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Hypothyroidism with excessive sleepiness.

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I can hardly stay awake. If I sleep or nap I am ok for an hour or two but then the heavy sleepiness takes over again and I have a terrible time trying to function. A couple hour nap and I am better but always low energy. I exercise every day and drink lots of water. I am in good health according to my doctors so why am I so sleepy all the time.

Category: Family Physician-GP

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Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.


Thank you for your consult at DoctorSpring.com. I need some more information in order to help you best.

1. How old are you and what is your approximate height and weight?
2. How is your sleep at night? Do you get good sound sleep throughout the night or do you catch yourself waking up frequently? Do you snore?
3. Have you had any feelings or depression or anxiety lately?
4. Are you currently taking any medications? Also, you mentioned that your thyroid levels are low. Are you currently getting any treatment for hypothyroidism?
5. Have you had any blood tests done, or any other tests done? If so please share the results.

With a little more information I can help you come nearer to a more accurate diagnosis. Please feel free to ask any further questions to me as well.


Patient replied :

I am 68. 5'4" and about 155lbs. I go to sleep easily and stay asleep until morning. I am only taking .088mg levothyroxine 1x. Once I a while I use an albuterol inhaler for my asthma wheez. Dr says I'm in better shape than most 68 yr olds. Still, I have these sleep attacks. Could my adrenal exhaustion have kicked up? I'm having blood tests tomorrow.

Expert:  Dr. Deepu Sebin Sebastian replied 3 Days.

Hello again,

Thanks for your reply. And my apologies for the delay with the response.

As per your query - This gives me a much clearer picture of what you are experiencing and thanks for the information. It seems like your sleepiness is related to your hormone levels either low thyroid hormones and/or low cortisol levels affecting your adrenal function. Here's what I suggest for your visit to the lab tomorrow:

1. You will need to check your baseline cortisol levels, and do an adrenocorticotropic (ACTH) hormone stimulation test as well. This will reveal the functionality of your adrenal glands. A urine analysis can also be helpful.

2. Check your glucose levels. Hypoglycemia can be a reason for your excessive sleepiness during the day. Do a random blood glucose test, a fasting blood glucose, and a post-prandial (after food) blood glucose test.

3. In addition to the blood tests, consult with your local physician about doing CT/MRI head and neck to look for pituitary abnormality. A pituitary tumor (mostly benign) can disrupt your hormone balance causing both low thyroid and low cortisol levels.

4. Also check your thyroid hormones once again. You may benefit by increasing your thyroid medication to treat your hypothyroidism (sleep disturbance can be relieved)

You seem to be in good health for your age. However, keeping your hormones in balance might be a challenge for you and treating early diagnosis can prevent illness due to complications. If you are particularly stressed, this can ramp up your adrenal insufficiency and you will need to pay attention to keeping your stress levels low. Also there is a possibility that you have a pituitary growth and the tests I mentioned will give you an accurate diagnosis if present. These are non-cancerous growths and the treatment is removal to relieve symptoms. Be patient while testing, as an accurate diagnosis can warrant appropriate treatment.

Take care of yourself and please do ask if you have any further questions or concerns.


Dr. Deepu Sebin Sebastian
Category: Select Speciality
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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