Diagnose me - updated in OP

[liverandonions]

Medical Background: Diagnosed with Hashimotos Thyroid disease in 2000 and had papillary carcinoma in 2017 and had a full thyroidectomy.
Autoimmune Hepatitis diagnosed in 2010 - basically in remission
Had a hysterectomy with fallopian tube and cervix removed in December 2023. 

A few weeks ago, i had some crazy pain in my left hand - top of wrist/back of hand. It was so bad if my hand was straight i was fine, but the second i had to move it or turn my wrist it was a sharp pain and almost impossible to move. 

Next day left hand was fine and right hand on right side of my hand, same feeling. 

Since then it has been one part of one hand - starts at night almost always. Comes on super randomly and always in a different part of a different hand. Most of the time it has waned overnight, but it will be problematic through the night even while sleeping. Today it's hurting still in my middle finger knuckle at the top of my hand/bottom of finger. 

I had an appointment with my Endocrinologist and she ran an rheumatoid panel and it was all negative. My TSH was low, but same as it was in June and we did switch up my meds so it's been about 2 weeks for that new med combo, pain started before that. 

I will be making an appointment with my PCP next, but was hoping someone had any idea of what this is and how to fix it I have a pretty high threshold for pain, but this feels like a broken bone each time it happens, and it's so random as to when and where it will hit me. I have had a few days where my knees felt funny/sore and once in my elbow but otherwise it has been pretty much in the hands. 

I take Ibuprofen and Turmeric each night, and have noticed that heat seems to help more than cold. 

Update: I had hand xrays that were normal and more blood work. The only abnormal lab was c-reactive protein which can be elevated due to Heart issues, Rheumatoid arthritis or being overweight.
So, i saw the rheumatologist this week who started me on an RA med for 6 weeks, and has recommended weight loss medication. My endocrinologist recommend qsymia last month but i have not purchased or started it so rheumatologist asked me to see if she will
Prescribe wegovy instead. He can prescribe it if needed but would have to see more for an obesity work up first.

So now we wait to see if the new med helps the pain and if i can get the wegovy.

[jamie.1022]

I was thinking carpal tunnel until I read that it happens in your knees and elbows too.

I don't have a good answer for you but hope you get some relief soon!

[jennistarr1]

hmmmmm i don't know...I was going down the rheumatoid arthritris route until you said that was addressed.

I would try a wrist brace, just stabilizing it most of the time...seeing how your wrist responds to that will be very telling.

[meanie]

Nerve pain? That can be random, sudden, and painful enough to take your breath away

Are you taking any medications that could have side effects?

@@ I got fifths disease from one of my kids when they were little - which in adults presents with very different symptoms than in children. I basically had sudden, severe, and thankfully short-lived arthritis. Some of your symptoms made me think of it.

[mommyatty]

Does it start when you’re asleep? A doc told me one time that your body has three physical ways to express stress while you sleep: grinding teeth, pointing or flexing toes/feet, and curling your hands down often with your arms tucked into your body. I do all three. And if I don’t realize I’ve been doing the third, I have weird, crazy pains like you’re describing. I had to sleep in wrist braces for a little while to break the habit and now sometimes have to put my hands together flat (like a little kid praying) to stop myself from curling them up.

[mcsangel2]

Menopause, joint pain due to a drop in hormones, I'd bet $100 real dollars on it. r/Menopause at Reddit has been a fantastic source of info for me. Talk to your endo or your PCP or gyno about getting some HRT, it's not the scary boogeyman the 20 year old flawed study made it out to be.

Meno is waaaaaaaaaaay more than just hot flashes and night sweats.

[abs]

It really sounds like RA to me. It can be tricky to diagnose and more detailed bloodwork may be needed. I’d recommend seeing a rheumatologist. I like mine if you need a recommendation. He is super detail oriented and a great listener.

[expectantsteelerfan]

I often get sharp, intense pain in my wrists/down my thumbs. I'm not sure if it's carpel tunnel, but I'm pretty sure it's from holding my phone/my Kindle (I read on my Kindle a lot, at least 1 hour every day, sometimes 3 or more).

It's been happening for years...most of the time there's no pain or a dull ache, but every once in a while I'll move my hand a certain way and it will be sharp and intense, like I'll go to open a door knob and pull my hand back like it burned me. I now wear 'thumb braces' in the evening while I'm reading and all night overnight, and that has kept the pain down.

I do have osteoarthritis (been checked for rheumatoid stuff but that is all negative too), so that might be the source for me.

I've tried a couple different thumb braces, and this is the one that has held up best. I'd say I do need to replace them after about a year or so (and I wash them occasionally) because the Velcro wears out. If the pain is really bad I'll wear them during the day too, but I like wearing a watch and I can't with it on my left hand.
www.amazon.com/Mueller-Medicine-Reversible-Stabilizer-Measure/dp/B004YIFA2C/ref=asc_df_B004YIFA2C/?tag=hyprod-20&linkCode=df0&hvadid=693403640392&hvpos=&hvnetw=g&hvrand=2834396457275347544&hvpone=&hvptwo=&hvqmt=&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=9005950&hvtargid=pla-425062956873&mcid=8cdbb99411f33793bd2468e5a61bb415&th=1&psc=1

[liverandonions]

Sept 24, 2024 13:17:06 GMT -5 jamie.1022 said:

I was thinking carpal tunnel until I read that it happens in your knees and elbows too.

I don't have a good answer for you but hope you get some relief soon!

I had considered it at first but it’s affecting all different areas of my hands and on different hands at different times. So odd

[liverandonions]

Sept 24, 2024 13:22:52 GMT -5 meanie said:

Nerve pain? That can be random, sudden, and painful enough to take your breath away

Are you taking any medications that could have side effects?

@@ I got fifths disease from one of my kids when they were little - which in adults presents with very different symptoms than in children. I basically had sudden, severe, and thankfully short-lived arthritis. Some of your symptoms made me think of it.

No new meds besides some probiotics but i can’t imagine those being the cause.

[liverandonions]

Sept 24, 2024 13:26:04 GMT -5 mommyatty said:

Does it start when you’re asleep? A doc told me one time that your body has three physical ways to express stress while you sleep: grinding teeth, pointing or flexing toes/feet, and curling your hands down often with your arms tucked into your body. I do all three. And if I don’t realize I’ve been doing the third, I have weird, crazy pains like you’re describing. I had to sleep in wrist braces for a little while to break the habit and now sometimes have to put my hands together flat (like a little kid praying) to stop myself from curling them up.

No before i am asleep,usually late evening. I actually sleep with a squishmallow to keep my arms and hands more extended because i have had issues with some morning pain after pulling my arms and hands in to weird tight positions

[liverandonions]

Sept 24, 2024 13:32:21 GMT -5 mcsangel2 said:

Menopause, joint pain due to a drop in hormones, I'd bet $100 real dollars on it. r/Menopause at Reddit has been a fantastic source of info for me. Talk to your endo or your PCP or gyno about getting some HRT, it's not the scary boogeyman the 20 year old flawed study made it out to be.

Meno is waaaaaaaaaaay more than just hot flashes and night sweats.

Interesting….and at 44 and after a hysterectomy i suppose this is possible! I’ll ask my pcp

[liverandonions]

Sept 24, 2024 13:34:04 GMT -5 abs said:

It really sounds like RA to me. It can be tricky to diagnose and more detailed bloodwork may be needed. I’d recommend seeing a rheumatologist. I like mine if you need a recommendation. He is super detail oriented and a great listener.

Sure, please send! I’ll discuss the results more with my PCP and see if she recommends further consultation with a rheumatologist

[liverandonions]

Sept 24, 2024 13:36:37 GMT -5 expectantsteelerfan said:

I often get sharp, intense pain in my wrists/down my thumbs. I'm not sure if it's carpel tunnel, but I'm pretty sure it's from holding my phone/my Kindle (I read on my Kindle a lot, at least 1 hour every day, sometimes 3 or more).

It's been happening for years...most of the time there's no pain or a dull ache, but every once in a while I'll move my hand a certain way and it will be sharp and intense, like I'll go to open a door knob and pull my hand back like it burned me. I now wear 'thumb braces' in the evening while I'm reading and all night overnight, and that has kept the pain down.

I do have osteoarthritis (been checked for rheumatoid stuff but that is all negative too), so that might be the source for me.

I've tried a couple different thumb braces, and this is the one that has held up best. I'd say I do need to replace them after about a year or so (and I wash them occasionally) because the Velcro wears out. If the pain is really bad I'll wear them during the day too, but I like wearing a watch and I can't with it on my left hand.
www.amazon.com/Mueller-Medicine-Reversible-Stabilizer-Measure/dp/B004YIFA2C/ref=asc_df_B004YIFA2C/?tag=hyprod-20&linkCode=df0&hvadid=693403640392&hvpos=&hvnetw=g&hvrand=2834396457275347544&hvpone=&hvptwo=&hvqmt=&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=9005950&hvtargid=pla-425062956873&mcid=8cdbb99411f33793bd2468e5a61bb415&th=1&psc=1

I actually initially considered De Quervains. But like today it’s my middle finger. Some days my wrist, some days my thumbs… no rhyme or reason

[mcsangel2]

Sept 24, 2024 13:42:56 GMT -5 liverandonions said:

Sept 24, 2024 13:32:21 GMT -5 mcsangel2 said:

Menopause, joint pain due to a drop in hormones, I'd bet $100 real dollars on it. r/Menopause at Reddit has been a fantastic source of info for me. Talk to your endo or your PCP or gyno about getting some HRT, it's not the scary boogeyman the 20 year old flawed study made it out to be.

