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What Causes Fatigue And Confusion When Taking Synthyroid?
Question: My latest TSH 0.39mIU/L.. Free T4 14.8 mnol/L,, Total T3 2.0nmol/L,, Thyroid Peroxidase Anti body 10kIU/L,, Tissue Transglutaminase IgA 1.7 kU/L,, hemoglobin 135 g/L,, IgM -0.35g/L ,, IgA 3.78 g/L,, IgG 11.15 g/L
Diabetic, Taking thyroid Synthroid 0.075 MG one pill daily morning empty stomach, all day feeling very tired, down,weak, confused cold heat in tolerance, catching infections frequently almost 24/7
Diabetic, Taking thyroid Synthroid 0.075 MG one pill daily morning empty stomach, all day feeling very tired, down,weak, confused cold heat in tolerance, catching infections frequently almost 24/7
Brief Answer:
Possible causes of your symptoms
Detailed Answer:
Good day,
Noted your concern. Your TSH is normal whilst on 75 mcg Synthroid and please continue the same dose. I presume the TTG IGA was done to rule out celiac disease and it shows a normal ( negative) value. Not to worry.
I will try to list out possible causes of your symptoms.
How is your diabetes status? You may feel tired if it is uncontrolled or if you are developing frequent hypoglycemias. Repeated infections especially urinary tract infection is another cause of tiredness. Have you done a recent Urine test or CBC?
Another cause of your symptoms could be a rare possibility of adrenal insufficiency. It is worthwhile doing an 8 AM serum cortisol and electrolytes.
Another important cause of your symptoms could be due to low testosterone levels. How is your shaving frequency and what about libido/erection etc?
Would appreciate a reply
Regards
Binu
Possible causes of your symptoms
Detailed Answer:
Good day,
Noted your concern. Your TSH is normal whilst on 75 mcg Synthroid and please continue the same dose. I presume the TTG IGA was done to rule out celiac disease and it shows a normal ( negative) value. Not to worry.
I will try to list out possible causes of your symptoms.
How is your diabetes status? You may feel tired if it is uncontrolled or if you are developing frequent hypoglycemias. Repeated infections especially urinary tract infection is another cause of tiredness. Have you done a recent Urine test or CBC?
Another cause of your symptoms could be a rare possibility of adrenal insufficiency. It is worthwhile doing an 8 AM serum cortisol and electrolytes.
Another important cause of your symptoms could be due to low testosterone levels. How is your shaving frequency and what about libido/erection etc?
Would appreciate a reply
Regards
Binu
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks Sir,
My testoterone 16.6 nmol/L,Sep, 10.2014 improved from previous results,doing shaving daily, being touching 56 erection is not so strong as in past.
CBC- Hemoglobulin 135 g/L, Hemotocrit 0.41L/L these both results are getting variations from 128 and 0.39 levels respectivly in past. RBC 4.6 10E12/L, MCV 91fL,,MCHC 325g/L,, RDW 13.5 %, WBC 8.510E9/L,,
Neutrophils 4.1 10E9/L ,,lymphocytes 2.9 10E9/L, Monocytes 0.7 10E9/L,,Eosinophils 0.8 10E9/L,, Basophils 0.0 10E9/L,, Platelet count 248 10E9/L,,
CRP 4.7 mg/L,, sodium 141 nmol/L,, Potasium 4.1 nmol/L,,Chloride 107 nmol/L. Co2 content 25 nmol/L, all done 10 sept 2014.
In my MRI done about 4-5 months back- shows pituitary assmyteric towards right side.
Yesterday family doctor again advise Amox 500 three times, dont know whether to take this, feeling super tired, fatigue.
Igm is low for last 3-4 years,
AIC Hemoglobin 0.063,glucose fasting 5.9 nmol/L, 10 sept 2014, taking 3 metformin 500 mg daily.
Sir, you can mention names of tests/investigations. there must be some undetected reason for these signs.
have nodule 4-5 mm on lung
My testoterone 16.6 nmol/L,Sep, 10.2014 improved from previous results,doing shaving daily, being touching 56 erection is not so strong as in past.
CBC- Hemoglobulin 135 g/L, Hemotocrit 0.41L/L these both results are getting variations from 128 and 0.39 levels respectivly in past. RBC 4.6 10E12/L, MCV 91fL,,MCHC 325g/L,, RDW 13.5 %, WBC 8.510E9/L,,
Neutrophils 4.1 10E9/L ,,lymphocytes 2.9 10E9/L, Monocytes 0.7 10E9/L,,Eosinophils 0.8 10E9/L,, Basophils 0.0 10E9/L,, Platelet count 248 10E9/L,,
CRP 4.7 mg/L,, sodium 141 nmol/L,, Potasium 4.1 nmol/L,,Chloride 107 nmol/L. Co2 content 25 nmol/L, all done 10 sept 2014.
