Suggest Treatment For Extreme Faigue

Posted on Wed, 19 Oct 2016

Question: Hello, I recently went to my GP and asked for a blood test because I have been feeling extremely fatigued for a long time now. My TSH is 0.674 mU/l, T4 76.3 mmol/l and T3 0.82 mmol/l. My GP said it was "on the low end but not a problem". However, since I am struggling to keep up with my daily tasks both at home and at work - I am a competitive runner but have had to stop running almost completely because of joint and muscle pain and lack of endurance - I contacted a specialist and got an appointment. They cannot see me until December, so is there anything I can do now? I am currently taking 55 mcg of Selenium and 25 mcg of iodine daily. The goal is to increase the doses slowly but I am worried about my sleep. Despite the exhaustion, I have problems falling asleep at night and often have to take something. I think the iodine is making me a bit "wired" even if I take it as soon as I get up in the morning (5am). Should I continue supplementing with selenium/iodine and/or change the doses? I am quite frankly desperate as my quality of life has plummeted during the last year. Thank you in advance for your help. Pia

Answered by Dr. Shehzad Topiwala (42 minutes later)

Brief Answer:
Tests

Detailed Answer:
Sorry to learn about your bothersome symptoms. If you are on a normal balanced diet then prime deficiency is unlikely. To my knowledge there is no guideline to routinely recommend iodine and selenium to people. If one strongly suspects iodine deficiency then a random urine spot sample for iodine and creatinine is helpful to make the diagnosis. When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:

CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Urine iodine to Creatinine Ratio ( off supplements)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
 None of these tests require any fasting and can be done at any time of the day

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar