Re: was memory problems - now Carbon monoxide, ferritin and thyroid

[Guest guest]

Thanks Bob,

I had been musing along the same lines so its nice to get something

more concrete on the subject! Hope you don't mind this long posting

but, as you're a scientist, I reckon the detail would be of interest

to you.

All along I had been convinced my thyroid was playing up but had

never been taken seriously by the medics. After the CO poisoning

influence became apparent, they were happy and relieved to attribute

everything to CO poisoning. It let them all off the hook for failing

to do anything about my thyroid and, for an enchanted 3 months, it

seemed that my ill health was behind me.

Alas in August 2006, I got exposed to my house full of next door's

car exhaust fumes, collapsed and instantaneously all the muscle

pain, fuzzy thinking, dizziness and unco-ordination came back. My

eyes swelled up and blistered, as did my mouth and nose lining. In

following months any volatile chemicals caused my eyes to blister

and me to have a rapid onset asthma attack. The violence of these

reactions has died down with time but my skin and eyes still reacts

by feeling like they are burning.

Here is the fuller sequence of my results. Note the only blood test

done when I was feeling terrible, and being unwittingly exposed to

CO, was in November 2005. All the others are post-exposure.

mid 1998 4.33 mu/L (following unexplained 2st weight gain and

total exhaustion, etc after my son's birth - PCOS tested and ruled

out)

02/11/2005 TSH=5.28 mu/L

08/06/2006 (a few weeks after CO exposure ended. Symptoms subsiding)

TSH=5.62 mu/L T4=10.30 pmol/ Ferritin=18 ng/mL

06/09/2006 TSH=7.18 mu/L T4=9.70 pmol/

08/11/1006 TSH=6.10 mu/L T4=11.20 pmol/

16/11/2006 TSH=5.31 mu/L

27/02/2007 TSH=6.01 mu/L T4=11.10 pmol/

16/05/2007 TSH=3.64 mu/L Ferritin=30 ng/mL

23/05/2007 TSH=5.49 mu/L

July 2007 NO TSH TEST Ferritin=24 ng/mL

Aug 2007 TSH=2.82 mu/L

Oct 2007 TSH=4.01 mu/L Ferritin=30 ng/mL

11/1/2008 TSH=6.18 mu/L T4=9.20 pmol/ Ferritin=52 ng/mL

6 weeks of low-dose thyroxine

11/4/2008 TSH=4.88 mu/L Ferritin=187 ng/mL

(NOTE TO SHEILA - 10 years is a long time to ignore results like

those. If the 4.33 TSH back in 1998 had not been labelled " Normal " ,

I reckon my life would have been completely different, regardless of

the CO exposure. I'm trying hard not to get too bitter, but

still...!!)

The only result relating to a period of wellness is the June 2006

one. I felt mostly awful for ALL the other tests. Ironically I

recall feeling truly terrible when the August 2007 test was done but

as it was only 2.82, the endocrinologist disregarded all the other

results and declared me well. Apparently he discharged me at that

time as I was considered normal, but my memory problems were so bad

then I can't remember being told. I only found out I was not under

the endo, when I phoned the hospital in January to ask when my next

appointment was.

Because the medical profession has been so loathe to diagnose or

treat me, it has provided ample opportunity to see what my body has

done without intervention. My ferritin levels did eventually respond

to high-dose liquid iron supplements as evidenced by the result on

11/1/2008 Ferritin=52. BUT, though I did feel perkier, there was no

corresponding improvement brain function or in TSH, which rose to

TSH=6.18 !!

That indicated to me that it wasn't low ferritin causing my main

symptoms but an underlying thyroid problem. Also, the thyroid

function had not improved, in spite of the ferritin level rise. I

was secretly hoping that the CO poisoning had caused my ferritin

drop which had triggered the thyroid malfunction and that the

removal of the cause of the ferritin drop would allow my thyroid to

sort itself out. The results indicate otherwise.

The big surprise is the 11/4/2008 blood test. I had been on low dose

thyroxine for 6 weeks. Note the huge rise in Ferritin to 187. The

TSH at 4.88 has dropped but is still too high methinks. My reasoning

is that the thyroid malfunction had compromised my absorbion of

iron, not the other way round. The CO poisoning had probably

depleted my iron reserves, whcih didn't help. Once the pressure was

off my thyroid, the iron levels were able to rise - either that or

it is a laboratory cock up !!