In my MRI done about 4-5 months back- shows pituitary assmyteric towards right side.
Yesterday family doctor again advise Amox 500 three times, dont know whether to take this, feeling super tired, fatigue.
Igm is low for last 3-4 years,
AIC Hemoglobin 0.063,glucose fasting 5.9 nmol/L, 10 sept 2014, taking 3 metformin 500 mg daily.
Sir, you can mention names of tests/investigations. there must be some undetected reason for these signs.
have nodule 4-5 mm on lung
Brief Answer:
Serum cortisol and IGF-1
Detailed Answer:
Hello,
Note the blood reports.
I hope the lung nodules are being monitored.
The CBC seems to be good and there are no signs of infection ( if it was done recently). Amoxycillin may not be necessary unless you have a severe sorethroat or urinary symptoms etc.
It is worthwhile checking an 8 AM serum cortisol and IGF-1 ( cortisol deficiency and adult growth hormone deficiency can cause tredness and weakness)
Serum cortisol and IGF-1
Detailed Answer:
Hello,
Note the blood reports.
I hope the lung nodules are being monitored.
The CBC seems to be good and there are no signs of infection ( if it was done recently). Amoxycillin may not be necessary unless you have a severe sorethroat or urinary symptoms etc.
It is worthwhile checking an 8 AM serum cortisol and IGF-1 ( cortisol deficiency and adult growth hormone deficiency can cause tredness and weakness)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thanks for skin rash like itiching doctor prescribed Taro Mometasone cream 0.1 %, mometasone furoate corticosteroid cream , does this is safe to use, means you does not support Amoxicilllin, it is ok, will only use these after second opinion from doctor. For IGF-1, it was checked last year it was low, again I will ask doctor will send details of tests done after low IGF-1 which came down at low.
Brief Answer:
Amoxycillin if secondary bacterial infection prese
Detailed Answer:
Hi,
Okay, for the skin rashes, you may use these creams. They are weak steroid creams which will reduce the inflammation and rashes. Your doctor might have observed some secondary infection there, that would have been the reason for prescribing amoxycillin.
The low IGF-1 is probably pointing towards adult growth hormone deficiency. You may need further tests to establish this. If you are deficienct, hormone replacement may improve many of the symptoms
Amoxycillin if secondary bacterial infection prese
Detailed Answer:
Hi,
Okay, for the skin rashes, you may use these creams. They are weak steroid creams which will reduce the inflammation and rashes. Your doctor might have observed some secondary infection there, that would have been the reason for prescribing amoxycillin.
The low IGF-1 is probably pointing towards adult growth hormone deficiency. You may need further tests to establish this. If you are deficienct, hormone replacement may improve many of the symptoms
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Endocrinologist have done stimulation tests I will send these details in a day, those results were out of reference range low and high, after these results She never intersted for growth hormone replacement mentioning reason- BMI at 41, and sleep apnea. There is research papers that Endocrinologist should take note of these findings before ordering of stimulation tests.
Brief Answer:
Bariatric surgery and symptom improvement
Detailed Answer:
Okay.
Obesity and sleep apnea are additional reasons for tiredness. Growth hormone replacement can worsen sleep apnea.
If you are unable to shed weight with diet and exercise, bariatric surgery is another option. Losing few kilos of weight will surely improve the sleep apnea and tiredness.
Please attach the GH stimulation reports
Binu
Bariatric surgery and symptom improvement
Detailed Answer:
Okay.
Obesity and sleep apnea are additional reasons for tiredness. Growth hormone replacement can worsen sleep apnea.
If you are unable to shed weight with diet and exercise, bariatric surgery is another option. Losing few kilos of weight will surely improve the sleep apnea and tiredness.
