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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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On Synthroid, Severe Random Headache, Leg And Arm Spasms, Now Low Testosterone. Is This Adrenal Defficiency ?

My husband had his thyroid removed in 2006 and is on synthroid . He had open heart surgery to repair his leaky mitral valve in mid August 2012. Starting around October1st 2012, be began having severe headaches- sometimes on the top of his head, and sometimes in the facial area. He has had a CAT scan of his head and sinuses and was told all looked normal. He began cardiac rehab the first of October also. Since starting cardiac rehab, he has severe cramps in his quads and calves (he quit going in around Thanksgiving to rehab as his legs and head hurt so much). He still has severe random headaches, random, severe leg (Quads mostly but calf muscles sometimes) and arm muscle spasms, and he is now Low- Testosterone . In late December his calcium was 8.9, his sodium was 104, and his potassium was 3.6 ( I may have the K+ and Na+ backwards). He is 6 ft 6 inches tall and weighs 264. His cholesterol is around 90 (total). He also is cold all the time and cannot concentrate when his head hurts. Stress makes all this worse. He takes his synthroid first thing in the am, then at breakfast he takes bystolic, a baby aspirin, and a 2000 unit Vitamin D capsule daily. If he takes 3 ibuprofen, 2 Excedrin, and a 2.5 mg valium, the pain lessens. He has also seen a neurologist and they ruled out chiari syndrome. I appreciate your input. I thought perhaps he has adrenal insufficiency, but we are at a standstill here. Any input is appreciated.
Mon, 23 Sep 2013
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Endocrinologist 's  Response
Dear Ma'm I understand and appreciate your concern. I would like to know few things,
1. TSH, FT4
2. Serum Cortisol (8 am)
3. Serum ACTH
4. LH, FSH, TESTOSTERONE
As you have rightly pointed out he can be having adrenal insufficiency. Adrenal insufficiency will have high potassium, it will not cause low testosterone. what is his Blood pressure? So ma'm my second diagnosis would be pituitar suppression. Let us work out things as I have suggested then we can review. Regards!
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On Synthroid, Severe Random Headache, Leg And Arm Spasms, Now Low Testosterone. Is This Adrenal Defficiency ?

Dear Ma m I understand and appreciate your concern. I would like to know few things, 1. TSH, FT4 2. Serum Cortisol (8 am) 3. Serum ACTH 4. LH, FSH, TESTOSTERONE As you have rightly pointed out he can be having adrenal insufficiency. Adrenal insufficiency will have high potassium, it will not cause low testosterone. what is his Blood pressure? So ma m my second diagnosis would be pituitar suppression. Let us work out things as I have suggested then we can review. Regards!