Extremely exhausted and worn out all the time

[awahab]

I'm a 32 year old mum of two kids (3 & 4 years old).

Beginning of March I went to see an endocrinologist as I wasn't feeling well and he asked for some tests. The thyroid result was over average but still within normal range, the tests also showed that I was

suffering from Vitamin D deficiency so I started taking medication for Vitamin D but nothing for Thyroid, instead I started taking Omega 3 and incorporating more fish into my diet.

After approximately a month (April 18th) I started to feel something stuck in my throat all the time, I went to see the endocrinologist again and he said it's not related to Thyroid and advised me to do

an ultrasound to see if there's something for real or its just a feeling.

The ultrasound showed 3 lumps, so I went to see a general practitioner dr who diagnosed my symptoms as gastroesphageal reflux although I didn't really suffer from any burning

sensation or acidity but I have a problem feeling bloated all the time as well as stomach pain and nausea in addition to tasteless belching.

Accordingly the dr prescribed gastroesphageal reflux medication which I took for 2 weeks but it didn't really fix my symptoms.

The dr said I need a higher dose of the medication so he doubled it.

I did some other tests yesterday CBC, Liver and Kidney Functions which were all good except for iron deficiency.

Symptoms:

- Exhausted all the time which is preventing me from performing my basic daily activities (duties as a mum).

- Stomach/Abdominal pain.

- Nausea.

- Bone and Joints ache.

- Bloated all the time.

- Dizzy sometimes.

- Insomnia and lack of sleep.

Has anyone had a similar experience? Is this related to Thyroid? Gastroesphageal Reflux? or something else?

This is hugely affecting my daily life as I'm unable to do basic day to day activities.

Would appreciate any insights...

[SeasideSusie Remembering]

awahab

Impossible to read your results I'm afraid, even on my PC, far too small.

Can you type them into your post please, results plus reference ranges.

[awahab in reply to SeasideSusie]

Date : 2/3/2018

Free T4 0.99 Ref.Range (0.82 - 1.44)

TSH 4.073 Ref Range (0.55 - 4.78)

Date : 24/3/2018

Free T4 1.13 Ref.Range (0.82 - 1.44)

TSH 2.618 Ref Range (0.55 - 4.78)

Date : 17/4/2018

Free T4 0.87 Ref.Range (0.82 - 1.44)

TSH 3.833 Ref Range (0.55 - 4.78)

Date : 8/5/2018

Free T4 1.23 Ref.Range (0.82 - 1.44)

TSH 2.730 Ref Range (0.55 - 4.78)

Complete Blood Picture CBC Date : 12/5/2018

Haemoglobin 12.30 Ref. Range (11.5 - 16)

Hematocrit 35.5 Ref. Range (34 - 44)

Red cell count 4.51 Ref. Range (3.8 - 5.4)

MCV 78.7 Ref. Range (78 - 96)

MCH 27.4 Ref. Range (26 - 32)

MCHC 34.8 Ref. Range (31 - 36)

RDW 13.8 Ref. Range (11.5 - 14.5)

Platelet Count 133 Ref. Range (150 - 450)

T.L.C 3.5 Ref. Range (4 -11)

Differential Count :

Basophils : 1 % Ref. Range (0 -1)

Eosinophils : 12 % Ref. Range (0 -6)

Stab : 0 % Ref. Range (0 -7)

Segmented : 35 % Ref. Range (40 -75)

Lymphocytes : 40 % Ref. Range (20 -45)

Monocytes : 12 % Ref. Range (1 - 10)

Comments : Normal Hb and red cell indices

Mild thrombocytopenia

Mild leucopenia

Mild relative eosinopilia

Mild relative monocytosis

Mild absolute neutropenia

Mild absolute lymphopenia

Immunology Unit

Ferritin in Serum 14.8 Ref. Range (4.63 - 204)

Chemistry Unit

Serum Creatinine 0.77 Ref. Range (0.56 - 1.04)

ALT(SGPT) 13 Ref. Range (0 - 35)

AST(SGOT) 20 Ref. Range (0 -35)

Iron,Serum 24 Ref. Range (50 - 170)

[SeasideSusie Remembering in reply to awahab]

awahab

Is your iron deficiency being treated? With such a low ferritin and below range serum iron, no wonder you feel exhausted.

