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Have Hypothyroidism, Feel Tired Easily, Hot Feeling, Sweating, Ears Ringing, Fingers Trembling. What Can This Be?

Posted on Wed, 26 Sep 2012

Question: I am 43 years old male. I AM HYPOTHYROID. My doctor says that my levels are ok. But I feel tired and exhausted if I do anything energetic Like go for a long walk. My question is that I get a hot feeling come over me I feel sweaty and my ears ring and then my little finger trembles for 30 secs. Afterwards I feel better than I did previously. This has been happening for about 6 years about twice a month. It is usually occurs when I am over tired. What can this be?

Answered by Dr. Sudhir Kumar (1 hour later)

Hi Mr XXXXXXX
Thank you for contacting Healthcare Magic.
You have hypothroidism and you are on thyroid supplements. Based on your blood reports, all seem ok, except TSH, which is slightly low. However, as T3 and thyroxine are normal, that is fine.
Regarding your symptoms, they are episodic and come only twice a month. The commonest reasons for episodic neurological symptoms are migraine and epilepsy. In migraine, headache is the main feature, which you have not reported.
Your symptoms could be a partial epilepsy (without loss of consciouness). Consulting a neurologist and undergoing investigations such as EEG could further clarify this.
Other possibility could be a pre-syncope, where the blood supply to brain is temporarily reduced due to exhaustion/tiredness. You improve after a short while, as the normal blood supply to brain is restored.
None of the conditions described above are serious, and they would improve with medical treatment (if they are diagnosed and treated).
Please revert if you have any more queries.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Health City, Hyderabad

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (31 minutes later)

thank you for asking my query. I might add it is that something can trigger this feeling of hot sweats and finger twitching. Things like after sex I feel ok the next day. But following day I will feel really bad. I will like suffer a hot sweat moment. Food like lemon always triggers it a few hours later. Bright lights (sunlight or to long on the computer) can trigger it off as well. I have recorded when it happens. The time of the day when I have seen it most is around 9:00 am and 4 to 5pm and 6pm.

Answered by Dr. Sudhir Kumar (6 minutes later)

Thank you for providing more details.
Migraines can get triggered by sunlight, excessive computer use and certain food stuffs. There is a variant of migraine, where headache may not be present. However, another point against migraine is the short duration of these episodes. To qualify as as attack of migraine, it should at least last for four hours (in your case, they last only for 30 seconds).
Therefore, I would still keep the possibility of partial sezire as the first one, followed by pre-syncope.
With best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (19 hours later)

Although I'm on a good amount of thyroid medication I still feel fatigued, low in energy and easily get drained. It takes me days to feel right again. If I do some physical work I will feel tired straight away and feel it for days. IF I have sex I will feel usually good the next day but then afterwards very tired and drained for at least a week. The hot sweats and finger trembling will occur when I am over tired and more often a few days after I have sex.

My father had parkinsons. I wonder if this could be related to what I'm getting.

Answered by Dr. Sudhir Kumar (3 hours later)

Dear Mr XXXXXXX
Thank you for getting back.
Regarding your symptoms of tiredness and fatigue, thyroid is not the reason, as you are on adequate treatment. You require further evaluation to find out the exact reason. You should consult your GP. Investigations that could be helpful for you include hemoglobin, serum vitamin B12 and Vitamin D levels. Cardiac evaluation would also be useful.
Regarding Parkinson's disease (PD), the symptoms include tremors at rest, rigidity of hands and feet and slowness of all movements. Your current symptoms are not suggestive of PD. Also, 90% of PD cases are not familial.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar