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Author Topic: Mother in hospital - questions about HIV, HAART and thyroid disease  (Read 1219 times)

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Offline komnaes

  • Member
  • Posts: 1,893
Some of you may recall that my LTS mother (12 yrs on treatment now) was diagnosed with Graves' Disease a while ago (2 years). It was treated and for a while it seemed to have gone on remission. I spoke with her HIV doctor then and he suggested that it might have something to do with HAART, a potential long term side effect.

In any case she was fine until about a month ago and she started to complain about feeling tired all the time. After a few rounds of tests the doctor has come up with a diagnosis of hypothyroidism, the opposite of Graves' disease. She's now in hospital - fortunately still fine (undetectable and a CD4 percentage of around 19%, but need to get updated) but the doctor is worried because some irregular heartbeat patent detected by a recent MRI scan. They want to keep her there for more tests and more importantly don't want her to suffer a heart failure.

I checked again and the only study I could find is this:

http://www.aidsmap.org/en/news/E48529BC-E3F6-433C-978B-AAD85A852F91.asp

which seems to conclude that though HIV and potent antiretroviral therapy have been linked with various hormonal abnormalities, doctors did not detect any variables that were significantly and independently associated with hypothyroidism. Any updates on similar studies?

Just need to inputs on what's our next step - I was told that hypothyroidism is relatively easy to treat. Anyone has had similar experiences/problems with similar thyroid disease?

Thanks, Shaun
Aug 07 Diagnosed
Oct 07 CD4=446(19%) Feb 08 CD4=421(19%)
Jun 08 CD4=325(22%) Jul 08 CD4=301(18%)
Sep 08 CD4=257/VL=75,000 Oct 08 CD4=347(16%)
Dec 08 CD4=270(16%)
Jan 09 CD4=246(13%)/VL=10,000
Feb 09 CD4=233(15%)/VL=13,000
Started meds Sustiva/Epzicom
May 09 CD4=333(24%)/VL=650
Aug 09 CD4=346(24%)/VL=UD
Nov 09 CD4=437(26%)/VL=UD
Feb 10 CD4=471(31%)/VL=UD
June 10 CD4=517 (28%)/VL=UD
Sept 10 CD4=687 (31%)/VL=UD
Jan 11 CD4=557 (30%)/VL=UD
April 11 CD4=569 (32%)/VL=UD
Switched to Epizcom, Reyataz and Norvir
(Interrupted for 2 months with only Epizcom & Reyataz)
July 11 CD=520 (28%)/VL=UD
Oct 11 CD=771 (31%)/VL=UD(<30)
April 12 CD=609 (28%)/VL=UD(<20)
Aug 12 CD=657 (29%)/VL=UD(<20)
Dec 12 CD=532 (31%)/VL=UD(<20)
May 13 CD=567 (31%)/VL=UD(<20)
Jan 14 CD=521 (21%)/VL=UD(<50)

BobF

  • Guest
Re: Mother in hospital - questions about HIV, HAART and thyroid disease
« Reply #1 on: April 07, 2009, 04:30:39 PM »
Hi.   I too was diagnosed with Graves Disease in 2008 after alot of issues (heavy sweating, severe nausea, diarrhea, fatigue/weakness, "jittery" feeling/heart racing, etc.).   It didn't resolve on it's own, so I underwent a radioactive iodine process to ablate or kill the thyroid.   Once that happens, you swing to hypothyroidism and need to be treated permanently with a synthetic thyroid hormone -- levothyroxine in my case.  The condition can be easily monitored via blood tests.

The question over whether the thyroid issues were related to HIV is uncertain - I've been on HAART since 9/07 and have been undetectable since shortly after that.

Hope this helps -- feel free to IM me if you have any questions!
Bob

Offline komnaes

  • Member
  • Posts: 1,893
Re: Mother in hospital - questions about HIV, HAART and thyroid disease
« Reply #2 on: April 07, 2009, 09:58:24 PM »
Thanks Bob,

I haven't had a chance to talk to her HIV doctor yet (actually same as mind). In your discussions with yours did s/he mentioned anything about any known interactions between thyroid hormone therapy (T3? T4?) with HAART?

What I worry in her case is also the long term potential heightened risk of heart disease associated with HAART and now hypothyroidism.

Again thanks for the reply.. sounds like you've been doing well with your treatment. Hope things are working well for you too.

