Can adalimumab for PsA affect Hashimoto's?

Maya_m

I'm 47 and have been on Methotrexate for about a year now since my diagnosis of psoriatic arthritis but it completely stopped working for me quite early on. Now after another failed trial with traditional DMARDs (Sulfasalazine - felt awful) and disease progression, involving more joints, I finally has been put on biologics - adalimumab (Amgevita). I have been very hopeful and tried not to panic about the long list of serious and common side effects, thinking if this is prescribed to children, must be safe enough! And a lot of patients happily stay on it for long time benefiting from treatment. I only had my first injection some 10 days ago and already had a few moments of "omg, has the pain subsided already?" - just a few hours here and there, generally still too early to feel improvement and still in a lot of pain. Next injection this Friday.

Thinking of side effects, I have been feeling quite ok. felt maybe a little light-headed on the day of injection - nothing much. But I have noticed a little bit strange and elevated heartrate, kind of palpitations maybe. This might be completely unrelated and due to prolonged stress. Work-related (not very supportive of my condition and need for appointments and much more nightmare) and going through that much pain and feeling like crap, not being able to do what I normally would (I'm 47yo) and not being understood (problem with all the invisible disabilities, am I actually disabled? I don't even know- so confusing) - possibly developed some anxiety by now?

BUT this might be to do with my levothyroxine for Hashimoto's (autoimmune also) . If my thyroid isn't completely destroyed yet, perhaps lowering TNF improved the function and my own thyroid hormones secretion and need to reduce levothyroxine? Not enough evidence from research yet but it was observed in some patients (apparently conflicting conclusions from research). Let's not forget this treatment was approved only in 1998, TNF purified allowing for further studies only in 1980 and we still need to learn a lot about it. I also have been diagnosed with pernicious anaemia and the PsA has affected my bowels to. I have been told I might feel my gut improving on adalimumab.

Has anyone else experienced similar? If I mention it to my Endocrine consultant, he might give me a funny look or treat me to a dose of gaslighting.

noddingtonpete

Hello @Maya_m it is always worth mentioning to your consultant as they should be aware of any possible side-effects and can advise you. Best to be safe.

jamieA

Hi @Maya_m

I was diagnosed with PsA in October 2020 at the age of 65 - I've had psoriasis since I was 15 and come from a family of psoriasis sufferers. My PsA diagnosis came seven months after I had a bout of covid most probably - my GP determined it was a chest infection in a telephone consultation but 2 months later a covid triage consultant said it was almost certainly covid. My left knee was the initial indicator followed by my hands, shoulders, hips and right sacroiliac joint. I was put on sulfasalazine and naproxen initially and then omeprazole was added to counter the side effects of naproxen. Four months later methotrexate was added and naproxen was replaced by etodolac. Eight months after diagnosis I had an episode of atrial fibrillation and tachycardia and was admitted to hospital - I had no previous heart issues. I put that down to the MTX as on the second occasion I was admitted with this problem I was seen by a rheumatologist - not a cardiologist - who halved my MTX dose. However the cardiologist I saw in a follow up consultation said it was more likely caused by covid. I was then diagnosed with pernicious anaemia and put on a course of vitamin B12. Although I had stopped taking etodolac due to an incompatibility with the heart drugs I was now on the medics hadn't stopped the omeprazole. There was a strong suspicion that this caused the anaemia. Two months after the AF issue adalimumab(Amgevita) was added to the sulfasalazine and MTX. Within 3 weeks I could feel a difference and two months in I was able to hand back the crutches I'd needed to be able to walk. I've now been on the trio of drugs for more than 4 years. I'm able to walk my dog 50-60kms a week even though my left knee was damaged by PsA to the extent I need a knee replacement. I'm not cured but my joint pain levels are much less than they were in early 2021.

I did however have a heart attack last November caused by a blocked left heart artery. I don't smoke or drink and there's no family history of heart issues. I eat probably an average of 7-8 pieces of fruit/veg a day and don't do fry ups/takeaways. The cardiologist said I'd just been unlucky but I do wonder about the effect the amount of medication I take has.

I hope adalimumab works for you.