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Suggest treatment for depression, weakness, constant light-headedness, shortness of breath,complete lack of energy and continual muscle soreness?

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General & Family Physician
Practicing since : 2011
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I am trying to figure out what is wrong with my 15 year old daughter. Her symptoms have developed most significantly over the past few months, and include depression, weakness, constant light-headedness, shortness of breath (even when sitting still), difficulty taking a deep breath (causes pain), episodes where breathing becomes especially difficult, a complete lack of energy, continual exhaustion, continual muscle soreness (especially in the calves), cold hands and feet (to the point of turning blue), intolerance to cold and heat especially, episodes of a racing heartbeat, and episodes of anxiety and disorientation. At first or focus was on her depression but now our focus is shifting toward her problems with physical activity and breathing, especially as she has now come to the point where she can no longer participate in any sports. We have seen a psychiatrist for her depression who discovered the MTHFR Mutation, which has since been addressed with a medadose of methyl folate. After three weeks on the medication there has been no improvement. Her pediatrician tested her for asthma and the results were negative. We have put her on various Vitamin B supplements and have made sure she is getting proper nutrition and rest. Again, nothing has helped. Other labwork, as well as some of her symptoms, has made us consider her thyroid. The thyroid results are as follows: TSH: 0.059 ulU/ml AntioTPO-Ab: 84.9 IU/mL Anti-Thyroglobulin: 134 IU/mL Total T3: 130 ng/dL T4: 10.5 ug/dL In spite of a low TSH we've been told that as long as the T4 level is within normal range there is no need for attention with the thyroid. Other labs that were out of the normal range are as follows: Ferritin: 31 ng/mL (her other iron results were normal) Differential (Audo Diff) Neutrophils: 66% Is there any guidance you can give us as to whom we should talk to next? My best guess right now is an endrocrinologist. Thank you.
Posted Thu, 20 Mar 2014 in Child Health
 
 
Answered by Dr. Vidya KR 6 hours later
Brief Answer: Thyroid problem? Endocrinologist Detailed Answer: Hi, I went through the query and understood your concern. I disagree with your doctors opinion. Low TSH level suggest that the thyroid gland is over acting. I would rather check free T4 and free T4 levels do decide thyroid state. This may be due to hyperthyroidism or thyroiditis. In hyperthyroidism you likely have symptoms of fatigue, intolerance to temperature changes, weight loss, rapid heart rate and a jittery feeling etc. Complete lack of energy, continual exhaustion, continual muscle soreness, cold hands and feet, intolerance to cold and heat especially, episodes of a racing heartbeat, and episodes of anxiety and disorientation also suggests thyroid hormone variations. So with the above features and low TSH level I suggest you to get evaluate with your endocrinologist once. Sometimes your doctor will do additional testing including a thyroid ultrasound to evaluate the gland. Also monitor her calcium levels, lipid profile and sugar levels. I hope these answers have been both informative and helpful for you. Should you have additional concerns I would be happy to address them. Wish you good health. Regards
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Follow-up: Suggest treatment for depression, weakness, constant light-headedness, shortness of breath,complete lack of energy and continual muscle soreness? 19 hours later
Thank you for your information. We have not yet seen an endocrinologist. We have been referred to one who is highly recommended, but must wait 6 weeks for an appointment. This is disappointing, but is there some danger in waiting so long for the appointment? If there is urgency to see an endocrinologist more quickly we can perhaps try to find someone else. Thank you.
 
 
Answered by Dr. Vidya KR 7 hours later
Brief Answer: Needs early treatment. Detailed Answer: Hi, Thanks for follow up query. Better to get evaluated early, waiting for 6 weeks is too long. If its a thyroiditis condition needs to treated early. Its not emergency condition to worry, but needs early treatment. Hope this information helps you. Feel free to ask further related query. if satisfied with my answer close the query and rate it. Regards
Above answer was peer-reviewed by
 
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