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Increasing Levels of Free Thyroxine as a Risk Factor for a First Venous Thrombosis: A Case Control Study

Post Published: 21 April 2010
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Category: Thyroid Patient Perspective Posts
This post currently has 12 responses. Leave a comment

(Written by, Lolly, Graves Disease/TED)

I came across this article today after researching something else and found it very interesting especially as,  I have gone through something myself very,  similar.

Let me give you a little back ground, back in 2003 I started to have slight chest pains thought nothing of it, throughout that evening the pain radiated down my arm but still I thought maybe it was my neck because I have had similar pains associated with cervical spondlyosis.

Well that evening things got worse, but me being the stubborn person I,  am still didn’t do anything about it, now my fingers were getting,  painful and I didn’t realise they were,  getting extremely cold. I took some pain killers and went to bed could I sleep no, the pain was just unbearable. I didn’t want to disturb anyone so I got up made myself a hot drink trying to warm my fingers up this didn’t work it was nearly morning and I’d had enough. I told my family that I was going to the doctors they felt my hand and said you need to go to emergency you fingers are freezing cold. So I did, I was on my own so the nurse who took,  my history and checked my left hand and finger,  moved me into,   the resuscitation room,  all systems go, she suspected either an air,  embolism or arterial thrombosis not very common having it in the hand.

They sent,  straight away for the vascular doctor who bought all his students around great now i was on show because this had never been seen in this hospital only one case many years ago. Most of them guessed I had Reynaud’s but they got it wrong I indeed had an arterial thrombosis in my hand which was cutting of the blood supply to four of my fingers left hand if they didn’t act quickly then chances are I would lose all four of my fingers. I was prepped ready to go down to the x-ray department after blood test results confirmed,  I had a thrombosis. They were to do the procedure in there, a great Japanese doctor so nice and all the X-ray staff and theatre nurses to assist they had to make a cut in the femoral Artery and put in a a femoral line flushing out the artery it went from my right side (groin),  passing through the Artery right the way down to my left elbow. Then drug busting drugs were put through the line via drip. All the time they were doing this procedure they were taking pictures and had my hand on full view for even me to see it looked like Spaghetti Junction( big major road in Birmingham UK),  . I was awake through the whole thing trying to keep a brave face when deep down I was scared to death.

Once the procedure was done I was then transported up to ITU,   (intensive care unit)hooked to everything,   heart monitor Femoral line drips no part of me was free and in some ways I wish I had been unconscious spent a night of not being able to move. then my left hand went into spasm they called for the doctor who took bloods to check potassium. they weren’t happy that the clots were going so I had to,  the have the procedure( angioplasty),  done the next day this time going farther down into my hand and spent yet another uncomfortable night on ITU. I was then transported to the ward after femoral line was removed and had to stay in for a further 13 days because my blood just wasn’t getting to a safe level, heparin warfarin bloods taken every few hours my fingers were still painful but now the ends were sloughing and either they were going to drop off or slough and regenerate thank god it was the latter I still get cold fingers to this day middle finger being the coldest. I don’t have all the nerve sensation back fully but better than no fingers at all. While I was still in hospital they wanted me to see a top Heart specialist who came up especially from London to review my case. He asked me lots of questions and some i found rather bizarre and stayed with me a long time. One was have I or do I have cancer have I ever had an abortion well the answer to both those questions was no although now I was wondering do I have cancer. they reason he asked because I wanted to know is this is his word my body was truing on itself and they had done antibodies test which showed specific antibodies associated with someone who had either cancer or an abortion WTF…

Now I guess you are wondering why any of this has to do with thyroid disease Graves disease. Well two years later I was finally diagnosed with Graves disease. I did have a condition called antiphospholipid syndrome (Hughes disease) which is now being managed by blood thinners Clopidgrel after a long time on warfarin therapy,  I was also tested for Lupus (negative),  had MRI scans of my neck.

My theory has always been that I was already displaying antibodies associated with thyroid disease they just hadn’t picked up on it because the thrombosis had masked it. After reading that article today i wonder how many other,  people are at risk from either a stroke DVT or something,   much more serious.  I was lucky had I not acted any quicker than i did and I wasn’t that quick I may not have been here to tell the tale.

