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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Severe Fatigue And Brain Fog Be Treated?

I had a thyroidectomy 16 months ago. I had no problems for the first year...taking 100 mcg of a generic Synthroid. My counts have been off the charts lately....high. My dosage was increased to 125 mcg four weeks ago.The second change since April. I continue to struggle with no energy, brain fog, feeling weak. Way is going on?
Fri, 17 Aug 2018
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General & Family Physician 's  Response
Hello and Welcome to ‘Ask A Doctor’ service.
I have reviewed your query and here is my advise.

If TSH levels are higher than 5 mUi/L than the thyroid dysfunction is a very likely cause of the fatigue and brain fog you are experiencing. The thyroid is an important hormone in the metabolism and effects the energy level and brain function.

It takes 6-8 weeks for TSH to come to maximal change after a dose change so in your case the dose change you had 4 weeks ago might need another 2-3 weeks to give the full effect. Sometimes some patients might need doses of 150 mcg of Levothyroxine or higher so that their TSH goes to norm.

While you wait for the 2-3 week period to pass so you can check again your TSH you may talk with your doctor on the possibility of having other tests like CBC, ERS, fasting glucose (or HbA1C if you are not fasting), lipids, renal function (creatinine and electrolytes: Ca+, Na+, Mg+, Cl-), liver function (ALT,AST, Bilirubine) which will help to do a general check and rule out other possible causes of the symptoms you are having.

Hope I have answered your query. Let me know if I can assist you further.

Kind regards,
Antoneta Zotaj, MD
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How Can Severe Fatigue And Brain Fog Be Treated?

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advise. If TSH levels are higher than 5 mUi/L than the thyroid dysfunction is a very likely cause of the fatigue and brain fog you are experiencing. The thyroid is an important hormone in the metabolism and effects the energy level and brain function. It takes 6-8 weeks for TSH to come to maximal change after a dose change so in your case the dose change you had 4 weeks ago might need another 2-3 weeks to give the full effect. Sometimes some patients might need doses of 150 mcg of Levothyroxine or higher so that their TSH goes to norm. While you wait for the 2-3 week period to pass so you can check again your TSH you may talk with your doctor on the possibility of having other tests like CBC, ERS, fasting glucose (or HbA1C if you are not fasting), lipids, renal function (creatinine and electrolytes: Ca+, Na+, Mg+, Cl-), liver function (ALT,AST, Bilirubine) which will help to do a general check and rule out other possible causes of the symptoms you are having. Hope I have answered your query. Let me know if I can assist you further. Kind regards, Antoneta Zotaj, MD