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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 63757
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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Have a lot going on. Suspected secondary hypothyroid due to

Customer Question

Have a lot going on. Suspected secondary hypothyroid due to hypothyroid symptoms long term. 25 years low tsh but overweight at the same time. Hypo symptoms brittle nails, extremely heavy periods for years on end with erratic days in the cycle, ended up having uterine ablation. For two years have had off and on extreme lathargy with daily headaches. 4.19.15 suddenly had strange symptoms of massive fatigue and a drugged feeling with confusion. Saw Dr. Test low tsh with low t4 and mid normal t3. Saw endo low prolactin, low serum cortisol, same tsh, t4 and t3. Thyroid ultrasound shows multinodules. Have also had daily irrigular heartbeat for 25 years. Had ACTH test today, felt so sleepy, as I do all day. My functions have not returned to normal at all since 4.19. Speech is off and I'm moving quite slow. Extreme fatigue. Low blood pressure, pale complexion, and low body temp always. Forgot to add the last symptoms as they have been going on for 2 years. Cannot handle any stress just about go into meltdown even opening the bills to pay them
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Thomas, MD replied 1 year ago.
Hello, what is your question?
Customer: replied 1 year ago.
Endo said I definitely have a hyper thyroid going on with the thyroid and it will have to be removed. But the secondary hypo at the same time is odd. I did have several head injuries one with concussion at one time. Or could it be autoimmune? I just feel like death and need to get well.
Customer: replied 1 year ago.
I also had MRI of pit with and without contrast and all I know so far is that the nurse said it was normal.
Customer: replied 1 year ago.
Results from cortisol stim test is 5.5, 30 min later 23.2, 60 min later 27.6.
Expert:  Dr. Thomas, MD replied 1 year ago.
It would not make sense to make this conclusion until you have a scan of the brain..has that been done?
Customer: replied 1 year ago.
I added that info before, but I guess you did not receive it. MRI was completed with and without contrast. Nurse said today that it was normal, as I suppose in there is no tumor of any type.
Expert:  Dr. Thomas, MD replied 1 year ago.
OK
So I would not suspect any reason for the pituitary not to secrete TSH.
In fact it sounds like the nodules are secreting thyroid.
That is the problem.
Many of the symptoms can be the same in both disorders.
OK, so that is an initial answer….
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