Hugs, Shaun
Aug 07 Diagnosed
Oct 07 CD4=446(19%) Feb 08 CD4=421(19%)
Jun 08 CD4=325(22%) Jul 08 CD4=301(18%)
Sep 08 CD4=257/VL=75,000 Oct 08 CD4=347(16%)
Dec 08 CD4=270(16%)
Jan 09 CD4=246(13%)/VL=10,000
Feb 09 CD4=233(15%)/VL=13,000
Started meds Sustiva/Epzicom
May 09 CD4=333(24%)/VL=650
Aug 09 CD4=346(24%)/VL=UD
Nov 09 CD4=437(26%)/VL=UD
Feb 10 CD4=471(31%)/VL=UD
June 10 CD4=517 (28%)/VL=UD
Sept 10 CD4=687 (31%)/VL=UD
Jan 11 CD4=557 (30%)/VL=UD
April 11 CD4=569 (32%)/VL=UD
Switched to Epizcom, Reyataz and Norvir
(Interrupted for 2 months with only Epizcom & Reyataz)
July 11 CD=520 (28%)/VL=UD
Oct 11 CD=771 (31%)/VL=UD(<30)
April 12 CD=609 (28%)/VL=UD(<20)
Aug 12 CD=657 (29%)/VL=UD(<20)
Dec 12 CD=532 (31%)/VL=UD(<20)
May 13 CD=567 (31%)/VL=UD(<20)
Jan 14 CD=521 (21%)/VL=UD(<50)

BobF

  • Guest
Re: Mother in hospital - questions about HIV, HAART and thyroid disease
« Reply #3 on: April 09, 2009, 06:47:57 PM »
Hey Shaun ... my Doc's didn't commit that the thyroid disease was related to either the HIV or HAART, but it's possible.  Given how terrible I felt they were doing alot of tests and found my T3 or T4 (and free T3/T4) were way out of line and diagnosed Graves Disease.   Treatment didn't help my symptoms, but after the radioactive iodine treatment I felt gradually better over the next couple of months -- it's a long process, but now they just monitor the blood to make sure the synthetic med is keeping my levels at the right place.   I had prior cardiac issues so feel comfortable now that it seems to be taken care and see my Endocrinologist and Cardiologist a few times a year for checkups.   I hope things go similarly well for your Mom.

Feel free to IM if you have any questions :)
Bob

Offline komnaes

  • Member
  • Posts: 1,893
Re: Mother in hospital - questions about HIV, HAART and thyroid disease
« Reply #4 on: April 10, 2009, 10:18:49 PM »
Thanks Bob,

The good news is that her doc has decided that there's no risk of any immediate cardiac problems, so they will put her on hormone therapy for the time being. She seems fine and just complains of being tired, and my worry is mainly concerning whether it will interact with her HAART, which apparently will not.

I have seen her at the worst of her Graves' Disease period so I know it must have been tough for you too. Best of luck my friend,

Hugs, Shaun
Aug 07 Diagnosed
Oct 07 CD4=446(19%) Feb 08 CD4=421(19%)
Jun 08 CD4=325(22%) Jul 08 CD4=301(18%)
Sep 08 CD4=257/VL=75,000 Oct 08 CD4=347(16%)
Dec 08 CD4=270(16%)
Jan 09 CD4=246(13%)/VL=10,000
Feb 09 CD4=233(15%)/VL=13,000
Started meds Sustiva/Epzicom
May 09 CD4=333(24%)/VL=650
Aug 09 CD4=346(24%)/VL=UD
Nov 09 CD4=437(26%)/VL=UD
Feb 10 CD4=471(31%)/VL=UD
June 10 CD4=517 (28%)/VL=UD
Sept 10 CD4=687 (31%)/VL=UD
Jan 11 CD4=557 (30%)/VL=UD
April 11 CD4=569 (32%)/VL=UD
Switched to Epizcom, Reyataz and Norvir
(Interrupted for 2 months with only Epizcom & Reyataz)
July 11 CD=520 (28%)/VL=UD
Oct 11 CD=771 (31%)/VL=UD(<30)
April 12 CD=609 (28%)/VL=UD(<20)
Aug 12 CD=657 (29%)/VL=UD(<20)
Dec 12 CD=532 (31%)/VL=UD(<20)
May 13 CD=567 (31%)/VL=UD(<20)
Jan 14 CD=521 (21%)/VL=UD(<50)

Offline aztecan

  • Member
  • Posts: 5,358
  • 28 years positive, 56 years a pain in the butt
Re: Mother in hospital - questions about HIV, HAART and thyroid disease
« Reply #5 on: April 10, 2009, 10:43:24 PM »
Hey Shaun,

Glad to hear your mother is doing better and the docs have come up with some answers.

Hang in there. and tell your mum to hang in there too.

HUGS,

Mark

"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

 


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