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Have indentation on the base of skull. Have hypothyroidism and chronic sinusitis. Suffer joints pain and fatigue

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General & Family Physician
Practicing since : 2005
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Hi, I have a pronounced indentation on the base of my skull above my neck region aligned with where my ears are positioned. Just to give you a quick health background. I was told in the past years I have chronic sinusitis and hypothyroidsm. I find I am very fatigued all of the time. Body and joints ache daily. My head is tender and hurts when touched. Have had these symptoms for several years I am 42 years old. Is this something to worry about? Is this related to hypothyroidism or sinusitis?
Posted Sun, 18 Aug 2013 in Infections
Answered by Dr. Prasad 1 hour later

Let me thank you first for giving me the opportunity to discuss your concerns. I went through the details with diligence. My comments are as follows.

1. Indentation at the base of the skull is most likely an anatomical formation. Many individuals do have a minor indentation at the area you describe. As long as this indentation was not a result of trauma, I would not be bothered.

You have a feature to upload pictures on this website. It is provided as on option on this page. You can upload a good quality picture of the area in discussion if you wish to discuss further about this indentation.

2. You were diagnosed with hypothyroidism, but I don't see any medication specified for it. Under active thyroid hormones can be responsible for easy fatigue. It can also be the cause of muscular aches.

If you are not on thyroid supplements or if you haven't reviewed the treatment, I think it's time to get your TSH levels checked. You can also request for blood sugar check you while you get the thyroid review.

3. I would like to know how severe the joint aches are and if the pain is localised to specific joints.

Age related joint degeneration is known to occur in all men. Some show degeneration early. It's quite common to see such changes around 45 years. If thyroid check is normal, perhaps the joint pains are age related.

4. Chronic sinusitis does cause chronic headache. Localised tenderness is associated complaint.

In short I see that most of your symptoms are related to age and your past medical illness. If I were to be your treating doctor, I would like to review your past illness with the help of relevant test and start its treatment. You might start feeling better than.

With this brief information I would say that symptoms do not sound serious; buy worthy of a visit to the doctor.

Write back if you want to discuss on any of the aforementioned topics.

With warm regards
Above answer was peer-reviewed by
Follow-up: Have indentation on the base of skull. Have hypothyroidism and chronic sinusitis. Suffer joints pain and fatigue 2 days later
Thank you so much for your well thought out response. I did want to mention I was on Synthroid for a year but I didn't see much change. I since stopped taking the synthroid months ago and have substituted for L-Tyrosine. Also incorporated vitamin D, Magnesium, Condrotin.

I also have seasonal allergies. Can that contribute to the exhaustion and tender scalp? My scalp is always very tender to the touch. Is this a cluster headache?
Answered by Dr. Prasad 1 hour later

Welcome back...

Seasonal allergy which is a chronic condition is in the list of causes of easy fatigability; however hypothyroidism is listed much higher in the list of causes. Though L-tyrosine supplementation can increase thyroid production, I would like to review your TSH level to clarify. I would not expect you to feel better if your thyroid hormone is under functioning.

Vitamin D, Condrotin and other minerals are just the treatment to prevent early age related degeneration. I am glad that you are on these supplements. Continue them as advised.

Tender scalp is seen in stress related Tension headaches. C If it is really bothering you, there are medicines available to treat it. Selective serotonin reuptake inhibitor group of drugs like amitriptyline is my choice in such cases. You should check with your treating physician about this drug.

Cluster headache has a typical presentation - cluster of headache lasting for few hours with nasal congestion / watery eyes / dropping eye lid / redness eyes. You did not report the associated features to name it cluster headache.

In short, as described earlier thyroid review is of utmost importance now. You can plan blood sugar check whilst checking thyroid hormones. Continue your medications. You can consider amitriptyline for tender scalp.

Hope this is helpful and informative. Write back for clarifications.
If all your concerns are addressed to your satisfaction, please close this discussion and review.

Thanks in advance. Good luck!!!
Above answer was peer-reviewed by
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