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Emergency symptoms of GRAVES DISEASE while on Antibiotics.

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Hello, I have recently been diagnosed with strep A and B through urine test and am on antibiotics (Amoxicilliin (sp?) ) for that. I've been on the antibiotics for 4 days. I also have graves disease treated with RAI, and now on Synthroid.

For the last week I have been having increasingly debilitating fatigue, dizzyness, and a general feeling of weakness and light headedness. I have also had periods of racing heart/palpitations and heart burn. I have also had stabbing pain under my left ribs/spleen sort of area that I sometimes have had before but much worse. My jaw is also oddly clenched and tight.

I went to the doctor a couple days ago and had some basic blood work (CBC (?), lyme, etc) and everything looked normal. I plan to follow up with a cardiologist and endocrinologist as soon as I can get an appointment.

In the mean time I am becoming increasingly scared and worried about my extreme fatigue and weakness. If I try to do the most mild of activity- very gentle yoga that barely uses any strength- I get a weak shakey feeling in my leg and arm muscles, and lightheaded. I have to lay down all the time.

I mainly want to know if this might be something urgent, or if I should see someone sooner if I can't get into to see an endocrinologist for several weeks. I have a general sense of weakness and malaise for lack of a better description- just total inability to do anything- slow in my mind and a feeling of moving through water.

Should I be concerned? Should I watch for an emergency situation? What specialist should I see?

Category: Endocrinologist

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Category: Diabetologist
 26 Doctors Online


Thank you for your query at

I understand your concern and will do my best to help you.

You seem to be having generalised weakness following the infection and the course of antibiotics that you are on. Although your symptoms are highly disconcerting, the good thing is, they're not an emergency and will subside in a few days. The heartburn and pain under the ribs seem to be be due to gastritis, which can be worsened by antibiotics. The lightheaded and dizzy feeling with palpitations could be due to inadequate hydration and electrolyte imbalance.

Thyroid function needs to be assessed to see if your replacement dosage of Synthroid is adequate.

You should be completely alright once the infection settles down.

Meanwhile you can take the following measures for relief.

- Please make sure that you are taking 3 to 4 healthy nutritious meals everyday.

- Please take plenty of fluids(minimum 2-3 liters/day) including fruit juices so that you are adequately hydrated and electrolytes are balanced.

- Please take an OTC Omeprazole 20 mg, at least 30 minutes before breakfast, for a week. This will take care of the gastritis.

- In case if symptoms do not improve after a day with these measures, you need to first see your general physician.

- As such, you will not have to look for any emergency situations.

- You can see your endocrinologist at your convenience, whenever you get an appointment.

I hope this was helpful.

Feel free to ask queries.

Thank you.

Dr. J Muthukrishnan
Category: Diabetologist
1. 10th Asia-Pacific Pediatric Endocrine Society  Fellows meeting, Seoul, Korea, Oct 2008
2. Eighth ICMR Course on Genetics and Genetic Counseling – Jul 2008 – SGPGI, Lucknow
3. Annual Certificate Course on Endocrinological Laboratory Techniques at National Institute of Nutrition (ICMR) Hyderabad,India, ( Aug-Sep 2006) 
Fellowship: Endocrinology, Diplomate of National Board, National Academy of Medical Sciences, New Delhi, 2008, Medwin Hospital, Hyderabad
Senior Residency: Diplomate of National Board (General Medicine), National Academy of Medical Sciences, New Delhi, 2002
Residency: MD, General Medicine, 1997-2000, Armed Forces Medical College, 2nd position in University
Medical School: MBBS, Armed Forces Medical College, 1992
Dr. J Muthukrishnan and 4 other Medical Specialists are ready to help you

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