “wired but tired”. I hope my articles help you get started
Thyroid storm requires emergent treatment and hospitalization. The main treatment is to decrease the circulating thyroid hormone levels and decrease their formation. Moreover, the high fever and possible dehydration is treated emergently with cooling of the body and IV hydration. PTU and methimazole are two agents that decrease thyroid hormone synthesis and are usually prescribed in fairly high doses. To inhibit thyroid hormone release from the thyroid gland, sodium iodide, potassium iodide and/or Lugol's solution can be given. Beta blockers such as propranolol ( Inderal , Inderal LA ) can help to control the heart rate, and intravenous steroids may be used to help support the circulation.
Data on the incidence of GO are limited (11). In a population-based setting in USA, an adjusted rate of 16 cases per per year in women and cases per in men was reported (12). In a recent study of a large cohort of newly diagnosed Graves’ patients, about 75% had no ocular involvement at diagnosis, only 6% had moderate-to-severe GO, and % showed sight-threatening GO due to dysthyroid optic neuropathy (DON) (13) (Figure 1). In a Danish population, moderate-to-severe GO showed an incidence of /million per year (women: ; men: ) (14). Ocular involvement is in most cases bilateral, although often asymmetrical, but it may be unilateral in up to 15% of cases (9). The onset of GO apparently has a bimodal peak in the fifth and seventh decades of life, but eye disease may occur at any age (15). It is more frequent in women, but men tend to have a more severe disease (15-17), as suggested by a decrease in the female/male ratio from in mild GO, to in moderately severe GO, and in severe GO (18). There is a close temporal relationship between the onset of GO and the onset of hyperthyroidism. In approximately 85% of cases GO and hyperthyroidism occur within 18 months of each other (15), although GO may both precede (about 20% of cases) or follow (about 40% of cases) the onset of hyperthyroidism (15).