What Causes Foggy Memory, Inexplicable Weight Gain, Knots And Acne On Face?

Posted on Fri, 24 Jul 2015

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

Fri, 24 Jul 2015 Answered on

Mon, 17 Aug 2015 Last reviewed on

Question : I had PTC three years ago and had a thyroidectomy followed by oral radiation. I have jad a few problems but nothing major. I have been on Synthroid for three yrs now at 124mcq for almost the whole time. The last month, I have felt horrible, lots of memory changes, fog memory, just not myself, gained 20 pounds, and face has broken out in the worst hard knots of acne. I normally do not have breakouts at all. I am beyond tired, can't even make myself get out of bed at times.......and the list goes on. Had my tsh checked and it was 32. I am freaking, What I do not understand is that I am not cold as one would expect but sweat constantly. my anxiety level is sky high which would be more of a hyper symptom and I experience diarrhea often, which once again would lean toward hyper not hypo. What is happening?

Answered by Dr. Shehzad Topiwala (4 hours later)

Brief Answer:
Thyroid

Detailed Answer:
I am sorry to learn about your condition.

Your medication history mentions synthroid 224 mcg and cytomel 5 mcg, but in the main stem you say you are on 124 mcg synthroid only.

Kindly clarify.

Moreover, synthroid does not come in these strengths. It is available in 125 mcg and 200 mcg among other dose strengths. Perhaps this was a typo on your part.

Now coming to the elevated TSH reading. This is not at all difficult to bring down to target. In fact, this is a fairly routine task for an endocrinologist. So I strongly suggest you see one in person.
After a thorough physical examination, (s)he will likely prescribe a higher dose and ask for a TSH and free T4 blood test in 4 to 6 weeks.

Cytomel is not recommended by most thyroid experts. Synthroid or any form of levo thyroxine alone is sufficient to achieve target TSH values.

Furthermore, I see you are puzzled about the variety of conflicting symptoms. I would like emphasize that symptoms can be varied and appear to suggest hypo / hyper but ultimately the blood levels of TSH are to be relied upon for final determinations.

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

Follow up: Dr. Shehzad Topiwala (12 minutes later)

Sorry about the misunderstanding. My synthroid comes in 112mcq and I take 2.
My concern is what made it rise to 32 when it stays 0.1 to 0.2 at all times. I have not done anything different not added any new meds. I get my Thyroid checked every three months without fail so what happened in 3 months that it would go from 0.1 to 32.
Is it possible my cancer has returned? Would this cause a rise in level.
How fast are we talking about until it comes down? I feel horrible. What is Cytomel supposed to do? Thank you so much!

Answered by Dr. Shehzad Topiwala (7 hours later)

Brief Answer:
Follow up

Detailed Answer:
I see.

We do encounter such things occasionally. It is not uncommon so don't worry.

Ask your doctor to test you for a condition called celiac disease. Sometimes this prevents the XXXXXXX thyroxine fro being absorbed.

Cancer coming back does not cause TSH to rise

It can come down to target within 6 weeks or so of taking the right dose.

Cytomel is not recommended. It can be harmful to the heart and bones

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

Follow up: Dr. Shehzad Topiwala (9 hours later)

I did not know Cytomel was harmful to the heart and bones. Why would Dr's use it all? I was told it would bring my levels down faster combining the two. As a matter of fact, my MD didn't change my Synthroid dose at all, they only added the Cytomel. My internist treats my thyroid. We have a very limited number of endocrinologist in my area that are well recommended.

One more question..... would checking my TSH in a week at least give me an indication as to whether my dose is at least in the right range or not. I can not imagine feeling this way for 6 weeks before testing my TSH again. How frustrating it would be to not have gone down.

Thanks so much for your help! I truly appreciate you.

Answered by Dr. Shehzad Topiwala (24 hours later)

Brief Answer:
Second follow up

Detailed Answer:
One week is too soon to recheck.

Doctors use cytomel in limited situations.

After an appropriate dose increase in synthroid, you could check TSH in 4 weeks

Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

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