I have to say that I do not think that the CO poisoning is the sole

cause of my thyroid problems, though it may well have been the

trigger. Every woman descended from my great-gran Charlotte (a

photograph shows she had Graves disease) has gone on to develop

mostly hypothyroidism at some stage of life. The male descendants,

while not getting diagnosed with thyroid problems, generally present

with high cholesterol (irrespective of diet and lifestyle) and have

a tendency to develop heart problems in their 40s and 50s. I have

discovered 2 cousins with triple-bypasses. Great-gran Charlotte's

forebears also have descendants with thyroid problems - 2 were even

committed to lunatic asylums as a result of mania, one eventually

being diagnosed as hyperthyroid during her postmortem (

So, I've lost my personal injuries claim for injury caused by CO

damage as, realistically, the symptoms which were so damaging are

more accurately attributable to underactive thyroid! Theoretically

the good news is that those symptoms, unlike CO damage, ought to be

reversible and managable. The bad news is, in practice, the NHS is

failing thyroid patients in the most scandalous manner, so it is

still going to be an uphill struggle for me.

Your comment " Leaking boilers may indeed be having a far more

serious effect than has been publicly admitted. " corresponds with

the findings of another support group I found. Check out

www.co-awareness.org I spoke to some of the organisers and learned

that their partners developed underactive thyroids following their

CO exposure. Like me they are trapped in a medical limbo. Unlike me,

all of those people had NO FAMILY HISTORY of thyroid problems. That

makes the issue very worrying for the general population. Worse, the

problem is widespead and the Co-awareness group has gathered

considerable research indicating that it is " products of combustion "

from a variety of unavoidable, everyday sources (car fumes, air

travel, etc) which is causing mass-malaise and possibly leading to

an increase in thyroid symptoms in the population.

Tracey

> >

> > Here is the timetable of events in context:

> >

> > Feb 1998 to March 2008 - classic underactive thyroid symptoms,

TSHs all between 3.8 to 7.8, constant GP visits BUT no diagnosis.

> > Starting ometime after 1997, ending May 2006 - faulty boiler

flue leaking Carbon Monoxide. This was subsequently blamed for all

my thyroid symptoms, which are extremely similar to CO poisoning.

> > Physical and mental improvement from June 2006 but symptoms

> returned

> > with a vengeance August 2006, so back to pestering the GP again.

[Guest guest]

Nitric Oxide/Carbon Monoxide

Hi Tracey,

Thanks for that follow-up; I'll do a quick reply and come back to a longer response later.

....One of the places that ferritin gets stored is in the mitochondria.

I can imagine that if it's all in the mitochondria, it would tend to stop the mitochondria working well (just supposition at this stage).

The other storage place for iron is the liver. In haemochromatosis (iron overload) excess iron is stored in lots of different tissues.

The usual reaction to infection is to hide the iron away from the pathogens, but I suspect that the good bacteria and the body's own cells would also suffer in these circumstances, and it would then look like iron deficiency anemia....so perhaps some of the thyroid problems look like iron deficiency on this account….the iron being hidden away in what the body perceives as an infection (inflammatory responses etc).

As long as the body is hypothyroid, the machinery for disposal of waste protein will only work at reduced effectiveness leaving partly demolished proteins that can cause prolonged autoimmune reactions, since these proteins then look like `foreign' protein with some of their intact sugars (glycoproteins) still in place. The sugars mark the protein as friend or foe.

Products of combustion include not just carbon monoxide, but also nitrogen mon- and/or di-oxide (known as NOx). Nitric oxide (NO) is otherwise known as nitrogen monoxide and it reacts quickly with oxygen to form an equilibrium mixture of NO and NO2 (hence NOx).

Since the discovery a couple of decades back, that NO is a profoundly influential signalling molecule in the body (nitroglycerine was used to treat angina ~ it releases a tiny amount of NO that dilates blood vessels), great strides have been made in discovering the other systems that are also affected (memory is one of them).

Work has been done on the combined action of carbon monoxide and nitrogen oxides due to this extreme sensitivity of the body to the influence of these two gases.

