Does Graves + Hashimoto's exclude CFS?

[Boule de feu]

My friend just found out that she has both auto-immune diseases.
For years, she has been very sick like me.
They told her she has CFS.
Now that she got a new Dx, does it exclude CFS?

 

[alex3619]

Hi Boule de feu, it might and it might not. To be exclusory a disorder has to:

1. Substantially explain all the symptoms.
2. The systems must go after treatment.

So it depends on symptoms and pathological testing. If it explains everything then CFS is ruled out. If it explains everything, and the patient has good treatment, but the symptoms remain, then CFS is back as a diagnosis.

I know of several with either Hashimotos or Graves and ME. They do not have to be exclusory.

Hopefully we will have biomarkers good enough for a diagnostic test soon. Highest specificity to date is 100% (NADPH), highest sensitivity is 97% (Nagalase), but these were different tests and neither has been fully validated.

Bye, Alex

 

[Boule de feu]

Hi Boule de feu, it might and it might not. To be exclusory a disorder has to:

1. Substantially explain all the symptoms.
2. The systems must go after treatment.

So it depends on symptoms and pathological testing. If it explains everything then CFS is ruled out. If it explains everything, and the patient has good treatment, but the symptoms remain, then CFS is back as a diagnosis.

I know of several with either Hashimotos or Graves and ME. They do not have to be exclusory.

Hopefully we will have biomarkers good enough for a diagnostic test soon. Highest specificity to date is 100% (NADPH), highest sensitivity is 97% (Nagalase), but these were different tests and neither has been fully validated.

Bye, Alex

Thank you for this, Alex.
She says that she feels "cured" now.
So, I guess it was not CFS?
Or it could be a remission and it will last a little while?

 

[SOC]

Thank you for this, Alex.
She says that she feels "cured" now.
So, I guess it was not CFS?
Or it could be a remission and it will last a little while?

If treatment has made her feel cured -- she has no symptoms -- then that would exclude her from a CFS diagnosis (lucky her). If she was given treatment for other conditions and still has CFS symptoms, then the conditions are not excluding a CFS diagnosis.

A common example: if someone is diagnosed with depression, gets treatment for depression and the CFS symptoms go away, they didn't have CFS. If they get treatment for depression and are less depressed, but still have CFS symptoms then they should be diagnosed with CFS with comorbid depression.

 

[rlc]

Hi Boule de feu, if your friends has had treatment for Graves and Hasimotos and is feeling cured then they never had CFS, they have been misdiagnosed and suffered for all that time needlessly. Thyroid conditions are supposed to be ruled out in all patients before they can be given a CFS diagnosis because thyroid conditions cause all the symptoms of CFS. All the CFS definitions say that thyroid diseases must be ruled out first! So your friends doctor has stuffed up colossally!

I dont know too much about the legal system in Canada which is where Im assuming your friend is from, but people who have been misdiagnosed due to medical negligence (which is what this sounds like) can get considerable financial compensation for their needless suffering. If your friend is interested in seeking compensation, there is a brief article that explains where to start in getting advice on how to do this in Canada here http://www.articlesforcanada.ca/claiming-compensation-for-a-misdiagnosis.html

All the best