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Taking levothyroxine for hypothyroidism. Why am I having episodes of severe fatigue with muscle pain?

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Practicing since : 2002
Answered : 52 Questions
Hello I was dignosed with hypothyroidism 7 yrs ago & i take my levothyroxine properly everyday but I continue to struggle with bouts of exhaustion and muscle pain, i recently had lab test everything was normal except for anti tpo ab was >1000 but thryoglobulin a was <20 in normal range my endocrinologist says i have hasmito`s .Why do i have these episodes of severe fatigue with muscle pain sometimes it comes on with stress but not always.Recently its been happening more frequently,my Dr started me on cytomel 1 month ago but it hasn't helped much.
Posted Sun, 5 May 2013 in Thyroid Problem and Hormonal Problems
Answered by Dr. Anantharaman 1 hour later
Thanks for writing in to WWW.WWWW.WW I'm a certified endocrinologist and will try my best to solve your problem.
Your diagnosis is hashimotos thyroiditis with hypothyroidism. There are many reasons why you can have fatigue despite taking medication for thyroid
A) thyroid related: Is your TSH normal it should be between 0.5 and 2.5 on treatment.
B) related to your autoimmunity you could be having low vitamin B12 levels because of poor absorption of the vitamin this is fairly common in those with hashimotos
C) other common causes for fatigue include the following
1) previously unrecognised diabetes you need to test your fasting and post meal glucose levels
2) anaemia due to other causes eg iron deficiency . You need to get a complete hemogram
3) vitamin D deficiency is another cause of body pains you need to get a 25 hydroxy vitamin D level.
D. your muscle pain
Requires a closer look are you taking any medication for lowering cholesterol. Do you have difficulty standing up from sitting position at times. If you have this symptom then it is important to get a creatinine kinase level done
All the above are suggestions that you could discuss with your doctor and get the tests done.please feel free to write back with more detail. Please give me 12 to 16 hrs to respond to your queries as I have a busy practice.
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