Will biopsy show autoimmune condition?

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Anonymous #1
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Report Thread starter 3 years ago
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Bit more detail on the biopsy stuff:
I've had two biopsies taken by colonoscopy. I believe it was large bowel, one may have been from something called an ileum(?). I believe everything looked normal.
I have been having IBS like pains for a couple of years now. No big deal and pepermint tablets usually deal with it. I've recently had more severe pain start in my side and back (around kidney-ish area). Saw a urologist as it seemed urinary, but got the all clear from them and referred onto a gastrentologist (or some complicated word like that). Had colonoscopy and now i'm waiting on results.

As for why i'm on about autoimmune:
I've been wondering for a while if I may have an autoimmune issue since I have symptoms that would seem to fit. I have an ungodly low energy level and am unable to do much at all because of it. I'll also ge aches and pains generally all over and tend to be affected more by things like infections (get them more than other people and seem to feel worse with them).
I have already been diagnosed with a Vitamin deficiency and hypothyroidism, but treatment for them hasn't made me feel better despite improving the levels measured in blood tests. All these things started around the same time.
I believe my thyroid condition is Hashimotos (immune system attacking thyroid gland) because immune cells were present in one of the tests done. I don't believe I have ever been told that it is Hashimotos though. If my immune system is to blame for my thyroid I assume it wouldn't be too far of a leap to guess it may be causing issues elsewhere.

Anyway, would an immune problem show in a biopsy of this type? If not, is it worth bringing up? Is there anything else I should look into or ask about? I'm going a bit crazy here cos I keep being diagnosed and treated for things, but it never actually has any impact on how I feel. I don't want to sound like a hypochondriac suggesting things to drs, but I really want to get to the bottom of things and feel better. I'm hoping this will give me answers without me having to put it out there, but i'm no good with what tests are for and google is just crazy.

Any advice, answers or comments are welcome and appreciated. Feel free to ask questions or anything too- there is a bit more to this than i've put cos I don't want to make it too long.

Thanks for any responses.
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neahel
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#2
Report 3 years ago
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Hi there,

Hashimoto's specifically will not show on gastrointestinal biopsies - automimmune IBDs such as crohns or colitis would, but based on the description you've given of your symptoms, you sound like you're in the clear for those as they would have far more extensive bowel involvement. Hashimoto's is really quite easy to test for. It only requires blood tests looking at your hormone levels and for antibodies affecting your thyroid gland. So there's no harm in asking your GP to run those tests or refer you to a specialist for them. You don't have to answer this question in this forum, but just for you to think about, Hashimoto's generally presents with quite severe constipation, so if your stomach pains are related to constipation, then you probably should get the blood tests. In addition, if you're female, Hashimoto's can also cause unusually heavy and prolonged periods. I just mention these two symptoms specifically because a lot of other symptoms of Hashimoto's are shared by a large number of other autoimmumne conditions (like the fatigue and aches and pains that you mention) and aren't all that useful diagnostically. But if you experience either of those two, and given your already noted hypothyroidism, you should be tested.

Speaking as someone with an autoimmune disorder, I know how frustrating the diagnostic process can be. I was only diagnosed by accident - in preparation for a colonoscopy, one of my doctors decided to run an unusually comprehensive blood panel (that really confused the people taking my blood) which showed an abnormality nobody had ever even thought to consider in me because I'm way out of the typical age range for the condition (generally affects people over the age of 60, and I was 19). I ended up being diagnosed with a very severe form of a generally mild to moderate autoimmune disorder called Pernicious Anaemia. You mention that you were treated for a vitamin deficiency? Was it B12 by any chance? Pernicious Anaemia affects the body's ability to absorb B12, and the lack of it causes all sorts of problems in the body, from the brain, to the stomach, to the nervous system. Doctors often give B12 shots to people who aren't actually deficient because it is a bit of a wonder vitamin that boosts your energy levels amazingly, so if you mentioned fatigue to your doctor, it's quite possible that you were given B12 supplements but weren't technically deficient in that vitamin.
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Anonymous #1
#3
Report Thread starter 3 years ago
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(Original post by neahel)
Hi there,

Hashimoto's specifically will not show on gastrointestinal biopsies - automimmune IBDs such as crohns or colitis would, but based on the description you've given of your symptoms, you sound like you're in the clear for those as they would have far more extensive bowel involvement. Hashimoto's is really quite easy to test for. It only requires blood tests looking at your hormone levels and for antibodies affecting your thyroid gland. So there's no harm in asking your GP to run those tests or refer you to a specialist for them. You don't have to answer this question in this forum, but just for you to think about, Hashimoto's generally presents with quite severe constipation, so if your stomach pains are related to constipation, then you probably should get the blood tests. In addition, if you're female, Hashimoto's can also cause unusually heavy and prolonged periods. I just mention these two symptoms specifically because a lot of other symptoms of Hashimoto's are shared by a large number of other autoimmumne conditions (like the fatigue and aches and pains that you mention) and aren't all that useful diagnostically. But if you experience either of those two, and given your already noted hypothyroidism, you should be tested.

