[34F] Experiencing brain fog, tics, and other symptoms with thyroid changes

Patient Description

A 34-year-old female reports experiencing brain fog that has been worsening over the past 2 weeks, particularly impacting her while driving. She describes the brain fog as a constant zoning out. Additionally, she has a history of tics and stuttering that have fluctuated over the years, currently presenting as a tongue and jaw tic. The patient also experiences misophonia and has difficulty focusing on reading, with her eyes gliding over text without retention. She has noted sudden changes in her thyroid labs, indicating excessive thyroid hormone levels despite being hypothyroid with minimal changes in the past. Sleep disturbances are present, with the patient feeling unrested upon waking and experiencing weight gain despite dietary adjustments. She also reports infrequent bowel movements. The patient has a long-standing history of hypothyroidism, depression, and anxiety, diagnosed 12 years ago. Current medications include levothyroxine, Pristiq, Claritin, and a multivitamin. No known drug allergies. The patient has also been feeling more stressed lately, which may be contributing to her symptoms.

Arora's Assessment

What might be happening

Based on your symptoms, here are some possibilities:

Hypothyroidism: You mentioned that you have a history of hypothyroidism and recent lab results indicated an excess of thyroid hormone. This could be due to over-treatment of your hypothyroidism. Symptoms of over-treatment include difficulty concentrating, feeling restless or jittery, and sleeping problems.
- Treatment typically involves adjusting the dose of your thyroid medication. Your doctor may need to do more frequent blood tests to monitor your thyroid hormone levels.
Depression and Anxiety: Both conditions can cause difficulty concentrating, changes in sleep patterns, and changes in weight. The stress you've been experiencing lately could be exacerbating these symptoms.
- Treatment often involves a combination of medication, therapy, and lifestyle changes. If your current treatment isn't working, your doctor may need to adjust your medication or suggest other treatment options.
Chronic Fatigue Syndrome (CFS): This is a complex disorder characterized by extreme fatigue that can't be explained by any underlying medical condition. CFS can cause 'brain fog', difficulty concentrating, and sleep problems.
- There's no single test to confirm a diagnosis of CFS. You'll need medical tests to rule out other health problems that have similar symptoms. Treatment for CFS focuses on symptom relief.

What you can do

Consult with your doctor: It's important to discuss these symptoms with your doctor, especially the changes in your thyroid hormone levels. They can adjust your medication and suggest other treatment options.
Monitor your symptoms: Keep track of your symptoms and anything that makes them better or worse. This can help your doctor understand what's causing your symptoms.
Take care of your mental health: Try to manage stress and practice good sleep hygiene. This includes going to bed and waking up at the same time every day, making your bedroom a comfortable sleep environment, and avoiding caffeine and large meals before bed.
Stay active: Regular physical activity can help reduce symptoms of depression and anxiety, improve sleep, and boost your mood.

What you should look out for

If you notice any of the following, seek medical attention immediately:

Severe depression or thoughts of suicide
An extreme increase in your anxiety level
Symptoms that interfere with your ability to function at home or work
New or worsening headaches

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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1 yr ago

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