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Have controlled hypothyroidism. Getting slurred speech, fatigue and insomnia. Proper diagnosis?

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Psychiatrist
Practicing since : 2004
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Hi, my wife is suffering from the following symptoms, ataxia to the point of having falls, slurred speech, fatigue, lack of co-ordination and chronic insomnia. She has been hypothyroid for years with elevated Abs. currently TFT's are normal as she is on thyroid meds. She is also on DHEA 15mg and on a range of supplements, D3, selenium, magnesium, multivitamin. We have been to two different neurologists an endocrinologist, not to mention many GP's and they can find nothing else wrong with her other than the thyroid issue. DHEA is for menopause symptoms as she is 60.
any help would be appreciated.
Posted Thu, 31 Jan 2013 in Thyroid Problem and Hormonal Problems
 
 
Answered by Dr. Ashish Mittal 1 hour later
Hello,
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:
•     26 year old female
•     Known case of hypothyroidism: currently controlled
•     Complaints of: Ataxia (to the point of having falls), slurred speech, fatigue, lack of co-ordination and chronic insomnia.
•     Currently on: DHEA and Multivitamins

Her case is interesting and but difficult too. Even your attending physician is facing problem to solve it. I will try to give my best effort to help you in this problem.


I would like to consider multiple possibilities in following hierarchy:
•     Neurological problem: She may need MRI brain. Following problems can present with above symptoms: Parkinson disease, Old stroke and Dementia. Hope neurologist had ruled out these issues.
•     Vitamin deficiency: She is already on multivitamins.
•     Thyroid related problem: It is already under control.
•     Side effect of substance use: considering her age, it is least possible.
•     Depressive disorder: need to be rule out by detailed interview by psychiatrist, which is left in her case. History of thyroid problem also increases chances of having depression. Depression usually present with low mood, decrease movement, decrease talk and insomnia.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
Regards,
Dr Ashish XXXXXXX Mittal
Above answer was peer-reviewed by
 
Follow-up: Have controlled hypothyroidism. Getting slurred speech, fatigue and insomnia. Proper diagnosis? 12 minutes later
Thanks for your reply, MRI has been done and is normal, as is CT scan of brain. Her mood is good depression has been discussed but she is a positive person and antidepressants do not agree with her, she hates the side effects and refuses them, GP and I don't feel that depression is a problem. Is it possible that the DHEA or Thyroid meds are contributing to insomnia? Has been on DHEA for about 7 years and insomnia began march 2012 almost 12 months from starting thyroid supps.
 
 
Answered by Dr. Ashish Mittal 8 hours later
Hello again,
Thanks for follow up,


Is it possible that the DHEA or Thyroid meds are contributing to insomnia?
Ans: Thyroid medicine is not a problem in her case as her thyroid functions tests are normal now. You can get them repeat to be sure (If previous test occur more than 3 months back).
DHEA is a steroid hormone. Its use can lead to depressive symptoms, even insomnia. In my view you can discus about slowly discontinuation of its use in current situation from her physician.

Wishing her good health,
Regards,
Above answer was peer-reviewed by
 
Follow-up: Have controlled hypothyroidism. Getting slurred speech, fatigue and insomnia. Proper diagnosis? 1 hour later
Thank you so much for your help. It is greatly appreciated. Regards XXXXXXX
 
 
Answered by Dr. Ashish Mittal 8 hours later
Hello again,

Thanks for feedback.

Please accept my answer in case there are no further queries and recommend our services to your friends too if you have found it helpful.

Wish you good health.
Regards.
Above answer was peer-reviewed by
 
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