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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Low HGB And T4 Levels, Fatigue, Insomnia With RSD-like Disorder?

My daughter (14yrs) was started on Tegrtol 600mg BID for the tx of RSD-like disorder . No bloodwoek has been done after 3 mos treatment and she is developing other issues. (low HGB and low T4 levels, c/o extreme fatigue and insomnia. Should i be overly concerned?
Tue, 28 Mar 2017
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Internal Medicine Specialist,  's  Response
HI..

Thanks for the query.

Your daughter has been dianosed with reflex sympathetic dystrophy syndrome and your worry is her sense of illhealth and insomnia.She has low T4 and low haemoglobin as well.

Yes the anaemia has to be corrected.

But regarding the thyroid hormone level i have a thought,could this be a sick euthyroid syndrome,where because of general deblitation T3 hormone and in established long term general ill health T4 also decreases.


For settling this issue you need to meet a doctor in person where he will clinically examine the patient,can take up investigations like TSH,T3 and REVERSE T3 ..

Hope this suggestion helps.

Take care.
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What Causes Low HGB And T4 Levels, Fatigue, Insomnia With RSD-like Disorder?

HI.. Thanks for the query. Your daughter has been dianosed with reflex sympathetic dystrophy syndrome and your worry is her sense of illhealth and insomnia.She has low T4 and low haemoglobin as well. Yes the anaemia has to be corrected. But regarding the thyroid hormone level i have a thought,could this be a sick euthyroid syndrome,where because of general deblitation T3 hormone and in established long term general ill health T4 also decreases. For settling this issue you need to meet a doctor in person where he will clinically examine the patient,can take up investigations like TSH,T3 and REVERSE T3 .. Hope this suggestion helps. Take care.