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Q. Can hypothyroidism cause tinnitus, tiredness, cold, and fatigue?

Answered by
Dr. Kaushal Bhavsar
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Oct 18, 2022

Hi doctor,

I am a 37-year-old man feeling cold all the time. I have tinnitus and feeling tired and fatigue. I tested my TSH and it was 1.3 mIU/L. My TSH free was 16 mIU/L. Is this normal or could I have hypothyroidism? What other causes could it be? I am otherwise healthy, exercise a lot and normal.

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Hi,

Welcome to icliniq.com.

I need a few more things to know about you to answer this. Please let me know. Do you have allergies or a stressful life or burning urination? Please answer these questions so that I can guide you better. I will be happy to help you further. Wish you good health.

Thank you doctor,

My answers to the questions asked are as follows:

1. No allergies, not that I know of. I am feeling cold especially after drinking coffee, but I am not allergic to caffeine (I have tested it). Could it be intolerance? I had dust mite allergy (mild 10 years ago), but not for a couple of years ago.

2. Not that much stressful no, but periods may cause a bit.

3. No burning urination. I have also tested and have no STI, but I have had surgery for Nissen fundoplication. It works 100 %, no reflux or esophagitis, but my stomach lining was red the last time I had an endoscopy. It gets worse after drinking coffee.

#

Hi,

Welcome back to icliniq.com.

I can understand your concern. Nissen fundoplication is an important clue in your case. This surgery can cause dumping syndrome. And this can lead to palpitations, sweating, chills, diarrhea, etc. It is due to reactive hypoglycemia. I need more information to confirm whether it is dumping syndrome or not. So please let me know. When did you have this surgery? Do you have any diarrhea or sweating or palpitations along with chills? Have you checked your blood sugar level before? Please reply with answers to these questions, so that I can guide you better.

Thank you doctor,

1. I had surgery three years back.

2. I have diarrhea and sweating (usually at night). No palpitations.

3. Yes, it was fine. I checked for diabetes last year. My blood pressure is very fine also.

It seems there is some burning sensation in my stomach or under left rib cage that makes this worse. It is strange because I have no acid reflux in my esophagus after PH24 test and manometry.

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Hi,

Welcome back to icliniq.com.

I can understand your concern. In my opinion, the possibility of dumping syndrome is more likely in your case. You need to get done glucose tolerance test, gastric emptying test and blood glucose test at the time of symptoms. If blood glucose is low at the time of symptoms then dumping syndrome is likely. Do you have a glucometer at home? What was your sugar level? Was it towards the lower side of normal? Please reply with answers to the above questions so that I can guide you better.

Hi doctor,

Thank you for your reply.

I tested my blood sugar levels today five minutes after eating, and the results were 4.9 mmol/L. And an hour after eating, it was 3.7 to 3.8 mmol/L. I had two pieces of bread with meat and drank water.

Is this normal? Should I repeat my test? Maybe I should try fasting blood sugar tests?

Please give your suggestions.

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Hi,

Welcome back to icliniq.com.

I can understand your concern.

I have gone through the reports you have mentioned. No, this is not normal. Your blood sugar remains low despite eating. Do you have any symptoms with a blood sugar level of 3.7 to 3.8 mmol/L?

You should get your blood sugar levels tested at midnight and when you have the symptoms.

Kindly reply with the answer to the question asked.

I will be happy to help you further.

I wish you a speedy recovery.

Hi doctor,

Thank you for your reply.

Yes, I feel a bit shaken, I cannot concentrate and I start to feel cold. I also get irritated sometimes, but not all the time.

I tested my fasting blood sugar levels today morning and it was 4.9mmol/L. Yesterday I tested it before and after eating. Before the meal, it was 4.7 mmol/L and it was 7.9 mmol/L, after an hour. I had a salad with lean meat which had low carbohydrates and I drank water. My second meal was 60 g of chocolate. After 1 to 2 hours of eating the last piece of chocolate, it was 4.4 mmol/L and 4.2 mmol/L. And it was 4.7 mmol/L before eating it. I have been taking Ranitidine occasionally from time to time. I feel this is making things worse. Coffee also worsens my symptoms after 1 to 4 hours of ingesting it. Also, I underwent a lobectomy of my upper left lobe for a typical carcinoid tumor. There is no sign of cancer two and a half years after.

Is there something I can do about this hypoglycemia?

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Hi,

Welcome back to icliniq.com.

I can understand your concern.

You have dumping syndrome. You should consume sugar to avoid such episodes. You have also given one important point on carcinoid tumors. It can recur in the intestine and cause similar symptoms.

Have you checked for intestinal carcinoid tumors?

Also, check your insulin levels.

I hope this was helpful.

Kindly reply with the answer.

Hi doctor,

Thank you for your reply.

I have been to yearly follow-ups for carcinoid tumors with CT thorax. But should they not have a CT scan of the abdomen also? Also, I underwent a colonoscopy last year, and my large intestine was good. Do they check the small intestine also with a colonoscopy, or is a CT scan best for testing tumors?

Also, I will get an insulin test next week.

Thank you.

#

Hi,

Welcome back to icliniq.com.

No, they will not recommend a CT (computerized tomography) scan of the abdomen unless asked for. And small intestine is not visualized by colonoscopy. To visualize small intestines, you need to undergo a capsule endoscopy or CT abdomen. Also, I have a few questions,

1. What were your symptoms when you had pulmonary carcinoid tumors?

2. Do you smoke?

Kindly follow up with the answers and your insulin level results.

I hope this has helped you.

Take care.


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