Meno is waaaaaaaaaaay more than just hot flashes and night sweats.

Interesting….and at 44 and after a hysterectomy i suppose this is possible! I’ll ask my pcp

Menopause triggers a lot of autoimmune conditions, including RA. In fact, if you go into meno early (before 45), your chances of getting RA go WAY up. And HRT is a good treatment for it.

[cuadrado]

LOL I asked Chat GPT and here's what it said:

Given your medical history, including autoimmune conditions like Hashimoto’s, Autoimmune Hepatitis, and your thyroidectomy, it’s possible that your hand pain could be related to an inflammatory or autoimmune process even if the rheumatoid panel came back negative. Autoimmune conditions sometimes overlap or present atypically, so this could still be something within that realm.

Here are a few possibilities to consider:

1. Inflammatory Arthritis (non-Rheumatoid)
Psoriatic Arthritis or another type of seronegative arthritis could cause joint pain and inflammation, even without positive rheumatoid factor or other standard markers. These conditions can cause pain in specific joints like your hands, and often the pain is worse at night. The fact that heat helps suggests inflammation, as heat can help reduce stiffness and ease joint pain.

2. Thyroid-Related Issues
Even though your TSH levels were low, changes in thyroid function, particularly after a thyroidectomy and with Hashimoto’s, can still affect joint health. Hypothyroidism can sometimes cause joint pain, particularly in the hands and wrists. Thyroid hormone imbalances can affect muscle and joint health, so it’s worth keeping this in mind with your endocrinologist, especially since you just changed meds.

3. Carpal Tunnel or Peripheral Neuropathy
Given that the pain is intermittent and often in different areas of your hands, you might also be experiencing some kind of nerve compression or peripheral neuropathy. Carpal tunnel syndrome is a possibility, especially with pain or discomfort in the wrist, though it often presents as tingling or numbness rather than sharp pain. Peripheral neuropathy could be connected to an autoimmune or thyroid condition, as both can affect nerves.

4. Osteoarthritis or Tendonitis
Sometimes osteoarthritis can develop in localized areas like the hands, particularly if you’re experiencing pain in joints or knuckles. Tendonitis could also be a factor if the pain comes on after specific hand movements, but given the random nature of your symptoms, this seems less likely.

5. Autoimmune Flare-up (New or Overlapping Condition)
Even though your autoimmune hepatitis is in remission, sometimes autoimmune conditions can flare or new autoimmune conditions can develop. This could be a localized inflammation response that isn’t showing up on the standard rheumatoid panels. A connective tissue disease, like Lupus or Sjogren’s syndrome, could be worth exploring, especially if the pain persists and you develop other systemic symptoms.


Since you’re seeing your PCP next, they might want to dig deeper into autoimmune markers or consider imaging (like an X-ray or MRI) to rule out structural issues in your hands. You might also benefit from seeing a rheumatologist, especially if this continues or worsens.

[liverandonions]

Sept 24, 2024 14:08:05 GMT -5 cuadrado said:

LOL I asked Chat GPT and here's what it said:

Given your medical history, including autoimmune conditions like Hashimoto’s, Autoimmune Hepatitis, and your thyroidectomy, it’s possible that your hand pain could be related to an inflammatory or autoimmune process even if the rheumatoid panel came back negative. Autoimmune conditions sometimes overlap or present atypically, so this could still be something within that realm.

Here are a few possibilities to consider:

1. Inflammatory Arthritis (non-Rheumatoid)
Psoriatic Arthritis or another type of seronegative arthritis could cause joint pain and inflammation, even without positive rheumatoid factor or other standard markers. These conditions can cause pain in specific joints like your hands, and often the pain is worse at night. The fact that heat helps suggests inflammation, as heat can help reduce stiffness and ease joint pain.

2. Thyroid-Related Issues
Even though your TSH levels were low, changes in thyroid function, particularly after a thyroidectomy and with Hashimoto’s, can still affect joint health. Hypothyroidism can sometimes cause joint pain, particularly in the hands and wrists. Thyroid hormone imbalances can affect muscle and joint health, so it’s worth keeping this in mind with your endocrinologist, especially since you just changed meds.

3. Carpal Tunnel or Peripheral Neuropathy
Given that the pain is intermittent and often in different areas of your hands, you might also be experiencing some kind of nerve compression or peripheral neuropathy. Carpal tunnel syndrome is a possibility, especially with pain or discomfort in the wrist, though it often presents as tingling or numbness rather than sharp pain. Peripheral neuropathy could be connected to an autoimmune or thyroid condition, as both can affect nerves.

4. Osteoarthritis or Tendonitis
Sometimes osteoarthritis can develop in localized areas like the hands, particularly if you’re experiencing pain in joints or knuckles. Tendonitis could also be a factor if the pain comes on after specific hand movements, but given the random nature of your symptoms, this seems less likely.

5. Autoimmune Flare-up (New or Overlapping Condition)
Even though your autoimmune hepatitis is in remission, sometimes autoimmune conditions can flare or new autoimmune conditions can develop. This could be a localized inflammation response that isn’t showing up on the standard rheumatoid panels. A connective tissue disease, like Lupus or Sjogren’s syndrome, could be worth exploring, especially if the pain persists and you develop other systemic symptoms.


Since you’re seeing your PCP next, they might want to dig deeper into autoimmune markers or consider imaging (like an X-ray or MRI) to rule out structural issues in your hands. You might also benefit from seeing a rheumatologist, especially if this continues or worsens.

Hey, this is awesome, thanks! 

[mcsangel2]

Sept 24, 2024 14:08:05 GMT -5 cuadrado said:

LOL I asked Chat GPT and here's what it said:

Given your medical history, including autoimmune conditions like Hashimoto’s, Autoimmune Hepatitis, and your thyroidectomy, it’s possible that your hand pain could be related to an inflammatory or autoimmune process even if the rheumatoid panel came back negative. Autoimmune conditions sometimes overlap or present atypically, so this could still be something within that realm.

Here are a few possibilities to consider:

1. Inflammatory Arthritis (non-Rheumatoid)
Psoriatic Arthritis or another type of seronegative arthritis could cause joint pain and inflammation, even without positive rheumatoid factor or other standard markers. These conditions can cause pain in specific joints like your hands, and often the pain is worse at night. The fact that heat helps suggests inflammation, as heat can help reduce stiffness and ease joint pain.

2. Thyroid-Related Issues
Even though your TSH levels were low, changes in thyroid function, particularly after a thyroidectomy and with Hashimoto’s, can still affect joint health. Hypothyroidism can sometimes cause joint pain, particularly in the hands and wrists. Thyroid hormone imbalances can affect muscle and joint health, so it’s worth keeping this in mind with your endocrinologist, especially since you just changed meds.

3. Carpal Tunnel or Peripheral Neuropathy
Given that the pain is intermittent and often in different areas of your hands, you might also be experiencing some kind of nerve compression or peripheral neuropathy. Carpal tunnel syndrome is a possibility, especially with pain or discomfort in the wrist, though it often presents as tingling or numbness rather than sharp pain. Peripheral neuropathy could be connected to an autoimmune or thyroid condition, as both can affect nerves.

4. Osteoarthritis or Tendonitis
Sometimes osteoarthritis can develop in localized areas like the hands, particularly if you’re experiencing pain in joints or knuckles. Tendonitis could also be a factor if the pain comes on after specific hand movements, but given the random nature of your symptoms, this seems less likely.

5. Autoimmune Flare-up (New or Overlapping Condition)
Even though your autoimmune hepatitis is in remission, sometimes autoimmune conditions can flare or new autoimmune conditions can develop. This could be a localized inflammation response that isn’t showing up on the standard rheumatoid panels. A connective tissue disease, like Lupus or Sjogren’s syndrome, could be worth exploring, especially if the pain persists and you develop other systemic symptoms.


Since you’re seeing your PCP next, they might want to dig deeper into autoimmune markers or consider imaging (like an X-ray or MRI) to rule out structural issues in your hands. You might also benefit from seeing a rheumatologist, especially if this continues or worsens.

FYI Chat GPT is not the same thing as Google:


While both ChatGPT and Google have their own unique capabilities, they are used for different purposes. ChatGPT is a sophisticated AI chatbot that is capable of understanding and responding to natural language, while Google is a powerful search engine that is used for finding specific information on the Internet.

Chat GPT answers are based on searches as well as real information, which means the answers it returns can include things frequently searched for together, even if they aren't related.

[liverandonions]

Non update update
Saw my PCP this morning and got a referral to a Rheumatologist.
Im currently waiting for xrays on both hands to see if she can see any rheumatalogical issues.