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Dr Abby, Board Certified Physician
Category: Endocrinology
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Experience: Practicing Family Medicine, including diabetic care, for over 10 years.
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Ive been feeling unreasonably exhausted for longer than I

Resolved Question:

I've been feeling unreasonably exhausted for longer than I can put a time to - a couple years, at least.
Almost daily, I feel tired enough to sleep in the late afternoon, but whether I nap, or not, I have a hard time falling asleep at night. I seem to sleep well enough, most nights, once I am asleep, but I still wake up tired, even when I've slept as much as 9 hours.
I was prescribed antidepressants (zoloft) at one point, with the theory that the general malaise and sleeping problems were depression. But after about 6 months it hadn't really made much of a difference and we stopped.
I have a host of other issues (EoE, Asthma, allergies, back, joint and tendon issues), all of which are mostly controlled through diet, medication, and chiropractic.
A friend, today, suggested that I get my thyroid checked. (I'm about 500 miles from the nearest doctor, so that's not an easy task.) Before I start looking to arrange $2000 flights and $500 hotels... does this seem like an appropriate step? No one has ever suggested it, before.

Submitted: 12 months ago.
Category: Endocrinology
Expert:  Dr Abby replied 12 months ago.

Good morning,

I have a few questions for you if you don't mind...

Are you thin or overweight? Have you gained weight recently?
Do you snore?
Do you have dry skin? Hair loss/thinning? Constipation? Swelling in your legs?
Any family history of thyroid disease?
Are your periods regular?

Dr Abby

Customer: replied 12 months ago.

Are you thin or overweight? Have you gained weight recently?

Overweight. I've gained about 20 pounds in the last 2 years.


Do you snore? Not often. When my nose is plugged, I will, sometimes, but not regularly.


Do you have dry skin?

My skin is both oily and dry, if that makes sense?


Hair loss/thinning?

It's hard to tell, but possibly. I always had really thick hair, and there's always been lots in the brush and in the tub, but it's definitely less thick than when I was younger.


Constipation?

Not particularly.


Swelling in your legs?

Not my legs so much. But my feet unless I sit with them up. And my hands, in the evening, are always tight.


Any family history of thyroid disease?

My mother does, but they said it was because she was on lithium.


Are your periods regular?

I've never really had a regular period. It's always been somewhere between 4 - 6 weeks. The last year or so has been much worse for cramps, and a much heavier flow the first day.

Expert:  Dr Abby replied 12 months ago.

Thank you for the information.

It is quite an endeavor that you must make to get to a doctor!
I understand that you don't want to make any unnecessary trips...

There are many signs/symptoms of thyroid disease. In your case, we would be looking for an underactive thyroid.

Some of the more common symptoms (as you may have guessed from my questions) include:

Fatigue
Weight gain
Constipation
Dry skin
Hair thinning or hair loss
Menstrual irregularities (heavy periods being one)

Other symptoms/signs--muscle aches, puffiness, thinning or loss of the outer 1/3 of the eyebrows, cold intolerance (which means you are colder than those around you) and depression

There are so many other reasons that someone can be excessively tired, however.
Sleep apnea is one; that is why I asked about snoring. Since you do not snore regularly, it is much less likely. However, if you have a bed partner and that person notes that you seem to stop breathing throughout the night, sleep apnea should be a consideration. A sleep study would be done to diagnose that condition.

Anema

At this point, because it has been going on for such a long time, it does not sound like you need to make a special trip to have your thyroid tested unless you have experienced a significant change.

I do think, however, that it is worth having it done in the near future. Thyroid testing involves blood tests, as you probably know. You do have some symptoms of hypothyroidism.

You should also have other basic blood tests (blood sugar, blood count to check for anemia) done at that time too.

I hope that this answers your question for you. Please ask any follow up questions you may have if you feel that your question has not been answered to your satisfaction. My goal is for you to be happy with my help!

Thank you,

Dr Abby

Dr Abby, Board Certified Physician
Category: Endocrinology
Positive Feedback: 100 %
Satisfied Customers: 10329
Experience: Practicing Family Medicine, including diabetic care, for over 10 years.
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