Complaints Of Fatigue, Dry Brittle Hair With Shedding. Thyroid Panal, TSH: 10mU/L And FT4: 0.3ng/dl. Diagnosis?

Posted on Tue, 10 Sep 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Tue, 10 Sep 2013 Answered on

Mon, 30 Sep 2013 Last reviewed on

Question : 55 Y/O CM present with complaints of fatigue, dry brittle hair with shedding and states “ I can’t seem to keep warm”

Thyroid Panal
TSH: 10mU/L
FT4: 0.3ng/dl
What is a diagnosis and plan of care based on evidence-based practice guidelines

I think hypothyroidism, but what do you think and what would be a good plan of care.

Answered by Dr. Minal Mohit (2 hours later)

Brief Answer:
Primary hypothyroidism

Detailed Answer:
Dear Sir,

Thanks for visiting XXXXXXX

As you rightly interpreted, the reports suggest that this patient has primary hypothyroidism and needs to start treatment with thyroxine replacement. The starting dose will depend upon body weight , so it would have been if you had mentioned this patients weight here. I would be glad if you can mention that in your follow up.

The tablet needs to be taken early morning, empty stomach with water . The patient need to observe a minimum of 30 minutes fast after the tablet. Thyroid profile need to be retested after 6 weeks of starting the treatment; the dose of thyroxine might need adjustment initially but once the thyroid balance is achieved then it needs a 3 monthly follow up.

Hope this helped. Take care.

Above answer was peer-reviewed by : Dr. Prasad