I have known a few people over the years who have had mild strokes associated with thyroid or DVT’s that is why it’s important to get all 3 tests Free T4, Free T3 and TSH.

I hope someone out there is reading this and knows exactly what I mean because they may have been through similar themselves.

Lolly

Increasing levels of free thyroxine as a risk factor for a first venous thrombosis: a case-control study

Abstract

There is a hypercoagulable state in hyperthyroidism, but the association with venous thrombosis (VT) is not fully explored. We aimed to investigate VT risk for different plasma levels of thyroid hormones and thyroid antibodies. We used a case-control study on leg vein thrombosis conducted between September 1999 and August 2006 at the Academic Medical Center, Amsterdam, the Netherlands. Parameters of thyroid function were assessed in 190 cases (mean age 57 years, range 19-90) and 379 sex-matched controls (mean age 56 years, range 18-93). Odds ratios (ORs) and 95% confidence intervals (CI) for VT risk were estimated according to several cut-off levels derived from plasma levels observed in controls. We found the risk of venous thrombosis to gradually rise with increasing levels of free thyroxine (FT4). In the absence of traditional acquired risk factors, FT4 levels above 17 pmol/L yielded a sex- and age-adjusted OR of 2.2 (95%CI 1.2-4.2) for deep venous thrombosis, which further increased up to an OR of 13.0 (95% CI 1.1-154.1) for FT4 levels above reference range. Our data suggest increasing levels of free thyroxine to be a risk factor for venous thrombosis, and may have implications for both the prevention and management of this disease.

Aside: Please continue supporting,  Dr. Sarah Myhill, to end the witch hunt for this fine doctor in the UK.

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12 Responses to “Increasing Levels of Free Thyroxine as a Risk Factor for a First Venous Thrombosis: A Case Control Study

  1. Miriam.L says:

    Lolly…

    Thank you for sharing your health problems with us. What a horrendous time you went through to finally find out you are suffering from thyroid disease. Shame it took the doctors 2 years to discover you were suffering from Graves disease?

    Thyroid disease is so hard to diagnosis as the symptoms like so many other diseases. Thyroid is so diverse, so many different symptoms and types of the Thyroid disease, everyone suffers differently, and I wonder if that is why its so hard to diagnose.

    Strangely, not so long ago I did go through a strange mild similar experience with slight pains and palpitations and pain down my left arm as well as a headache. I just took pain killers and rested and it went over after a couple of hours. I forgot about it till I read your blog and recognised the symptoms from that night and got me wondering.

    I hope that one day soon, the doctors will find the correct meds and doses for you and you will begin to feel in much better health.

    Thank you for describing your health problems in detail.

    BTW sent you a FB msg too.

  2. Dear Thyroid says:

    Lolly –

    So sorry you went through this. Thank you for sharing your story with us, and for educating us about this extremely important topic.

    xo

  3. lori says:

    Lolly, I am so HAPPY you are here to tell this tale. This is certainly something I would never know or think could be related to thyroid disease. It seems the majority of doctors don’t even consider the immune system involvement and they only treat the thyroid levels. What a horrible experience and now you must worry about it happening again, even though you are on a blood thinner. I’m sure I would.

    The study says – “Our data suggest increasing levels of free thyroxine to be a risk factor for venous thrombosis, and may have implications for both the prevention and management of this disease.” – Does this mean people with hyperthyroidism are at risk and not people with hypo?

    I have been told recently I am at high risk right now for sudden death and heart attack because of the inflammation in my body. I never would have known had I not met my now current doctor but my family probably would have found out after they did an autopsy on me. This is the result of not being diagnosed many years ago, and I am sure what happened to you did not happen over night either, and is likely also the result of not being diagnosed earlier. These things occur over time.

    Lolly, thank you so much for sharing your story. I am very happy we are both here and I have you for a thysistah!