Speaking as someone with an autoimmune disorder, I know how frustrating the diagnostic process can be. I was only diagnosed by accident - in preparation for a colonoscopy, one of my doctors decided to run an unusually comprehensive blood panel (that really confused the people taking my blood) which showed an abnormality nobody had ever even thought to consider in me because I'm way out of the typical age range for the condition (generally affects people over the age of 60, and I was 19). I ended up being diagnosed with a very severe form of a generally mild to moderate autoimmune disorder called Pernicious Anaemia. You mention that you were treated for a vitamin deficiency? Was it B12 by any chance? Pernicious Anaemia affects the body's ability to absorb B12, and the lack of it causes all sorts of problems in the body, from the brain, to the stomach, to the nervous system. Doctors often give B12 shots to people who aren't actually deficient because it is a bit of a wonder vitamin that boosts your energy levels amazingly, so if you mentioned fatigue to your doctor, it's quite possible that you were given B12 supplements but weren't technically deficient in that vitamin.
Thanks for this. I had no idea hashimotos affected the gut too. I figured it was just thyroid stuff. I guess your thyroid does a bunch of things around your body though.
I know i've had one test that showed antibodies when my thyroid was being looked at. I don't know if that would be the hashimotos test though cos it was never mentioned to me as far as I know. Do you happen to know if hashimotos would have a different treatment than just taking levothyroxine?
This may sound stupid, but is constipation just hardened stool or does it have to be no often passing too? Cos i'm pretty regular, but I think i've had things like that mentioned once or twice so it could be related.
As for periods, i'm on the pill to stop them cos they were painful and irregular (by like 5 months once) so i'm not sure about that. Only bleeding I get now is light spotting and some slightly heavier bleeding when i'm on antibiotics. I actually ended up being tested for endometriosis though cos I have pain with intercourse. Apparently i'm clean though.

My deficiency is D, but I think I may have been given a short dose of B12 once and not been re-tested so I guess it's possible that's involved. I believe my D deficiency is relatively significant. My consultant told me that on no condition am I to ever let a doctor reduce my dosage, cos I will always be mega deficient. One of my doctors took me off it once or put me on a "maintenance dose" and boy was he mad. :P

Guess maybe I should bring up this whole autoimmune thing. Might mention it to this consultant first, even though he's only gut, cos he seems to have considered it and might take me more seriously. He asked me about joint aches and took those biopsies despite me looking fine. Maybe he'll be able to guide me a little on what to talk about with my GP.
My GP seems pretty happy assuming that all this is separate coincidences though. I have a feeling he'll tell me to stop digging if I try to bring it up. Oh well. Guess I have to at least give it a go.

Thanks for your advice. And I hope your condition is going okay, sounds like quite a nasty one.
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neahel
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Interesting that your test results did show antibodies. Your doctors really should have told you what they were antibodies to, because antibodies are a normal byproduct of your body fighting off infection, but if your immune system is fighting normal healthy tissue, that's when it's an autoimmune issue. For example, like most people, I've got antibodies to chicken pox because I had that as a small child, but I also have antibodies to intrinsic factor, which is the protein that helps the gut absorb B12 and which (as the name suggests) is quite important and not something that the body should be attacking. Personally I would call the doctor that performed that test back and get them to confirm which antibodies they tested for. I'd say it's unlikely that they'd test for Hashimoto's but not tell you, especially if the results were positive. That said, the treatment for Hashimoto's is levothyroxine, so if you've taken that before and had no improvement, then perhaps Hashimoto's isn't the answer. Levothyroxine is used to treat nearly all forms of hypothyroidism, not just Hashimoto's though. Either way, keep on trying to find the answer! You can always try another doctor if yours isn't really bothering to follow up properly, or doesn't believe you. The problem with a lot of chronic diseases is that they're uncommon and your regular GP might never have actually encountered someone with that before.

