Effect of rituximab

A goiter can be associated with hyperthyroid, which causes loss of potassium. Hyperthyroidism can be caused by Grave's disease, which Melinda mentioned above. Grave's disease is autoimmune.

www.ncbi.nlm.nih.gov/pubmed/7237944
Total body potassium in relation to thyroid hormones and hyperthyroidism.
... a considerable loss of body potassium is usual in hyperthyroidism...
Among the patients with hyperthyroidism, the greatest muscular weakness was present in those with the greatest body potassium loss...

Is your goiter large enough to affect your breathing when you lie down? That could make your sleep apnea worse.

It seems important to get that goiter checked as soon as possible

I wouldn't think ITP has anything to do with making sleep apnea worse - someone will correct me if my thinking is incorrect.

steel head if you haven't had your thyroid checked you are doing yourself a disservice. Are you treating your sleep apnea - if you aren't you are doing yourself a disservice.


That is interesting Rob - my potassium is usually near the top of the range & I've been told to not take any supplements with potassium in them.

Melinda - are you hypo or hyperthyroid? Maybe that is the difference.

Melinda I had a full thyroid screen, and they said it was normal. As far as my sleep apnea, I can't wear the masks and I have tried them all. I have central sleep apnea which I was told was a neurological disorder...all I know is that I have a lot more fatigue and will fall a sleep at anytime much more often now with the ITP...or at least it seems that way.

Rob16 wrote: Melinda - are you hypo or hyperthyroid? Maybe that is the difference.

Graves - so now it's up and down.

I wouldn't think that ITP would make sleep apnea worse. It could make the fatigue worse.

My daughter had a huge goiter for about 7 or 8 years and it didn't affect her breathing. It did affect swallowing. It actually went away once when she changed her diet. She was too busy to keep up with it though and eventually had it surgically removed.

Have you tried a Bi-PAP? Odd that there isn't anything that can be done. I'd try a different pulmonologist. What happened when you tried a C-PAP?

steelheader I had to look up central sleep apnea and came up with these:
www.mayoclinic.org/diseases-conditions/central-sleep-apnea/symptoms-causes/dxc-20209494
•Excessive daytime sleepiness (hypersomnia)

www.alaskasleep.com/blog/types-of-sleep-apnea-explained-obstructive-central-mixed
Scroll down to Central Sleep Apnea
•Excessive daytime drowsiness

I'm sure you have researched this condition and know all about it - I've listed the above for anyone who reads this and doesn't know what it is.

There are many masks out there - why can't you wear one? With the problems one can have due to sleep apnea wouldn't you want to do something? Also reading the symptoms listed for central sleep apnea it seems maybe your extreme tiredness is due to that.

Glad your thyroid blood work was normal - that's great, thyroid problems are the pits. But do you know why your thyroid was/is enlarged? That I would want to know the answer to if it were me.

Sandi wrote: I wouldn't think that ITP would make sleep apnea worse. It could make the fatigue worse.

My daughter had a huge goiter for about 7 or 8 years and it didn't affect her breathing. It did affect swallowing. It actually went away once when she changed her diet. She was too busy to keep up with it though and eventually had it surgically removed.

Have you tried a Bi-PAP? Odd that there isn't anything that can be done. I'd try a different pulmonologist. What happened when you tried a C-PAP?

I have a c-pap and a bi-pap machine, I've had 3 sleep studies, 2 different sleep Dr's. The problem is I can't get any rest with the machines because the pressures are too high, and wake me up after it ramps to full...so no rest. That and I get a lot of anxiety from just trying to keep the mask on long enough to go to sleep, can't draw deep breath and panic...just craziness. Finally just gave up on whole thing. I think the prednisone is making my sleep condition worse, and hope to get off of soon. Will see dr in few weeks to see if Rituxan worked.

Melinda wrote: steelheader I had to look up central sleep apnea and came up with these:
www.mayoclinic.org/diseases-conditions/central-sleep-apnea/symptoms-causes/dxc-20209494
•Excessive daytime sleepiness (hypersomnia)

www.alaskasleep.com/blog/types-of-sleep-apnea-explained-obstructive-central-mixed
Scroll down to Central Sleep Apnea
•Excessive daytime drowsiness

I'm sure you have researched this condition and know all about it - I've listed the above for anyone who reads this and doesn't know what it is.

There are many masks out there - why can't you wear one? With the problems one can have due to sleep apnea wouldn't you want to do something? Also reading the symptoms listed for central sleep apnea it seems maybe your extreme tiredness is due to that.

Glad your thyroid blood work was normal - that's great, thyroid problems are the pits. But do you know why your thyroid was/is enlarged? That I would want to know the answer to if it were me.

I thought the thyroid was enlarged, but when panel came back normal I think the big lump was near the thyroid. Now it is about a quarter of the size, but more hard, like a marble. Still worried about it, but heard that prednisone could cause these lumps in the neck. Have another lump about 2 inches below that one near collar bone and throat, but it has not changed...more bigger and softer ( fattier). Hope to be off prednisone in a few weeks.

The problem is I can't get any rest with the machines because the pressures are too high, and wake me up after it ramps to full...

Have you told the doctor or tech the flow is too high? If so then the doctor or respiratory tech should adjust your machine so it is not too high for you.

There are machines out there that increase the flow only when you stop breathing - so the flow is low until needed while sleeping. I know - I have one and it is great.

What is your mask like - if it covers your mouth & nose get one that only is at the nose, one with nose cushions I believe they are called. You are not doing your organs any favors by depriving them of the amount of oxygen they need.

Now it is about a quarter of the size, but more hard, like a marble. Still worried about it, but heard that prednisone could cause these lumps in the neck. Have another lump about 2 inches below that one near collar bone and throat

What does your doctor say about the marble size lump near your thyroid - why worry, get an answer. How did you hear prednisone can cause lumps in your neck? Again, if it were me I'd sure want answers on those lumps!

Good luck to you!