    {{HUGS}}
    Lori

  4. Hey Lolly,

    Thanks for sharing your story and spreading the awareness. I’m actually taking one aspirin a day right now because my thyrombocytes are too high, putting me at risk of thrombosis. I too hope you find the right doctor/treatment for you very very soon. I’m right behind you and cheering you on, thysistah! Love, Sarah

  5. Gina says:

    hey lolly,
    that is a very interesting story that u have been thru… and it certainly makes me think about what i have been thru over the last 8 yrs…
    i was diagnosed with thyroid cancer a yr ago… however 8 yrs ago i developed a very large deep vein thrombosis in my left thigh – too large that they couldnt operate or do anything else with it other than just put me on blood thinners because they were hoping that it would dissolve on its own.
    surprisingly i had a harder time being diagnosed with the dvt then they thyroid cancer… it took them 4 days to diagnose the clot even though i had all of the correct symptoms (and i know this doesnt seem like a long time for a diagnosis, but trust me it is, espically when ur blood circulation is being cut off to a limb)… it was only once my leg swelled up to twice its normal size and turned a lovely shade of blue that they thought there was something else wrong other than there original diagnosis of that i had fallen off a cow or kicked by a horse (i live in a large country town – and since i was 19 at the time they would not believe anything i said)!!! stupid drs!!! eventually i got diagnosed with a genetic predisposition for clotting – factor 5 laden!
    i never had my thyroid levels checked (that i know of) at the time of my DVT… but during my whole cancer diagnosis my thyroid levels were within normal range… but it certainly puts forward an interesting idea of whether there is a link between the two. i also wonder if there is a link between dvt, thyroid disorders and other hormones, esp female hormones such as estrogen.
    i am now taking everyday for life thyroxine and an asprin (i used to thin my blood naturally but am going thru a bit of money trouble at the moment and the asprin is cheaper)!
    but the thing i have discovered is that you just cant be complacent with ur body… these symptoms that you are feeling are your bodys way of telling you that there is something wrong… and even if the medical profession doesnt believe you then u need to scream louder till they take notice of you and do something about it!
    im releieved that you ended up going to the hospital and getting medical attention! and i am so happy for you that you are here today to tell your story and to help other people become aware of dvt’s!
    luv gina

  6. Lolly says:

    Miriam,

    It certainly was a scary time things happened so quickly I really didn’t know what was going on.

    ,I wanted answers and I wasn’t getting them they wanted answers and couldn’t find them. The only thing they knew at that time was I had antibodies and that my immune system was turning on itself this is how it sounded to me. I had an army that wasn’t defending very well and it had been taken over by an invading army with more man power and I was stuck in the middle of this battle field not knowing what would happen next, I had what you would call sticky blood sending off clots in my body Lucky for me it was my hand and not another part of my body.

  7. Lolly says:

    Katie,

    If you remember a good fee weeks back I had a scare with pain radiating down left arm and pain in my hand and if it wasn’t for you and Lori encouraging me to go to Emergency I don’t think I would have bothered . they did take it seriously did and ECG there and then and took blood to check for a thrombosis. Good news it was okay heart was fine and was put down to muscular skeletal.

    I want to thank you both for being there when I needed someone.

    Lollyxoxo

  8. Lolly says:

    Lori,

    Thank you so much for you reply and support. And you are so right this didn’t happen over night even though the clot did my immune system was up the creek without a paddle.

    According to the study DVT which is a deep vein thrombosis has a higher risk in high levels of free T4, this is only one study I bet if more studies were done other things would be revealed we know hypo can have an effect on the heart so why not the blood that supplies the heart. I think it’s our bodies way of telling us that they are not happy with inadequate or over production of thyroid hormones coupled with antibodies makes for a battle field.

    I had Arterial thrombosis (effecting the artery) which passed through the heart and down to my hand. Yes I do wonder sometimes as recently when I had that scare if it will happen again its always going to be a risk factor I am also at risk of stroke so have to watch for signs. Having the blood thinners is saving my life so too speak.

    I am happy that we are still both here too thysis and thank you agaion for being there for me yesterday. and for everyones support love you guys.

