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

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.

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.

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.

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.

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?

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.