In addition to my autoimmune disorder, I was also born with a fairly benign cardiac arrhythmia called Supra Ventricular Tachycardia. Nowadays it can be easily corrected surgically, but that operation wasn't available when I was a baby and because I don't have any particular problems with the symptoms, I've never actually had it fixed. When I was about ten, I started developing other cardiac symptoms that worried me more, but my parents and my doctors all believed they were just related to my SVT. Personally, I thought it was a condition called Inappropriate Sinus Tachycardia, because what I was experiencing fit exactly the described symptoms of IST. It wasn't until two years ago that I managed to convince people to take me seriously about it and get a referral to an electrophysiologist (a cardiologist who specialises in rhythm disorders), who took one look at my scans and confirmed that I was right all along and it was a textbook case of IST. Point of that story is to trust your gut. You know your body better than anyone else, and if you think there is something seriously wrong, you need to be your own advocate.

Also, I'm from Australia, so vitamin D deficiencies are almost unheard of down here - we get more than enough sun! Vitamin D deficiency can cause bone and muscle weakness, particularly as your deficiency was quite pronounced. Those things won't be fixed quickly, so I suppose it's possible that some of your symptoms are still being caused by that, even if your vitamin D is now back in normal range, but that still wouldn't account for your hypothyroidism.

Good luck!
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Anonymous #1
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Report Thread starter 3 years ago
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(Original post by neahel)
Interesting that your test results did show antibodies. Your doctors really should have told you what they were antibodies to, because antibodies are a normal byproduct of your body fighting off infection, but if your immune system is fighting normal healthy tissue, that's when it's an autoimmune issue. For example, like most people, I've got antibodies to chicken pox because I had that as a small child, but I also have antibodies to intrinsic factor, which is the protein that helps the gut absorb B12 and which (as the name suggests) is quite important and not something that the body should be attacking. Personally I would call the doctor that performed that test back and get them to confirm which antibodies they tested for. I'd say it's unlikely that they'd test for Hashimoto's but not tell you, especially if the results were positive. That said, the treatment for Hashimoto's is levothyroxine, so if you've taken that before and had no improvement, then perhaps Hashimoto's isn't the answer. Levothyroxine is used to treat nearly all forms of hypothyroidism, not just Hashimoto's though. Either way, keep on trying to find the answer! You can always try another doctor if yours isn't really bothering to follow up properly, or doesn't believe you. The problem with a lot of chronic diseases is that they're uncommon and your regular GP might never have actually encountered someone with that before.

In addition to my autoimmune disorder, I was also born with a fairly benign cardiac arrhythmia called Supra Ventricular Tachycardia. Nowadays it can be easily corrected surgically, but that operation wasn't available when I was a baby and because I don't have any particular problems with the symptoms, I've never actually had it fixed. When I was about ten, I started developing other cardiac symptoms that worried me more, but my parents and my doctors all believed they were just related to my SVT. Personally, I thought it was a condition called Inappropriate Sinus Tachycardia, because what I was experiencing fit exactly the described symptoms of IST. It wasn't until two years ago that I managed to convince people to take me seriously about it and get a referral to an electrophysiologist (a cardiologist who specialises in rhythm disorders), who took one look at my scans and confirmed that I was right all along and it was a textbook case of IST. Point of that story is to trust your gut. You know your body better than anyone else, and if you think there is something seriously wrong, you need to be your own advocate.

Also, I'm from Australia, so vitamin D deficiencies are almost unheard of down here - we get more than enough sun! Vitamin D deficiency can cause bone and muscle weakness, particularly as your deficiency was quite pronounced. Those things won't be fixed quickly, so I suppose it's possible that some of your symptoms are still being caused by that, even if your vitamin D is now back in normal range, but that still wouldn't account for your hypothyroidism.

Good luck!
I seem to remember him telling me that my immune system was targeting my thyroid, but i'm not 100%. Unfortunately the doctor who ordered those tests did so 3 years ago and is a consultant my insurance will no longer cover me seeing. Basically it'd cost me £200 to talk to them again. I'm sure they sent results and things to my GP though so I guess I can just ask them. I do get sent to a few specialists but I think all of them just look at the issue in their area and don't think that there may be a link.
I know that the levothyroxine is improving my TSH levels or something so in at least some sense it is working. I just don't feel any improvement though.

I guess I do need to keep pushing. It just feels like i'm fighting a lonely and pointless battle. Thanks
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