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Suggest treatment for fatigue and thyroid level of 3.00

Answered by
Dr.
Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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Posted on Sat, 17 Sep 2016 in Thyroid Problem and Hormonal Problems
Question: My thyroid level has gone from 1.91 to 3.00 uIU/mL in the last year and a half. I have never had an issue with my weight but I have gained about 15 pounds during the same period and can't seem to lose it, despite exercising 4-5 times a week and eating the same or less than I always have. I also have a fair amount of fatigue. I am 53 and am in "deep menopause." I am wondering if this is all menopause related, or, there could be a link to my thyroid as well.
doctor
Answered by Dr. Shehzad Topiwala 7 minutes later
Brief Answer:
Thyroid unlikely

Detailed Answer:
It is extremely unlikely your thyroid can be the cause of so much weight gain. Sorry to learn about your other bothersome symptoms too. When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:

CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)

Free T4 (this checks your thyroid too)                                                                                    Thyroid  autoantibodies :  Anti Thyroid Peroxidase (TPO) antibodies  and   Anti Thyroglobulin antibodies                                                       25 hydroxy Vitamin D   levels                                                 

None of these tests require any fasting and can be done at any time of the day

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala 23 minutes later
I also had these tests (with results)

Component     Your Value     Standard Range
WBC     5.4 K/ul     4.0 - 10.0 K/ul
RBC     4.61 M/ul     3.80 - 5.10 M/ul
HGB     13.4 g/dl     11.5 - 15.5 g/dl
HCT     42.2 %     34.0 - 45.0 %
MCV     91.5 fL     80.0 - 100.0 fL
MCH     29.1 pg     27.0 - 34.0 pg
MCHC     31.8 g/dl     31.0 - 36.0 g/dl
PLT     241 K/ul     150 - 400 K/ul
RDW     13.3 %     11.0 - 15.0 %
MPV     9.8 fL     9.4 - 12.4 fL
NE%     67.5 %     34.0 - 70.0 %
LY%     23.6 %     20.0 - 53.0 %
MO%     8.7 %     5.0 - 12.0 %
EO%     0.0 %     1.0 - 6.0 %
Basos     0.0 %     0.0 - 2.0 %
NE#     3.6 K/ul     1.6 - 6.0 K/ul
LY#     1.3 K/ul     0.9 - 5.3 K/ul
MO#     0.5 K/ul     0.0 - 0.8 K/ul
EO#     0.0 K/ul     0.0 - 0.4 K/ul
BA#     0.0 K/ul     0.0 - 0.2 K/ul

Component     Your Value     Standard Range
Sodium     138 mm/L     135 - 145 mm/L
POTASSIUM     4.4 mm/L     3.5 - 5.1 mm/L
CHLORIDE     106 MM/L     96 - 109 MM/L
ECO2     27 mm/L     23 - 33 mm/L
GLUCOSE     90 mg/dl     70 - 100 mg/dl
Nonfasting Range: 70-130 mg/dl
BUN     10 mg/dl     7 - 22 mg/dl
Creatinine, Ser     0.67 mg/dl     0.50 - 1.40 mg/dl
eGFR NON-AFRICAN AMER.     >60 mL/min/1.73m^2     >60.00 mL/min/1.73m^2
eGFR XXXXXXX AMER.     >60 mL/min/1.73m^2     >60.00 mL/min/1.73m^2
Ca     9.5 mg/dl     8.4 - 10.2 mg/dl
BILIRUBIN, TOTAL     0.2 mg/dl     0.0 - 1.2 mg/dl
SGPT (ALT)     31 U/L     15 - 78 U/L
SGOT (AST)     27 U/L     9 - 44 U/L
ALKALINE PHOSPHATASE     95 U/L     37 - 127 U/L
PROTEIN, TOTAL     7.7 g/dl     6.7 - 8.8 g/dl
ALBUMIN     3.8 g/dl     3.1 - 4.5 g/dl
CALCULATED GLOBULIN     3.9 g/dl     3.1 - 5.0 g/dl
CALCULATED A/G RATIO     1.0 ratio     0.7 - 1.4 ratio
Anion Gap     5 mmol/L     5 - 15 mmol/L
B/C ratio     14.9 ratio     10.0 - 20.0 ratio

Component     Your Value     Standard Range
VITAMIN D, 25 OH     31.8 ng/ml     25.0 - 80.0 ng/ml
doctor
Answered by Dr. Shehzad Topiwala 30 hours later
Brief Answer:
Follow up

Detailed Answer:
I have reviewed the results.

These seem normal. The only test I do not see are thyroid auto antibody results.

Ask you endocrinologist if you could be tested for uncommon causes of weight gain such as

Cushings syndrome and Acromegaly.

Your endocrinologist will first examine you in-person and the two of you can jointly discuss whether to proceed with tests for these 2 conditions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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