I'll go dig some of this out later.

The somewhat surprising ebb and flow of your thyroid condition and the fluctuating level of ferritin, with/or without iron supplementation is worth looking at.

I'd call the ambivalent diagnosis of your thyroid status as unhelpful, even post-natally. There has to be a limit as to how long and for which severe symptoms, there can be an excuse for ignoring the clear signs and symptoms of hypothyroidism.

Were you tested for your folate and/or vit B12 status during any of that relevant period? No signs of pernicious anemia? No iron deficiency? No neurological signs?

best wishes

Bob

>> Thanks Bob,> > I had been musing along the same lines so its nice to get something > more concrete on the subject! Hope you don't mind this long posting > but, as you're a scientist, I reckon the detail would be of interest

[Guest guest]

Tracey, I can't believe what you have been through. I really hope

that your health returns to normal and that you feel good again soon.

P

[Guest guest]

Thanks Patersonia,

In all of this the thing I have found most astonishing is the

difference in how I was treated as a CO victim in contrast to how I've

been treated as a thyroid sufferer.

The toxicology team were compassionate and treated me as an

intelligent human being. They asked questions, listened to my answers

and encouraged me to ask questions. They carried out tests and, more

importantly, kept me in the loop by providing me, not just the GP,

with results. They also seemed to use a great deal of common sense and

autonomy - for example, one of the team got an expert outside the team

to re-examine the MRI scan of my brain. If they were just ticking

boxes, they could have just closed their report on the basis of the

alarming results of the 1st cognitive fuction test and no-one would

have been any the wiser. I'm so glad they chose to investigate further

rather than concluding my brain function was impaired and leaving it

at that.

It has really shown up the deficits in the management of thyroid

illnesses. I am frequently shocked when I read what other people on

this forum have gone through and are still going through.

Tracey

>

> Tracey, I can't believe what you have been through. I really hope

> that your health returns to normal and that you feel good again soon.

> P

[Guest guest]

Thanks for the explanation Bob. To answer a couple of your comments:

> The somewhat surprising ebb and flow of your thyroid condition and the fluctuating level of ferritin, with/or without iron supplementation is> worth looking at.The GP was also puzzled by the erratic fluctuations and swings in my TSH levels. I have been tested for antibodies on 2 occasions now and both came back negative. Unfortunately the lab does not provide actual figures, so "negative" may not mean no antibodies but may mean a certain number of antibodies. On record Hashimotos has been ruled out.> Were you tested for your folate and/or vit B12 status during any of that> relevant period? No signs of pernicious anemia? No iron deficiency? No neurological signs?

At one stage the GP commented on my marked facial assymetry. There was some concern that I may have suffered a minor stroke BUT, with current hindsight, the MRI scan indicates that I did not - thank goodness!

I do have some B12 and foliate results, as it happens.

8/6/2006 - B12= 132 ng/L folate=8.3ug/L16/5/2007 - B12 "normal"July 2007 - B12= 216 ng/L Folate not tested

All the above were considered OK. What do you reckon?

Tracey

[Guest guest]

Hi Tracey,

It is good that the toxicology team were so thorough and cared for

you so well. Sorry to hear that it hasn't been the same re thyroid

treatment. I continue to wonder WHY this is the case Tracey. It's

isn't as though everyone wants to be rushing off to the doctor just

to visit them! I can think of at least a thousand things that I'd

rather be doing than going to the doctor and I'm sure that most

people feel the same way!!!! The thing that 'gets' me from reading

messages on this forum is that most of the symptoms seem to be

considered thyroid related by the doctors UNTIL the TSH level

becomes 'normal' and then they seem to think that the symptoms are

related to something else or that people have made them up. That

just doesn't make any logical sense to me. If the symptoms are the

same and the TSH level is normal, doesn't it stand to reason that

the thyroid related symptoms still exist despite the TSH level.

Anyone could work that out, so I just don't understand the docs.

I live in Australia and I have a family member whose thyroid

condition hasn't been treated correctly. The doc has basically

written her off as a lost cause. Told her she will never be well

again. Just terrible. I saw a doctor for years who told me I

didn't have a thyroid condition despite a TSH of 5.6. She told me

that she wouldn't start treating me until my TSH was around 10!!!!

It ended up that my TSH got close to that level anyway!!! Luckily I

sought and found two doctors who are willing to explore options, do

the tests I want + also suggest other tests (which have shown that I

have a number of 'abnormal' results).

It shouldn't be this difficult for people in the UK and other

countries to seek and get quality health care for thyroid related

conditions.

P

>

In all of this the thing I have found most astonishing is the

difference in how I was treated as a CO victim in contrast to how

I've been treated as a thyroid sufferer.

It has really shown up the deficits in the management of thyroid

illnesses. I am frequently shocked when I read what other people on

this forum have gone through and are still going through.

>

[Guest guest]

Hi Tracey

'save as'

https://content.nejm.org/cgi/reprint/348/22/2204.pdf

Pernicious Anemia with Neuropsychiatric Dysfunction in a Patient

with Sickle Cell Anemia Treated with Folate Supplementation

n engl j med 348;22 www.nejm.org may 29, 2003

I got to recall some work I did 45yrs back in real chemistry (ignore

the boring bits)....I was making ruthenium nitrosyl trihydroxide from

ruthenium chloride. It reacts very much like iron.

They both are able to add either carbon monoxide or nitrosyl

molecules to the iron/ruthenium in varying proportions as likely will

happen in carbon monoxide poisoning.

Because cobalt will also bolt on carbon monoxide under appropriate

circumstances, it too will affect the incidence of low vit B12

(cobalamin ~ contains cobalt).

The apparent iron deficiency anemia caused by the carbon monoxide

will the take time to resolve on removal from exposure. Something

like six-nine months if the half-life of erythrocytes is about 50

days, but maybe longer or shorter if the erythrocytes are impaired in

their breakdown.

During that time the iron will be recycled into either new red cells

or it will be stored. It needs a good supply of thyroid hormone to

renew blood cells.

Looking at the report above, I'd suspect you were mentally impaired

with a low cobalamin (vit B12) and/or a low folate level (in view of

the other factors).

Added to the low iron anemia that would be a very serious problem.

Whether or not your thyroid dysfunction was evident or indeed caused

by the ongoing low iron/ferritin, one might expect that recovery

would be haphazard and difficult to explain.

A surprising rebound of ferritin might be accounted for by the ready

availablity of the iron in your liver but it was not mobilised until

the thyroid function started to recover and/or the cobalamin level

began to 'normalise'.

Iron is available in what's known as the Chelatable Iron Pool and it

seems to need dinitrosyliron to cause changes and/or movement of that

iron across the cell/organelle membranes.

I saw a paper a couple of months back, that hinted at this; other

papers also place emphasis on the expanding knowledge associated with

iron metabolic processes.

More on this later....

best wishes

Bob

(not copyright to me ~ please use as best fits the need)

>

> Thanks for the explanation Bob. To answer a couple of your

comments:

>

> The somewhat surprising ebb and flow of your thyroid condition and

> the fluctuating level of ferritin, with/or without iron

> supplementation is worth looking at.

>

> The GP was also puzzled by the erratic fluctuations and swings in

> my TSH levels.

[Guest guest]

Hi Tracey

....and I wonder if the Sickle Cell phenomenon HAS ANYTHING TO DO WITH

CARBOXYHAEMOGLOBIN AND/OR LOW COBALAMIN ?? ie do the erythrocytes

change shape merely due to the pernicious.. and/or low iron anemia?

Best wishes

Bob

>

>

> Thanks for the explanation Bob. To answer a couple of your comments:

>

> > The somewhat surprising ebb and flow of your thyroid condition and

the

>

[Guest guest]

Hi Tracey,

...so I looked up Sickle Cell anemia ~ Linus ing discovered it was

a 'molecular disease'.....that fits...:-)

best wishes

Bob

>

>

> Thanks for the explanation Bob. To answer a couple of your comments:

>

[Guest guest]

Hi Tracey,

Look what came out of the woodwork...?

http://www.springerlink.com/content/w3udxdp7832t95b9/

Circular dichroism spectra of human hemoglobin reveal a

reversible structural transition at body temperature

Journal European Biophysics Journal

Publisher Springer Berlin / Heidelberg

ISSN 0175-7571 (Print) 1432-1017 (Online)

Issue Volume 33, Number 6 / October, 2004

Category Article

DOI 10.1007/s00249-004-0401-8

Pages 490-496

Subject Collection Physics and Astronomy

SpringerLink Date Thursday, March 25, 2004

Lowered body temperature ( as per hypothyroidism ) changes the shap

of the haemoglobin in the red cells!

