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Suggest treatment for fatigue and weight gain

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Posted on Sat, 30 May 2015
Question: Hi~
I am 44 years old with 2 kids (15 and 12). I have been noticing an increase in fatique (I am constantly rallying to stay busy and keep going instead of laying down) and weight gain. I work out 2x a week with a trainer (HIIT) and at least 2 more times by myself. I try to keep a very high intensity of weight training and cardio for about an hour. I eat very healthy and try to stay around 1200 calories. Weight loss is very slow if non existent. I currently weight 181 and am 5'6".
I had my thyroid tested. My Free T4 is .9 and my TSH is .77. I wanted to get your opinion about this. My doctor feels that treatment would increase chance of heart disease and this outweighs the symptoms I am having. He also stated my results are similar to central hypothyroidism but not low enough to make this diagnosis. I do not take any medications or supplements. I don't take any pre work out and have about 1 cup of coffee a day.
Thanks for your help, XXXXXXX
doctor
Answered by Dr. Binu Parameswaran Pillai (2 hours later)
Brief Answer:
Need more investigations

Detailed Answer:
Good day,

Noted your concern. Sorry to hear about your symptoms. Could you attach the thyroid blood reports? I wanted to know the units of Free T4.

Apart from this, you should discuss about getting following bood tests.

1) CBC, ESR
2) 8 AM serum cortisol ( fasting)
3) Renal and liver function tests
4) Urine routine
5) Electrolytes
6) Vitamin D, Serum calcium( fasting)
7) Fasting blood glucose

What about your periods? Is it regular?

Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Binu Parameswaran Pillai (38 hours later)
Hi~
Thank you for your quick response. My periods are somewhat regular. Plus or minus a couple of weeks. More regular now that my daughter is regular.
Also, not sure if this is age, but have a lot of duh moments. Forget about things that happened recently, what I was doing, if I asked someone something, etc.
I could not download the results but they are: (normal range in parenthesis)
T4Free .9 (.8-1.5ng/dL)
TSH .77 (.35-4 mcIU/mL)
WBC 7.6 (4-11 x 1000/mL)
rbc 4.28 (4.20-5.40 mill/mcL)
HGB 13.0 (12.0-16 g/dL)
HCT 40.1 (37-47%)
MCV 93.8 (81-99fL)
MCH 32.4 (32-37 g/dL)
rdw/ blood 12.9 (11.5-14.5%)
platelets 274 (130-400x1000/mL)
HGBA1C 5.8 (<= 6.9%) estimated average 119
ALT 18 (<=54u/L)
CK 158 (<=235u/L)

Thank you, XXXXXXX
doctor
Answered by Dr. Binu Parameswaran Pillai (1 hour later)
Brief Answer:
NORMAL THYROID

Detailed Answer:
Hi your thyroid blood works are normal doesn't represent hypothyroidism. May I request to get the previously requested investigations done? Besides, you may also need to get a vitamin B12 level. Hope you are sleeping well and take adequate rest.
regards XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1435 Questions

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Suggest treatment for fatigue and weight gain

Brief Answer: Need more investigations Detailed Answer: Good day, Noted your concern. Sorry to hear about your symptoms. Could you attach the thyroid blood reports? I wanted to know the units of Free T4. Apart from this, you should discuss about getting following bood tests. 1) CBC, ESR 2) 8 AM serum cortisol ( fasting) 3) Renal and liver function tests 4) Urine routine 5) Electrolytes 6) Vitamin D, Serum calcium( fasting) 7) Fasting blood glucose What about your periods? Is it regular? Regards Binu