    Lollyxoxox

  9. Lolly says:

    Hi Sarah,

    My thyrombyctes were dangerously low it took nearly 4 months of anticoagulant therapy just to get them to a safe place. And now I have to take Clopidgrel(plavix) similar to Aspirin for the rest of my life.

    Thanks for your support.

    Lollyx

  10. Lolly says:

    Hi Gina,

    How bad that it took them so long to diagnose you with a DVT in your thigh 4 days is far too long considering the clot can disslodge and travel to the lungs or worse cut of the complete supply to the leg causing serious damage even loss.
    So glad in the end they got it sorted and you were lucky.

    but to not beleive you because of your age, things like this have no afge barrier it can happne to anyone anytime and as you said how much of it was probably related to an imbalance of thyroid hormones or other fagctors really makes you think.

    May I ask what you were using naturally to thin your blood. I have no choice but to take Clopidgrel but I am also at risk of ulcers having had a duodenal ulcer in the past.

    thank you for sharing your experience too and it must have been scary for you at the time and always the thought is this going to happen again.

    I do worry when I have to come off the blood thinners a few times due to surgery as I am also at risk of bleeding out or Haemorrhaging.

    Luv

    Lolly

  11. Bee says:

    Thankfully that ordeals’s over—thanks for the info—i’m printing it off to give to my PCP—what would we have done without one of our fav Brits to encourage us ?

  12. Jillian says:

    Hi Lolly

    I have been wondering about the link between hypercoagulibility and hyperthyroidism and have just read your article with great interest.

    Whilst my experience does not seem to be anywhere near as bad as yours. I took ill with pneumonia and pleuracy in Feb 2008. In May the same year, I was at home and realized I couldn’t walk across my bijou room without running out of breath. I was taken into our local hospital where they carried out a series of tests and discovered I had only half a lung working for me due a couple of pulmonary embolisms filling the rest. The pain was extreme and so they doctors kept me in hospital for 6 weeks whilst they got my coagulation under control. I have been on warfarin ever since.

    I had an operation on my ear in August last year, and since then my PT levels have not settled down and indeed have been increasing, which means that the amount of warfarin I need to take has decreased.

    Anyway, to get to the point of my post. Four weeks ago, I went to my doctor feeling real fatigued and I would say in a state of malase i.e. I didn’t really know what was going on. She sent me for some blood tests which included such things as CBC – complete blood count, LFT – liver function and amongst them was TFT – Thyroid Function.

    A couple of days after the blood tests, I spoke with the receptionist who advised me that the result for the Thyroid was abnormal and she arranged an appointment with the doctor.

    Whilst I was waiting for the doctor’s appointment, I came on the net and compared my symptoms, or so I thought, to those of Hypothyroidism – mainly because I was feeling tired to the point of fatigue, and the fact that I was a little bit constipated. However, the doctor advised me that the results had come back showing that my thyroid has gone Hyper and not Hypo, can you imagine my surprise.

    The symptoms I had forgotten to match off although they are always there include: not being able to walk very far without getting out of breath, my hands and body shake all the time which I think is called tremor, and my heart was pounding and extremely fast, and during the winter I have had to open the window at work where others in the office have had to put extra heaters on.

    I put the heat, irratibility down to the menopause, but not the HRT I have been on for years was not having an effect, and although I don’t feel it I have lost 2 stone in weight.

    The doctor prescribed Carbimazole, of which I was originally on 2 x 20mg a day, which has since been increased to 2 x 25mg a day and Propanol which I take 80mg twice a day to ease the symptoms.

    I went to see the Occupational Health Doctor today, who did ask me during the appointment how I had coped with working full time. He is going to advise the Directors at my work that I should reduce my hours to half time until this settles down a bit more.

    I am currently waiting for an appointment to come through from a specialist doctor at the hospital when I will find out more about what is going on with my thyroid. At the moment I am not sure whether it is “graves” or not. But I will ask them to check for antiphospholipid syndrome (Hughes disease) you mentioned in your article.

    Thank you very much for your publication.

    Regards
    Jillian

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