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Suggest remedy for low body temperature and fibromyalgia

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Posted on Tue, 26 May 2015
Question: I have been taking my temp every am under my armpit before I get out of bed in the am. It ranges from 94.9 to 97.4. I am tired, do not sleep well (Fybromyalgia) have digestive issues (Reflux) (Irritable Bowel). I get cold easily. At night, even tho I live in Hawaii, I wear socks every night and have a blanket and or quilt over me. I eat well, exercise 4 days a week in the water. I was seen by an Endoc Doc and he said I was in "normal" range. BTW, during the day, my temp gets to about 97 or so at Doc office. What do you think?
doctor
Answered by Dr. Shehzad Topiwala (8 hours later)
Brief Answer:
Temperature

Detailed Answer:
Sorry to note your symptoms relating to low body temperature.

I understand you have been evaluated by an endocrinologist and have been told to have no hormone-related problems.

However, to be certain I would have liked to make sure the results of the following tests are normal, in order to rule out any major pituitary condition that can explain your symptoms;

CBC
CMP
TSH
Free T4
FSH
LH
Prolactin
Serum cortisol at 8 am

Fasting is not necessary for these tests but the time of the day is important.

These assist in being quite sure that there is no problem in the pituitary which can explain your symptoms.

It is likely that your TSH has already been tested and has come back normal. Most of the time this is the only blood test which is performed to assess the thyroid.
But there is a rare condition called Secondary hypothyroidism in which the TSH can be normal, and unless the Free T4 is checked one can miss the possibility of this type of hypothyroidism.
Hypothyroidism (an under active thyroid) can very well result in low body temperatures.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (1 hour later)
This is the info you requested in your answer. It is a year old.

FT4 - 1.2 TSH 1.35
TPO antibodies and AM cortisol 6.0 at 9.59 am.

CBC with platelet Ct CMP
RDW - 13.8 Bilirubin, Total - 0.3
white blood count - 6.0 BUN - 19
red cell blood count - 4.53 Calcium - 9.1
hemoglobin - 13.9 Chloride - 102
hematocrit - 40.9 C02 - 23
MCV - 90.3 Creatinine - 0.6
MCH - 30.7 GFR, calc.if non-African Am. - >60
MCHC - 34.0 Potassium - 4.2
Abs Neutrophils - 3.63 Sodium - 137
Neutrophil - 60.6 Glucose - 90
Lymphocyte - 27.3 Total Protein - 6.7
Monocyte - 9.8 SGOT(AST) - 19
Eosinophil - 1.8 SGPT(ALT) - 20
Basophil - 0.3 Albumin - 4.4
Platelet count - 213 Globulin - 2.3
Alkaline Phosphatase - 103


You also asked for LH and Prolactin, I do not see anything on this report that would tell me if these were measured.

Or, is this old data, that is useless. My symptoms have not changed in a year.
Although the Endocrinologist stated that I was in range of "normal", he did say,
"If concerns continue about adrenal insufficiency, she should probably have ACTH stimulation test."

Thank you.


doctor
Answered by Dr. Shehzad Topiwala (43 minutes later)
Brief Answer:
Follow up

Detailed Answer:
I have reviewed the attached information.

I agree with your previous endocrinologist about the possible need for an ACTH stimulation test.

However I would first recommend re-testing all the tests I mentioned in my first reply. In particular the cortisol blood sample must be drawn at 8 am and no later.

Based upon the results, only an endocrinologist can guide you further as to whether or not more testing is necessary
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (1 hour later)
Thank you very much! Because of your responses, I feel much more courage to address these issues again with my own doctor. Aloha!
doctor
Answered by Dr. Shehzad Topiwala (1 hour later)
Brief Answer:
Second follow up

Detailed Answer:
You are welcome. Best wishes for good health
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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Suggest remedy for low body temperature and fibromyalgia

Brief Answer: Temperature Detailed Answer: Sorry to note your symptoms relating to low body temperature. I understand you have been evaluated by an endocrinologist and have been told to have no hormone-related problems. However, to be certain I would have liked to make sure the results of the following tests are normal, in order to rule out any major pituitary condition that can explain your symptoms; CBC CMP TSH Free T4 FSH LH Prolactin Serum cortisol at 8 am Fasting is not necessary for these tests but the time of the day is important. These assist in being quite sure that there is no problem in the pituitary which can explain your symptoms. It is likely that your TSH has already been tested and has come back normal. Most of the time this is the only blood test which is performed to assess the thyroid. But there is a rare condition called Secondary hypothyroidism in which the TSH can be normal, and unless the Free T4 is checked one can miss the possibility of this type of hypothyroidism. Hypothyroidism (an under active thyroid) can very well result in low body temperatures.