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Suggest Treatment For Hypothyroidism And Migraine
Question: Hello,
I feel like I have starting falling to pieces in the past 4 or 5 months. My right eyelid, into the side of my face, has been twitching since Christmas. I have been mentally and physically exhausted for months (even though I get a full 8 hours of sleep every night). My back has a weird ache in it. I have been constipated for months. My vision has been oddly blurry for months (off and on during the day). And, every time I stand up from a sitting position, I feel like I just ran a marathon. I always feel completely exhausted, like I couldn't lift my arm over my head if I had to. I'm 43 years old and have always been active. I have put on a few extra pounds and have a hard time dropping them. I have migraines (and and on medication for them) and hypothyroidism. Did I just get the body of an 80 year old over night?
Thank you so much for your help.
I feel like I have starting falling to pieces in the past 4 or 5 months. My right eyelid, into the side of my face, has been twitching since Christmas. I have been mentally and physically exhausted for months (even though I get a full 8 hours of sleep every night). My back has a weird ache in it. I have been constipated for months. My vision has been oddly blurry for months (off and on during the day). And, every time I stand up from a sitting position, I feel like I just ran a marathon. I always feel completely exhausted, like I couldn't lift my arm over my head if I had to. I'm 43 years old and have always been active. I have put on a few extra pounds and have a hard time dropping them. I have migraines (and and on medication for them) and hypothyroidism. Did I just get the body of an 80 year old over night?
Thank you so much for your help.
Brief Answer:
Hypothyroidism may be the cause.
Detailed Answer:
I read your question carefully and I understand your concern.
Your description deserves some attention. The primary hypothesis to be considered in my opinion would be that the symptoms are due to low thyroid function. Hypothyroidism can manifest with fatigue, weight gain, constipation. It can also cause myopathy, muscle damage involving muscles responsible for eye movement, hence resulting in eye movement abnormalities which can lead to blurry vision (due to asynchronous eye movement). So raising the dosage of medication (I assume you are taking substitute hormone therapy) should be considered, depending also on thyroid function lab results.
Other possibilities (if hypothyroidism is excluded by your doctors) would be that of other metabolic disorders, for which a metabolic panel should be considered as well as nerve conduction studies and electromyography.
I remain at your disposal for other questions.
Hypothyroidism may be the cause.
Detailed Answer:
I read your question carefully and I understand your concern.
Your description deserves some attention. The primary hypothesis to be considered in my opinion would be that the symptoms are due to low thyroid function. Hypothyroidism can manifest with fatigue, weight gain, constipation. It can also cause myopathy, muscle damage involving muscles responsible for eye movement, hence resulting in eye movement abnormalities which can lead to blurry vision (due to asynchronous eye movement). So raising the dosage of medication (I assume you are taking substitute hormone therapy) should be considered, depending also on thyroid function lab results.
Other possibilities (if hypothyroidism is excluded by your doctors) would be that of other metabolic disorders, for which a metabolic panel should be considered as well as nerve conduction studies and electromyography.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hypothyroidism is excluded, as my blood work has come back perfect the last several months (12 months and I am tested every other month). I take 350 mcg of Synthroid daily. Also, I have had this disease for many years, why would I just be getting these symptoms now that it is under control? I have also had a metabolic panel done. I did not test positive for anything. I also have no real symptoms for a metabolic disorder, other then feeling listless. I always had a great metabolism growing up...until I hit about 30. I don't know what else to do at this time.
I also had the EMG test. Is that the same thing? My hands and feet were going numb a lot.
I also had the EMG test. Is that the same thing? My hands and feet were going numb a lot.
Brief Answer:
Read below
Detailed Answer:
Thank you for the additional information.
The remaining thyroid function and the necessary replacement dosages may vary in time, even after many years, otherwise you wouldn't need to check levels regularly, so it would be possible to get symptoms even now. However since you have checked levels pretty frequently and they are alright I agree that that shouldn't be the cause.
Yes EMG stands for electromyography. Nerve conduction studies are something else, but they are usually done together with the EMG, so one can safely assume they were measured.
So since EMG and metabolic studies have been done your doctor seems to have been thorough. I suppose they have done tests for chronic inflammation and infection as well.
At this point one other hypothesis to consider would also be that of sleep apnea, episodes of interrupted breathing during the night leading to sleep disruptions. While one may seemingly sleep for the needed amount of hours, if the quality of sleep is bad, with interruptions, it may lead to fatigue and exhaustion during the day. It would be even more likely if you are overweight and snore at night (but may happen in the absence of overweight as well). So it is a possibility to consider and a polysomnography may be scheduled.
If that has already been considered and excluded, then the possible role of stress and anxiety or depression must be taken into account.
When no cause is identified, the chronic fatigue syndrome (myalgic encephalomyelitis) which is a condition which origin is not well elucidated by medicine is the remaining diagnosis.
Read below
Detailed Answer:
Thank you for the additional information.
The remaining thyroid function and the necessary replacement dosages may vary in time, even after many years, otherwise you wouldn't need to check levels regularly, so it would be possible to get symptoms even now. However since you have checked levels pretty frequently and they are alright I agree that that shouldn't be the cause.
Yes EMG stands for electromyography. Nerve conduction studies are something else, but they are usually done together with the EMG, so one can safely assume they were measured.
So since EMG and metabolic studies have been done your doctor seems to have been thorough. I suppose they have done tests for chronic inflammation and infection as well.
At this point one other hypothesis to consider would also be that of sleep apnea, episodes of interrupted breathing during the night leading to sleep disruptions. While one may seemingly sleep for the needed amount of hours, if the quality of sleep is bad, with interruptions, it may lead to fatigue and exhaustion during the day. It would be even more likely if you are overweight and snore at night (but may happen in the absence of overweight as well). So it is a possibility to consider and a polysomnography may be scheduled.
If that has already been considered and excluded, then the possible role of stress and anxiety or depression must be taken into account.
When no cause is identified, the chronic fatigue syndrome (myalgic encephalomyelitis) which is a condition which origin is not well elucidated by medicine is the remaining diagnosis.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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