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Thyroid Problems/Should Additional Blood Factors be Checked?


QUESTION: Hello Dr. Kulkarni,

My family physician always checks my TSH and Free T-4 levels because I have a history of Graves Disease followed by hypothyroidism. My TSH and Free T-4 are well controlled now with synthroid and always test within the normal range. Lately, I have had hair loss and hand tremors for the past 4 months but TSH and Free T-4 are still within the normal range. Are there other factors in my blood my doctor should be testing to see if I might have some additional kind of thyroid disease? Thank you for your time.

ANSWER: Ingrid,
Can you tell me your age? Did you get thyroidectomy for graves in the past? If TSH is in normal range then tremors could be related to other conditions. Anxiety, vit B deficiency, alcohol, parkinsonism, exhaustion/ over work, sleep deprivation. Any other medicines you take?(other than synthyroid?) How many mcg of synthyroid are you taking?

Thanking you!

---------- FOLLOW-UP ----------

QUESTION: I am a 57 year old female. I took Propylthiouracil for one year which put my Grave's disease in remission. I still have my thyroid gland. I take 50 mcg of synthyroid a day. My other daily medications are: lisinopril, HCTZ, etodolac, cyclobenzaprine, and omeprazole. I do not use alcohol and I get plenty of sleep. My hand tremors are barely noticeable but constant, and my hair loss has been quite significant and still continues.
Thank you, again, for your time.

Your tremors are present while resting or it starts when you start hand movement? My recommendation considering your age is you get the physical examination done for parkinson's from your doctor. Other than that cyclobenzaprine can also produce tremors as side effect. May I know why are you taking etodolac and cyclobenzaprine? If possible you can take OTC vit B12 1.5mg(1500mcg) once daily along with 5mg folic acid. If a combination pill/capsule of B-complex is available then its even better. It would be very helpful if you describe about your tremors in couple of sentences. Is it present whole day? or any specific time? or any specific chore stimulates its onset? Is it noticeable while resting on a chair/ sitting idle? etc.

Thanking you!

Thyroid Problems

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Dr.Shrinidhi Kulkarni


Dont hesitate to ask your health related queries. 24 X 7 ready to provide solutions to your health concerns. All questions are welcome ! Speciallly Endocrinology.


Working as a Doctor in Primary Health care Centre.

KIMS, Bangalore

MBBS, Intership in Internal Medicine

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