Have Controlled Hypothyroidism. Getting Slurred Speech, Fatigue And Insomnia. Proper Diagnosis?
any help would be appreciated.
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.
Important aspects of your query are:
• 26 year old female
• Known case of hypothyroidism: currently controlled
• Complaints of: Ataxia (to the point of having falls), slurred speech, fatigue, lack of co-ordination and chronic insomnia.
• Currently on: DHEA and Multivitamins
Her case is interesting and but difficult too. Even your attending physician is facing problem to solve it. I will try to give my best effort to help you in this problem.
I would like to consider multiple possibilities in following hierarchy:
• Neurological problem: She may need MRI brain. Following problems can present with above symptoms: Parkinson disease, Old stroke and Dementia. Hope neurologist had ruled out these issues.
• Vitamin deficiency: She is already on multivitamins.
• Thyroid related problem: It is already under control.
• Side effect of substance use: considering her age, it is least possible.
• Depressive disorder: need to be rule out by detailed interview by psychiatrist, which is left in her case. History of thyroid problem also increases chances of having depression. Depression usually present with low mood, decrease movement, decrease talk and insomnia.
I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.
Wish you good health.
Regards,
Dr Ashish XXXXXXX Mittal
Thanks for follow up,
Is it possible that the DHEA or Thyroid meds are contributing to insomnia?
Ans: Thyroid medicine is not a problem in her case as her thyroid functions tests are normal now. You can get them repeat to be sure (If previous test occur more than 3 months back).
DHEA is a steroid hormone. Its use can lead to depressive symptoms, even insomnia. In my view you can discus about slowly discontinuation of its use in current situation from her physician.
Wishing her good health,
Regards,
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