Please attach the GH stimulation reports
Binu
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I will send Insuline tolerance test and Glucagon stimulation test reports done 7 and 31 oct 2013
Brief Answer:
sure
Detailed Answer:
Sure. Shall wait for it
sure
Detailed Answer:
Sure. Shall wait for it
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Insuline Tolerance test-
31 Oct,2013
-
1- Glucose random- 5.3 ref 3.3-10 mmol/L
2- ------do------- 5.8 -----do---
3- ------do------- 7.6 --do---
4- --do--- 9.1 --d0--
5- Cortisol 585 not mentioned nmol/L
6- --do-- 206 ---do---
7- --do-- 640 --do---
8- --do-- 508 --do---
9 TSH 3.17 mIU/L 0.20-600 ref range
10 Free T4 13.4 pmoI/L 10.0-25.0 --do--
11 Glucose random 2.3 mmoI/L 3.3-11.0 --d0--
12. Human Growth Hormone 0.3 ug/L 0.0 -3.0 --do
13. --do--------------- 1.0 -do- --do---------
14. --do-------------- 1.1 -do-----------------
15. --do------------- 1.0 -do-----------------
Glucagon Tolerance test
07 Oct.2013
a. CORTISOL 193
b. --do--- 374****
c. --do--- 245
d. --do--- 311
e. --do--- 341
f. Human Growth Hormone-- 0.7 ref range 00-3.0
-------do------------ 0.5 ----do---------
-------do------------ 0.5 ----do---------
-------do------------ 0.1 ----do---------
-------do------------ 1.0 ----do---------
**** Endocrinologist noted this result- pretty good, all human growth hormone as low
AFTER GLUCAGON STIMULATION TEST SHE ORDERED ITT test , but on the bases of reports she never go for human replacement therapy.
31 Oct,2013
-
1- Glucose random- 5.3 ref 3.3-10 mmol/L
2- ------do------- 5.8 -----do---
3- ------do------- 7.6 --do---
4- --do--- 9.1 --d0--
5- Cortisol 585 not mentioned nmol/L
6- --do-- 206 ---do---
7- --do-- 640 --do---
8- --do-- 508 --do---
9 TSH 3.17 mIU/L 0.20-600 ref range
10 Free T4 13.4 pmoI/L 10.0-25.0 --do--
11 Glucose random 2.3 mmoI/L 3.3-11.0 --d0--
12. Human Growth Hormone 0.3 ug/L 0.0 -3.0 --do
13. --do--------------- 1.0 -do- --do---------
14. --do-------------- 1.1 -do-----------------
15. --do------------- 1.0 -do-----------------
Glucagon Tolerance test
07 Oct.2013
a. CORTISOL 193
b. --do--- 374****
c. --do--- 245
d. --do--- 311
e. --do--- 341
f. Human Growth Hormone-- 0.7 ref range 00-3.0
-------do------------ 0.5 ----do---------
-------do------------ 0.5 ----do---------
-------do------------ 0.1 ----do---------
-------do------------ 1.0 ----do---------
**** Endocrinologist noted this result- pretty good, all human growth hormone as low
AFTER GLUCAGON STIMULATION TEST SHE ORDERED ITT test , but on the bases of reports she never go for human replacement therapy.
Brief Answer:
GH levels are low
Detailed Answer:
Hi,
The GH levels are too low. But there are many contrinidcations for it's use in adults.
That must be the reason why the endocrinologist didnt prescribe it in your case.
GH levels are low
Detailed Answer:
Hi,
The GH levels are too low. But there are many contrinidcations for it's use in adults.
That must be the reason why the endocrinologist didnt prescribe it in your case.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
You are correct,
there are medical findings that these high end tests should only be done in case Endocrinologist ordering these tests evaluate patient history to treat in case results comes out low, any way our health system is like this.
What do you suggest?
Should I go for Adrenal deficiency tests in requesting Cortisol 8 AM, again IGF-1 or any other tests.
Amoxy has been started, for infections-
I am sure there are some slow moving things/changes in side body
there are medical findings that these high end tests should only be done in case Endocrinologist ordering these tests evaluate patient history to treat in case results comes out low, any way our health system is like this.
What do you suggest?
Should I go for Adrenal deficiency tests in requesting Cortisol 8 AM, again IGF-1 or any other tests.
Amoxy has been started, for infections-
I am sure there are some slow moving things/changes in side body
Brief Answer:
Please get sleep apnea corrected
Detailed Answer:
No point in checking IGF-1 again as the GH deficiency is allready established in 2 stimulation tests.
Your cortisol levels are looking good and there is no need to repeat that again.
If you have untreated sleep apnea, it is risky to start GH treatment.
You may consult a respiratory physician and get sleep apnea evaluatiion and if it improves with treatment, then your endocrinologist may revise her decision on GH replacement
Please get sleep apnea corrected
Detailed Answer:
No point in checking IGF-1 again as the GH deficiency is allready established in 2 stimulation tests.
Your cortisol levels are looking good and there is no need to repeat that again.
If you have untreated sleep apnea, it is risky to start GH treatment.
You may consult a respiratory physician and get sleep apnea evaluatiion and if it improves with treatment, then your endocrinologist may revise her decision on GH replacement
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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