View Full Version : Advice needed...
07-14-2009, 08:12 AM
Hello all, I have only posted here once, and it was about being a Hashimoto's patient and finding out my ANA being positive. I recently got a re-check and also another blood test specifically for Lupus, Sjorgen's, and RA, and it all turns out to be negative. However, the immulogist I went to offer me to take Plaquenil, saying it would help lower the anti-thyroid body and also prevent other AI from developing....
I am confused! Cause I always thought there is no cure for my Hashimoto antibody??
And also, doesn't plaquenil have really bad side effects???
Any advice is appreciated.....
07-14-2009, 10:29 AM
Sometimes, physicians will recommend plaquenil to see if it will help alleviate some of your symptoms. As far as side effects, some people experience nausea, etc. Many people find that eating before taking it helps.
The side effect of most concern is damage to the retina of your eye. This may occur, in rare circumstances, after years of use. It is important to have your eyes checked before taking the medicine, and then annually thereafter. Tell the eye doctor you are getting a baseline exam before starting plaquenil, then remind them annually that you are on the drug. If you notice some change to your eyesight while on the meds, obviously go see the doctor, even if it isn't time for your annual exam.
I was concerned about this risk, so I resisted the drug for over a year. For me, that was a mistake. I have received tremendous benefits from taking plaquenil. But that's just my experience. Read about the drug, talk to an eye doctor, and make your own decision.
I hope this helps. Good luck to you.
07-14-2009, 10:41 AM
Plaquenil is one of the best tolerated drugs in the treatment regimen for Auto-immune disorders. Plaquenil is actually in a class of medications called anti-malarials but it is also used to treat rheumatic and autoimmune conditions which are unrelated to malaria. Like any drug, there are side effects. Side effects associated with plaquenil are categorized as common, less common, and rare. The common side effects which are linked to plaquenil use include nausea and diarrhea. Taking the medication with food can solve that for most patients. Less common side effects which may be tied to plaquenil include skin rashes, hair thinning, and weakness. A rare side effect of plaquenil involves visual changes or loss of vision. Since the side effect of vision loss is so rare it is important to tell your doctor about any changes you notice to your vision. Your doctor will recommend regular eye exams while on plaquenil in order to catch early changes. Vision changes from plaquenil are rare, but certain people are at higher risk for developing the problem. High risk patients would include those who: took high doses of plaquenil for years - are 60 years or older - have known kidney disease
When taking Plaquenil for Lupus, the average adult dose is 400 mg (=310 mg base) once or twice daily. This dose may be continued for several weeks or months, depending on how well you respond. For prolonged maintenance therapy, a smaller dose, from 200 mg to 400 mg (=155 mg to 310 mg base) daily will frequently suffice. Retinopathy has only been reported when a higher maintenance dose is exceeded.
Plaqueni is cumulative in action and will require several weeks to exert its beneficial effects, whereas minor side effects may occur relatively early. Several months of Plaquenil therapy may be required before maximum effects can be obtained. If improvement (such as reduced joint swelling, increased mobility) does not occur within six months, the drug is usually discontinued and a different therapy is initieated.
Each dose of Plaquenil should be taken with a meal or a glass of milk to prevent stomach upset. In a small percentage of patients, troublesome side effects may require temporary reduction of the initial dosage. Later (usually from five to ten days), the dose may gradually be increased to the optimum response level, often without return of side effects.
When a good response is obtained (usually in four to twelve weeks), the dosage is reduced by 50 percent and continued at a usual maintenance level of 200 mg to 400 mg (=155 mg to 310 mg base) daily. Should a relapse occur after medication is withdrawn, therapy may be resumed or continued on an intermittent schedule if there are no problems with vision.
The antithyroid drugs include carbimazole, methimazole, and propylthiouracil (PTU). These drugs are used to treat hyperthyroidism (overactivity of the thyroid gland) in order to reduce the excessive thyroid activity before surgery and to treat and maintain patients not having surgery.
ANA is one type of auto-immune marker -- has this number been decreasing? If you are being treated for another auto-immune disease (Lupus) with plaquenil, then the thyroid antibodies may fall - but doctors generally do not use Plaquenil for thyroid autoimmune diseases.
Hashimoto's thyroiditis is the most common type of thyroiditis and the most common cause of hypothyroidism. There is no cure for Hashimoto's thyroiditis, but there is treatment. People with Hashimoto's thyroiditis will generally have other endocrine disorders, such as diabetes, an underactive adrenal gland, or underactive parathyroid glands, and other autoimmune diseases, such as Lupus, pernicious anemia, rheumatoid arthritis, or Sjögren's syndrome. There is no specific treatment available for Hashimoto's thyroiditis. Most people eventually develop hypothyroidism and then must take thyroid hormone replacement therapy for the rest of their lives.
I hope that I've answered your question. Please let me know if you need any thing further!
Peace and Blessings
07-14-2009, 02:16 PM
Wonderful replies you have received....
I would like to add, Plaquenil does not prevent other auto-immune disease (AI) from developing like your immunologist implied. Buzzer buzzed...wrong answer!
And welcome to WHL...hugs, Aimee.
07-14-2009, 02:35 PM
i am so glad your questions were answered by Oluwa, Saysusie, and Jana. I just want to wish you the very best luck. You are doing a great job educating yourself and studying treatment options, keep up the good work.
07-15-2009, 10:25 PM
Thanks for the replies guys. If this is really the case, then I guess I would have to reconsider my doctor's recommendation....cause to my knowledge he is only prescribing me the med for my Hashimoto's. He is a pretty well known immulogist; base on what he tells me, it is suspected that thyroid antibodies not only attacks the thyroid but also other parts of the body, plus he says because I also have a positive ANA (but negative for all the specific tests), he thinks it is to my best interest to take the Plaquenil and lower the chance of other AI from developing. So do you guys think I shoudl trust him? He is a very famous doctor in treating autoimmune disorders, but he is also very controversial. I really don't know who I should listen to.
07-16-2009, 09:38 AM
His logic is understandable, even though (As Oluwa pointed out), Plaquenil does not prevent Auto-Immune diseases. He may be thinking that you do, indeed, have some type of auto-immune disorder that has not yet fully developed (hence, the negative lupus-specific tests) and that by taking Plaquenil, you may be able to nip it in the bud before it becomes fully developed.
This is, in a skewed kind of way, logical. Especially given the fact that Plaquenil is usually the first line of defense against many auto-immune diseases (especially Lupus), and especially given the fact that many of the symptoms of auto-immune diseases resemble each other, so Plaquenil would be an appropriate treatment for mild cases. Also, as I mentioned, it is a very well tolerated drug, so he is not prescribing anything that has severe side-effects.
So, I guess that I am saying that it sounds as if you can trust this doctor and that it is his intent to provide treatment to give you relief from symptoms and to, hopefully, prevent any other symptoms from occurring. Please know that with auto-immune diseases, this may work and there is a possibility that it may not. But, it sounds like he is the type of doctor who will stay on top of things and if symptoms worsen or new ones appear, he will take immediate action to help you deal with them.
I wish you the very best and I hope that this treatment does work for you!
Peace and Blessings
07-17-2009, 04:49 AM
Thanks for your reply, I feel much comfortable about the doctor's treatment now. Although I do not have any symptoms so far (except for Hashimoto antibody, a 160 positive ANA, and dry eyes), I think I will do what he says and lower my thyroid antibody first, then get off the med and just do regular check ups to track any development.
I felt much relieved having heard that plaquenil is well tolerated. Thanks again for you guys replies.