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Suggest Treatment For Takayasu's Arteritis, Fatigue And Drowsiness

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Posted on Wed, 7 Oct 2015
Question: hi Doctor , im takayasu arterties patient , now under prednisone 5 mg , also I had coronary bypass and aortic valve replacement on 2008 , I had checked Tsh t3 and T4 before 4 months . That time TSh was 56 , T3 t4 normal , doctor prescribed thyronorm 137.5 mcg daily , for the last one week I was having fatigue, always sleepy, so went for a blood test my tsh decreased to 0.26 rest all normal . What to do now
doctor
Answered by Dr. Sandip Kabra (2 hours later)
Brief Answer:
Need to reduce the dose,take 100 microgram instead of 137.5

Detailed Answer:
Hi,

Welcome to health care magic,

I have read all your query and saw the attached report carefully.

Your serum TSH has gone down 0.29 mU/L (below normal 0.4),so you may need to reduce dose by approximately 50 microgram means instead of of taking 137.5,you should take 100 microgram once daily and repeat S.TSH after 1 month to check the response.

You can discuss it to your treating physician.

One more thing it might require some time to stabilize the exact dosage initially but once your dosage will be set then there will be no issue with elevation of thyroid hormones (lowering value of TSH). So no need to worry.

Continue your thyroid treatment with regular follow-up at your treating physician and if possible check your thyroid profile on every alternative months at initial stages.

And when the dosage will be set you can go for testing every 3 to 6 monthly.

Also,thyroid tablet (Thyronorm) must be taken on empty stomach to get maximum absorption from the stomach as food might interfere with its absorption.

Ideally it is taken after 2 hours of having meal or before 45 minutes of meal.
Means it is best not to eat anything for at least 1 hour after taking thyronorm.

Hope this detailed answer will be helpful.

Regards,

Dr.Sandip Kabra
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Sandip Kabra (1 hour later)
Dr whether fatigue and always sleepy feeling is due to thyroid issues or due to my takayasu arteries issues. Feeling cold always and night sweats . Most of the time my clinic results are normal . Now I hate to go to hospitals I can't explain to doctors about my brain fog situation , nobody is understanding me . Fed up with this life..
doctor
Answered by Dr. Sandip Kabra (3 hours later)
Brief Answer:
likely to be related to your excess thyroid hormones.

Detailed Answer:
Hi,
Thanks for the follow-up.

Fatigue,sleepy feelings or night sweating symptoms are likely to be related to your excess thyroid hormones and unlikely to be related to takayasu's arteritis.

As i said earlier,it will require some time to stabilize the exact dosage initially but once your dosage will be set then there will be no issue with elevation of thyroid hormones with tab.thyronorm.

I think your symptoms would also start improving once your TSH will come in normal range (euthyroidism).

Also,continue with your other medications as per your doctor's advice.

Regards,
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Sandip Kabra

General & Family Physician

Practicing since :2009

Answered : 3078 Questions

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Suggest Treatment For Takayasu's Arteritis, Fatigue And Drowsiness

Brief Answer: Need to reduce the dose,take 100 microgram instead of 137.5 Detailed Answer: Hi, Welcome to health care magic, I have read all your query and saw the attached report carefully. Your serum TSH has gone down 0.29 mU/L (below normal 0.4),so you may need to reduce dose by approximately 50 microgram means instead of of taking 137.5,you should take 100 microgram once daily and repeat S.TSH after 1 month to check the response. You can discuss it to your treating physician. One more thing it might require some time to stabilize the exact dosage initially but once your dosage will be set then there will be no issue with elevation of thyroid hormones (lowering value of TSH). So no need to worry. Continue your thyroid treatment with regular follow-up at your treating physician and if possible check your thyroid profile on every alternative months at initial stages. And when the dosage will be set you can go for testing every 3 to 6 monthly. Also,thyroid tablet (Thyronorm) must be taken on empty stomach to get maximum absorption from the stomach as food might interfere with its absorption. Ideally it is taken after 2 hours of having meal or before 45 minutes of meal. Means it is best not to eat anything for at least 1 hour after taking thyronorm. Hope this detailed answer will be helpful. Regards, Dr.Sandip Kabra