What Causes Fatigue, Feeling Cold All The Time, Depression, Anxiety And Constipation?

Posted on Sun, 24 May 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sun, 24 May 2015 Answered on

Tue, 16 Jun 2015 Last reviewed on

Question : I was diagnosed w/hypothyroidism in 5-09.( I am 51 years old) My TSH in Feb 2015 was 5.7, my Dr. upped my dosage of levothyroxine to 200mg (from 175), retested 4-16-15 and it was 2.726
retested on 5-14-15 it was 0.066. On 5-14-15 I also had an Anti-Thyroid Peroxidase AB (ANTI-TPO) test done and it was 135.4. My main symptoms, very unusual tired/fatigue/total lack of energy, I used to be hot blooded now I'm cold all the time, depression, anxiety (which has caused HBP/increased heart rate), constaption (I'm drinking magnesium citrate every 2/3 days) I have not been back to my endo dr to go over these results yet. I think he was testing for Hashimoto's. Any advice ?

Answered by Dr. Ajish TP (3 hours later)

Brief Answer:
Hashimoto's hypothyroidism

Detailed Answer:
Hi,

Welcome to HCM. I have gone through the question and understand your concerns.

The doctor has tested you for Hashimoto's hypothyroidism- elevated anti TPO antibodies. You have to maintain your TSH between 0.5 and 3 miu/ml. After maintaining TSH in this range for another 3 months if your symptoms persists, you have to be evaluated to look for other causes.

Your TSH now is below the above target. So your Endo will be decreasing your thyroxine dosage now - probably to 175 and 200mcg alternate days.

Hope I have answered your questions. If you have any further queries I will be happy to help you

Regards,

Dr Ajish TP [MD,DM]
Consultant Endocrinologist

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Ajish TP (22 hours later)

Are you saying that Hashimotos Diease, Hashimotos Hypothyroidism and Hypothyroidism are 3 different diganosis? This is the first time in 6 years that my TSH has been so off.( low) So you are saying my low TSH is what caused the high Anti TPO ??

Answered by Dr. Ajish TP (11 hours later)

Brief Answer:
Singe diagnosis, Not related

Detailed Answer:
Hi,

Welcome back.

Let me explain these medical terms to clarify things.

Your disease is hypothyroidism or under functioning thyroid gland. Here your thyroid is not producing enough thyroid hormones (T3 and T4). So body try to produce more thyroid hormone by stimulating the thyroid gland by producing more of thyroid stimulating hormone (TSH). When even with increased TSH, your thyroid cannot produce enough thyroid hormones, you will develop the symptoms of low thyroid hormones (hypothyroidism).

Here initial blood tests will show high TSH and low T3, T4. The treatment of hypothyroidism is to replace thyroid hormones (T4&T3) as medications (Thyronorm). So our body get enough thyroid hormones and TSH will decrease to normal values (0.5-4 miu/ml). If we are over replacing thyroid hormones the TSH will drop below normal as in your case.

Hypothyroidism can be due to several causes like iodine deficiency, auto immune disease, after viral infection or after thyroid surgery. In your case, the thyroid is underfunctioning due to auto immune disease - increased level of anti TPO antibodies that has destroyed your thyroid. This is called "Hashimoto's disease" or "Hashimoto's hypothyroidism " or "auto immune thyroid disease".

Anti TPO antibodies are not related to your TSH levels. It would have been there from the start of this disease.

Hope I have answered your questions.

Regards

Dr Ajish TP

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar