Question: Dear Doctor, I am 40 years old male, hypothyroid since last 2 years. I take one ELTROXIN tablet 25 mcg daily morning on an empty stomach. I have a history of B12 deficiency and Vit D deficiency.
Over the last 5 months I have been not feeling fit physically. I have consulted various specialists, underwent several blood / urine / stool tests, and also had an annual health check-up which revealed normal results.
As I was concerned for B12 deficiency, I underwent a course in B12 injections in Aug / Sept'15. My B12 level was 273 and Vit D level was 14.5 (against minimum 30 required). I took a total of fourteen B12 shots - 7 shots every alternate day, subsequently followed by one shot every week. I also took a course of Vit D supplements for a month. There was not test further to check the 'corrected' Vit B and Vit D levels.
Though I felt a bit better after the injection course for almost a month, however, since last 4-5 weeks I have again started feeling unfit viz. mind-fogginess, dizziness, difficulty walking, occasional palpitations, lack of focus, total loss of libido, fatigue, momentary loss of balance while getting up from 'squat' position etc. I also get pains in my lower limb even after climbing just one storey.
I experience the above more, especially when I step out of office for home every evening (In general when I come out from any cool air-conditioned place after 3-4 hours). I had an episode of sinusitis in 2013 where there was mucosal thickening in the right maxillary, sphenoid sinuses and ethmoidal air cells. There was no specific treatment for this though, and the last 2 years were absolutely normal.
I need to come out of this problem as it is affecting my personal / professional life. I have also lost any hope to get accurate cause for the above from the doctors, as almost all doctors assert that this is a psychological problem, as clinically I am normal - based on exhaustive testing done over the last 4-5 months.
I expect to have your response at the earliest.
Thanks

Dear Doctor,

Thanks for your response !

Though I do not agree completely with your views, I understand that due to my current stress, some of the non-specific symptoms as above may be experienced.

However, I cannot undergo any medication course in SSRI's, as withdrawing from this is a very difficult task. Moreover, I had also consulted a psycho-therapist in July this year, where I underwent 4 sessions. This was, however, not useful.

Can you elaborate on the specific cause of feeling dizzy/foggy whenever I step out from an air-conditioned room / car. Is this related to 'mucosal thickening in the right maxillary, sphenoid sinuses and ethmoidal air cells' ? Is there any safe method to extract the mucous ?

Warm regards,

Jagdish Mulimani