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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes chronic fatigue, joint pain and yeast infection while having hypothyroidism?

Answered by
Dr. Shehzad Topiwala


Practicing since :2001

Answered : 1663 Questions

Posted on Wed, 8 Jun 2016 in Thyroid Problem and Hormonal Problems
Question: I am currently on cytomel for hypothyroidism. This has been working pretty well, but my new doctor said my T4 was a little low, and changed me to Synthroid which I cannot tolerate. After a month of misery, I am now back on my Cytomel, 25 mcg. 1 1/2 day. I am feeling better, but feel a little tired, what vitamins, supplements, herbs can I take to boost my energy. I am taking vit C 100 mg, Iron, L-Lisene, Vit A,B, D, E, Calcium Magnesium, Biotin, selineum, iodine, meletonin for sleep,

vit C is 1000, and if you need other info let me know

Also, I have all the symptoms of chronic fatigue, which usually goes with hypothyroidism. Tired, fatigued, loss of hair, dry brittle nails, yeast overgrowth, yeast infections, joint pain, foggy head, etc.

I forgot Vit DHEA 50 mg.

Also, I take Nexium 40 mg 2 X day for stomach problems. I used to have an ulcer.
Answered by Dr. Shehzad Topiwala 1 hour later
Brief Answer:

Detailed Answer:
Sorry to note your symptoms.

1 When a person takes cytomel it is often seen that the T4 levels are on the lower side. This is because cytomel is T3

2 Cytomel is generally not recommended by thyroid experts as it is deemed unsafe

3 Taking biotin has recently been shown to affect blood test results for thyroid. Check with the laboratory if such an interference in reporting is possible withthe method used by them

4 You will be best served by seeing an endocrinologist in person who will have the opportunity to examine you, and manage the complexities of hypothyroidism

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 3 month glucose average)
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
Free T4
Anti Thyroid Peroxidase (TPO) antibodies
Anti Thyroglobulin antibodies
25 hydroxy Vitamin D

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
Follow up: Dr. Shehzad Topiwala 36 hours later
Thank you for your response. I do have an appointment with an endocrinologist.
Why is Cytomel deemed unsafe? I have been on it for over 20 years, and it has worked the best for me. I recently had my health provider change my prescription to Synthroid, and had a terrible reaction to it. I explained to him that years ago when I first had my Hypothyroidism detected that the doctor put me on Synthroid, and I had a reaction then, and that is why I have been taking Cytomel.
Recently, he changed me over to Synthroid, and I had feelings in my legs like I was getting a blood clots. Could hardly walk, heart palpitations, insomnia, and other terrible signs. Just 3 days off it , and I am feeling myself again!
I don't understand why Cytomel is not good?
If I stayed on Synthroid I feel that it would kill me!
Answered by Dr. Shehzad Topiwala 10 hours later
Brief Answer:
Follow up

Detailed Answer:
Cytomel has T3 which is the active hormone and can harm the heart and bones.

Synthroid is a brand name of levo thyroxine which is T4. It is best to let the body convert T4 to T3 based on its requirements.

If Synthroid is not suiting you, discuss the following with your doctor:

1 try taking the 50 mcg tablet in appropriate doses (for example two of the 50 if your daily dose is 100). The reason is that 50 mcg synthroid is colorless and white because it has no XXXXXXX in it. Some people are allergic to the XXXXXXX in synthroid.

2 try another brand of levo thyroxine.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Shehzad Topiwala 12 hours later
Thank you for your answer. However, I tried Both the Synthroid and the generic version of levo thyroxine, and both made me feel sick. I have been on Cytomel sucessfully.
I will let my new doctor know all of this, but I would like to know why you feel that
The Cytomel is harmful, when after only a month on the generic synthroid I felt like I was getting blood clots in my legs, and had heart palpitation. I have never experienced these symptoms on Cytomel
Answered by Dr. Shehzad Topiwala 1 hour later
Brief Answer:
Second follow up

Detailed Answer:
Thyroid hormone preparations containing T3 alone or in combination with T4 include the following : T3 alone (eg, Cytomel), T4-T3 combination preparations (eg, Thyrolar), and desiccated thyroid (a mixture of T3 and T4 made from porcine thyroid glands, eg, Armour Thyroid).

For most patients with hypothyroidism, experts do not suggest treatment with T3 containing preparations. Patients treated with currently available T3-containing preparations have wide fluctuations in blood T3 levels throughout the day due to its rapid gut absorption and its relatively short half-life ('duration of stay in blood') in the circulation (about one day).

In addition, blood T4 levels remain low in patients treated with T3, and relatively low in those treated with preparations containing both T3 and T4 or T3 alone; while blood TSH in steady state conditions will reflect the adequacy of therapy, measurement of serum T4 may be confusing and lead to inappropriate changes in dose.

Temporary treatment with T3 is appropriate in patients with thyroid cancer who are to undergo radioiodine imaging and possible treatment. To shorten the period of hypothyroidism, the patient's T4 therapy is discontinued and T3 is substituted for three to four weeks until the T4 is cleared.
Other than this cytomel has little role in the treatment of hypothyroidism
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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