What Causes Fatigue And Fluctuating Thyroid Levels?

Brief Answer:
Up and downs due to decrease absorption

Detailed Answer:
Hi XXXX,

Welcome to HCM. I have gone through your question and understand your concern.

Please share with us the thyroid function reports to give you a better answer.

T3 is the active form of thyroxine. Even if you take levothyroxine it will naturally get converted to T3 in your body. There are some rare situations in which we use T3, like in hypothyroid coma where faster action is needed and T4 to T3 conversion defect. These are very very rare situations and in 99.9% T4 (Levothyroxine) alone is needed.

Ups and downs in thyroid function is probably because the drug is not getting absorbed properly or the medications are not taken properly. Before you change the medications or your doctor please follow the following instructions

1. You have to take levothyroxine in morning empty stomach. You can take food or drinks other than water 1 hour after your medications.

2. Store the medicine in sun protected area. Always purchase medications in bottle or complete strips.

3. Have the medications regularly. If you miss a tablet one day take 2 tablets the other day. So even if you are irregular with medications make sure that you take 7 tablets a day - all morning empty stomach.

4. If you are on any other medications take it after 3 hours of levothyroxine dose. Especially calcium and antacids.

5. Please consult a doctor and make sure that you don't have a gastric problems like gastritis which will decrease the levothyroxine absorption.

If you still have ups and downs in thyroid function please let us know.

Regarding weight gain, it could be due to uncontrolled hypothyroidism. Still consult a doctor and have evaluated for other causes of weight gain like diabetes or Cushing's syndrome.

Hope I have answered your query. If you have any further questions I will be happy to help
With warm regards,
Dr Ajish TP (MD,DM)
Consultant Endocrinologist.

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Brief Answer:
Delay ranitidine to 3 hours, Check vitamin D

Detailed Answer:
Hi XXXX,

Thanks for the information provided. Ropinirole dose can be upto 5 mg in restless leg syndrome. You can increase the dose after consulting your doctor if you are symptomatic.

Please check your calcium, phosphorus, magnesium and vitamin D. If you are having calcium and magnesium deficiency, you can take magnesium along with calcium and vitamin D. Pure magnesium deficiency is rare. It could be a vitamin D deficiency which can be easily treated with vitamin D supplementation. That will help your restless leg syndrome. Please discuss with your doctor on this.

If you are comfortable with taking ranitidine, ferro and other medications at night, do so. If not take it 3 hours after levothyroxine.

Hope I have answered your question. If you have any further questions I will be happy to help.


Regards
Dr Ajish TP
Consultant Endocrinologist

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Brief Answer:
They can interfere

Detailed Answer:
Hi XXXX,

1. The benefit from these medications are less than 5% weight reducation. So not that significant. Luckily these are without much side effects.

2. There are some reports saying thyroxine interfering with coffee bean and garcia. Since your thyroid function are fluctuating I suggest you to have at least 1 hour gap between these two.

Hope I have answered your queries

Regards
Dr Ajish TP
Encocrinologist

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