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What Causes Fatigue And Tremors When Diagnosed With Hypothyroidism?

Posted on Sat, 21 Oct 2017

Question: My mother is very weak and shaky, with poor balance in the morning. She also has a difficult time speaking.
She has been diagnosed with essential tremors and has hypothyroidism. As the day wears on, these conditions improve. She takes most of her medicines in the morning.
what could be the problem?

Answered by Dr. Mirjeta Guni (20 minutes later)

Brief Answer:
About your mother's situation;

Detailed Answer:
Hello and thank you for asking!
I can understand your concern regarding to your mother's health.
The situation described by you suggests for neurological complication. She needs to be seen by a neurologist in person.
An under active thyroid may cause, general fatigue, feeling sleepy ect but not such abrupt events.
Anyway, the dose of levothyroxine should be monitored by checking TSH level. If it is within the normal ranges, continue with 50 mcg.
You didn't mention Diabetes as one of her diagnosis, because a low blood sugar caused by antidiabetics may be manifested with the above described symptoms. But it does not seem to be her case.
So, my suggestion is to see a physician ( neurologist is posdible) assap.
Wish her good health,
Kind regards,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Mirjeta Guni (31 minutes later)

She does not have diabetes, although her blood serum was slightly high at 108.
She has a neurologist appointment this week, regarding essential tremors.
Recent TSH levels:
on 75 mg
April 1.54
July 0.371

on 50 mg
Sept. 0.658

Answered by Dr. Mirjeta Guni (4 hours later)

Brief Answer:
need to decrease the dose of levothyroxine;

Detailed Answer:
Welcome back,

I would suggest keeping higher TSH levels for her age. The normal ranges of TSH for her age are higher ( up to 6.5) so 0.6 is too low but can not be the cause of actual symptoms.

I would suggest a 62.5 mcg of Levothyroxine for the next 3 months and see a neurologist to exclude any ischemic event.

Wish her good health,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Mirjeta Guni (2 hours later)

Thanks so much for your responses. Would you suggest that she see an endocrinologist, as well?

Answered by Dr. Mirjeta Guni (14 hours later)

Brief Answer:
Check the blood sugar;

Detailed Answer:
Hi again,
I do not see it necessary for the moment, just check the blood sugar ( if there more than 3 months that she didn't check it) and lower the levothyroxine dose.
Best wishes,

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Mirjeta Guni (1 hour later)

Thank you so much. However, I am confused. Ypu suggested that she lower the dose to 62.5, but she's on 50 right now. What is your suggested dose?

Answered by Dr. Mirjeta Guni (4 hours later)

Brief Answer:
Suggested dose;

Detailed Answer:
Hi again,
Sorry, it is a lapsus, 42.5 mcg (skip 1 dose once weakly).
Kind regards,
Dr.Mirjeta

Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Raju A.T