What was your Vit D level and what are you taking for it?

Were all your thyroid tests done under the same circumstances? We always advise this so that they can be compared accurately.

Early morning test will give a higher TSH than blood drawn later in the day, as TSH is highest early morning and falls throughout the day.

Eating lowers TSH. So if you had a meal before your blood draw the TSH would be lower than if you had not eaten.

With your ultrasound, were the three lumps on your thyroid, did they say they were nodules?

Have you had thyroid antibodies tested? If not that would be a good idea.

Is the medication for your reflux a proton pump inhibitor (PPI) eg Omeprazole?

Have you had B12 and folate tested? Dizziness can be linked to low B12.

[awahab in reply to SeasideSusie]

No I didn't take medication for iron deficiency, I used to take Vitahair (stopped it a month ago) which contains some iron but not primarily for iron deficiency.

My 25(OH) Vitamin D result was 17.72 ng/mL

Ref. Range is as follows:

<20 Deficiency

21-29 Insufficiency

30-100 Sufficiency

over 150 Hypervitminosis

No unfortunately my Thyroid tests weren't done under the same circumstances.

First one was done in the evening, the second and third times were in the morning and I didn't eat beforehand. Fourth one was in the morning also but I had breakfast before taking the test.

As for the lymps, the report said:

- The left thyroid lobe shows two solid nodules, one is isoechoic measuring 5.5 x 6.7 mm and the other one is hypoechoic measuring 5.2 x 5.8 mm.

- The right thyroid lobe shows a small cystic nodule measuring 3.9 x 4.4 mm.

No I didn't get my thyroid antibodies tested.

My initial reflux medication was pantoloc 20mg twice a day for 2 weeks then now I'm on pepzol 40 mg (Omeprazole) once a day (just started taking it today).

I didn't have B12 tested but I already take B12 injections twice a month just in case.

[Dee8686]

You might want to post your results and ranges as the pic is quite small.. not sure if it’s just my phone but it’s hard to read x

[awahab in reply to Dee8686]

Please check my reply above

[trelemorele]

Low iron, insufficient iron makes you exhausted. Your low levels thyroid adds to it.

Your symptoms are consistent with hypothyroid and anemia.

I bet your b12 levels are not so good either.

You need to increase your iron levels and it will improve fatigue.

I doubt they'll give you Levo with those TSH results.

Ask to check b12 levels and as others said antibodies and keep monitoring thyroid, you may struck lucky and go over the range with TSH so they'll give you meds.

If antibodies confirm Hashi you'll know you'll get hypo sooner or later.

[julesmarg]

Hi, this may be a red herring, but I dont see bone profile eg calcium results amongst your blood tests. Your symptoms could relate to hyperparathyroid. I suggest asking for bone profile, vit d and Parathyroid Hormone test - these three tests need to be requested together from the labs to see if there is an issue with your parathyroid (this is different to thyroid but located just behind your thyroid gland and controls the levels of calcium and parathyroid hormone in your blood)., Having these abnormal can give all kinds of symptoms like the ones you describe. Even if your calcium is within normal range, if your parathyroid hormone is low or high in relation to this it could indicate an issue that needs looking at further. Hope this helps, I only mention it as this happened to me and 8 months later has been resolved with surgery. I had constant fatigue, excessive thirst and Vit D deficiency, my GP only did these tests as she had come across 3 other women with same symptoms. This is something GP's are not always clued up about.

[Herbert123]

B vitamins brought all my energy back. Serum levels are well known to be unreliable.

[awahab]

Just did new tests yesterday, results:

- Anti TG Abs is 8.0 IU/ml (ref. range less than 4.1)

- Anti TPO is 16.4 IU/ml (ref. range up to 5.6)

- Free T3, Free T4 and TSH are within ref. range

[Sarahmsa]

Symptoms of hashimoto are similar to extraesophagel reflux disease?