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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18427
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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My wife is 45 and having a problem staying awake the whole

Customer Question

My wife is 45 and having a problem staying awake the whole day and complains about being constantly sleepy. She wakes up at 5am and takes a nap at 3pm to 4pm- after work and picking up the three teens from school. By 9:30 pm she can't stay awake and is totally drained and can barely drive anywhere. There are times she calls me even before lunch complaining she is very sleepy and wants to go home to nap. It is common for her to fall asleep on demand. For example if I'm driving or she lays down somewhere - she can fall asleep pretty much anywhere in 5 minutes
She is relatively healthy with no signs of depression. Gets exercise by walking about a mile or two a day (walking the dog) as well as taking karate classes 3 times per week. She is fit looking at 5 feet and 120 lbs. She doesn't drink alcohol or any kind of drug and eats well.
The only medication she takes is thyroxin for thyroid. Each time she goes to the doctor for past 5 years her prescription is increased and now she is at 100 micrograms. She's concerned that if she goes to the doctor now, the dose will be increased even more, which will work for about 3 months and then she will be back to struggling to have energy throughout the day again. Also, if she doesn't take the med for one day she swells up particularly in the fingers. She's been taking the med for 5 years and doesn't think its the right answer for her problem. She has had blood tests to track her thyroid etc.
Any thoughts on what else she might want to look into and/or should she consider trying to ween off the med? She's been taking the thyroxin for 5 years and it just isn't giving her the energy she wants to make it through the day. She's been seeing the same doc that whole time so is there something else the doc may need to look into?
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. D. Love replied 1 year ago.
Hello from JustAnswer.Do you have the results of the last thyroid blood tests?
Customer: replied 1 year ago.
Yes but I will need to provide them tomorrow.
Expert:  Dr. D. Love replied 1 year ago.
The first issue is adjustment of the thyroid ills to achieve normal thyroid blood tests, but we can discuss this more tomorrow. The other considerations are whether there are other conditions that may be causing her symptoms. There are some other metabolic conditions that can cause these symptoms, such as adrenal disease, but these conditions are far less common to present as daytime drowsiness. It is more common for daytime sleepiness to be due to conditions that interfere with getting adequate sleep. In some of these conditions, there is a decrease in the number of hours of sleep, but in others, the problem is that the sleep that does occur is not able to achieve deeper levels of sleep that are restorative. For example, a common condition to cause daytime drowsiness is sleep apnea. People with sleep apnea will usually appear to sleep for a full night, but they are unable to get into a normal amount of the deeper levels of sleep. There are also two types of sleep apnea - obstructive and central sleep apnea. Obstructive sleep apnea is much more common in overweight people, although it can occur in people of normal weight. Central sleep apnea is not associated with excessive weight. The proper test to evaluate for these conditions would be a sleep study, or polysomnogram, which can detect these common conditions as well as other less common primary disorders of sleep. There are a variety of conditions that interfere with getting a good number of hours of sleep. Some are physical conditions, such as acid reflux, which frequently will get worse when lying down, and others are mental health conditions, such as depression or anxiety. So, after first addressing the thyroid blood tests, which we can discuss more tomorrow, the next test that I would typically consider would be a sleep study, unless there are other findings on history and physical examination that would suggest another medical condition. If I can provide any clarification about these conditions, please let me know. Otherwise, we can discuss the thyroid blood tests tomorrow.