Now we can see why the red cells might have changed shape, merely

from lowered body temperature...OMG...irrespective of the carbon

monoxide poisoning ?

best wishes

Bob

>

>

> Thanks for the explanation Bob. To answer a couple of your

comments:

>

> > The somewhat surprising ebb and flow of your thyroid condition

and the

[Guest guest]

Hi Tracey

I think they missed the pernicious anemia in Jun 2006 and, most likely,

again in May/July 2007 ( whatever the range used ~ these values look

too low ).

A mechanism for carbon monoxide depleting cobalamin probably exists but

I haven't found it in the literature yet...it must be there somewhere.

If I have to propose it to get it looked for:

I propose that carbon monoxide poisoning is a cause of low vit B12.

By inference, that might also include the rapid hemolysis of blood in

raising carbon monoxide through the breakdown of the haem units.

It goes without saying that the same applies to smokers.

ie if the leaking boilers are causing carbon monoxide poisoning on a

pretty massive scale, then one ought to see an epidemic of unexplained

pernicious anemia. ( you read it here first ~ 16th June 2008)

best wishes

Bob

>

>

> Thanks for the explanation Bob. To answer a couple of your comments:

> I do have some B12 and foliate results, as it happens.

>

> 8/6/2006 - B12= 132 ng/L folate=8.3ug/L

> 16/5/2007 - B12 " normal "

> July 2007 - B12= 216 ng/L Folate not tested

>

> All the above were considered OK. What do you reckon?

>

> Tracey

>

[Guest guest]

Thanks again Bob. I've just been catching up with all your postings,

you have been busy!

I DID ask both the GP and the endo if I had anaemia and both said

that I did not as my results were " normal " . How I hate that word! In

fact, during the time I was being poisoned anaemia was discounted

altogether because I was so rosy cheeked (side effect of CO

poisoning!!) and not at all pale.

The CO-Awareness group think that faulty boilers are the least of

our worries as there are many other harder to avoid sources.

Incidentally the wife of one of the CO group has pernicious anaemia

and toxic hypothermia (when her temperature drops to such low levels

she ends up in hospital) - that fits one of your deductions in

another post.

Tracey

>

> Hi Tracey

>

> I think they missed the pernicious anemia in Jun 2006 and, most

likely,

> again in May/July 2007 ( whatever the range used ~ these values

look

> too low ).

>

> A mechanism for carbon monoxide depleting cobalamin probably

exists but

> I haven't found it in the literature yet...it must be there

somewhere.

>

> If I have to propose it to get it looked for:

>

> I propose that carbon monoxide poisoning is a cause of low vit B12.

> By inference, that might also include the rapid hemolysis of blood

in

> raising carbon monoxide through the breakdown of the haem units.

>

> It goes without saying that the same applies to smokers.

>

> ie if the leaking boilers are causing carbon monoxide poisoning on

a

> pretty massive scale, then one ought to see an epidemic of

unexplained

> pernicious anemia. ( you read it here first ~ 16th June 2008)

>

> best wishes

> Bob

[Guest guest]

I had no idea you lived in Australia Pat, I always imagined you just

down the road. Seems things are no different the world over regarding

the appalling lack of diagnosis and treatment of hypothyroidism, and I

seriously wonder WHY. I hate conspiracy theories, but ....

Luv - Sheila

> It shouldn't be this difficult for people in the UK and other

> countries to seek and get quality health care for thyroid related

> conditions.

>

> P

>

>

> >

> In all of this the thing I have found most astonishing is the

> difference in how I was treated as a CO victim in contrast to how

> I've been treated as a thyroid sufferer.

> It has really shown up the deficits in the management of thyroid

> illnesses. I am frequently shocked when I read what other people on

> this forum have gone through and are still going through.

> >

>