Goodmorning ! 32 Years,female,Bp 100/75,weight-55 Kg,height – 5.3” History-b12 And

Brief Answer:
HYPOTHYROIDISM/ANAEMIA/VITAMIN DEFICIENT

Detailed Answer:
Hi.
Welcome to Ask a doctor
I am Dr Ajeet XXXXXXX

As per your history ,complaints and investigations,you have borderless anaemia which causes lethargy,malaise and fatigue.
Do dietary changes and have more of organ meat,jaggery,green leafy vegetables cooked in iron utensils and vitamin c rich foods like citrus fruits.

Your urinalysis report shows bacterial infection (UTI) so have plentiful oral water and fluids and keep hygeine.You may need a urinary alkalisers and a short antibiotics course after urine culture.

You have deficient vitamin B12(vegetarians are very prone to it because there are few sources like yeast,soyamilk).You can have commercially available vitamin supplements.

You have an impending overt hypothyroidism.Please procure a Free T3 and Free T4 test to clearly evaluate.FT3 /FT4 are better predictors of thyroid abnormality as compared to total T3 ,T4.
All your symptomatology also coincides with hypothyroidism.
Hope that I have answered your query.
Regards

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Brief Answer:
ANAEMIA

Detailed Answer:
Hi...

TSH is a hormone secreted by brain pituitary to stimulate thyroid to secrete the thyroid hormones.
When thyroid hormone level increases,by a negative feedback,level of TSH decreases.
When thyroid hormone level decreases,by a positive feedback,level of TSH increase.
So changes in Thyroid hormones always precedes changes in TSH.
Your TSH levels are normal.
Please procure your FT3,FT4 reports before opting for management.

You don't need any B12 supplements,at the moment.
Vitamin B complex is water soluble and excess of it is excreted in urine so can't be stored in the body,once the stores get saturated.
Kindly restart them after a gap of 3 months.
Neurobion Forte would be better option as it is a multivitamin supplement with a specific combination of Vitamin B Complex with Vitamin B12.
Vitamin B1 is essential for converting glucose into energy.
vitamin B6 is important for a a healthy nervous system.
Vitamin B12 is required for the formation of red blood cells.

The purpose of oral iron supplementation is to treat your symptoms by increasing the levels of iron and hemoglobin in your body.
The iron in your body is called "elemental iron."
Oral iron supplements contain different amounts of elemental iron.
Iron supplements are available as ferrous salts and ferric salts .
Ferrous salts (ferrous fumarate, ferrous sulfate, and ferrous gluconate)are the better absorbed iron supplements and are often considered the standard as compared to ferric.
Adults need these daily dietary amounts of the following vitamins for hemoglobin production...
1)Vitamin B-12 — 2.4 mmcg
2)Folate or folic acid — 400 mcg.
3)Vitamin C — 75 to 90 milligrams.
As you have enough of vitamin B12,you can have commercially available preparations of folate and vitamin C,in addition to iron.

Emphasize on dietary sources of calcium.Have more of milk and milk products.You are in reproductive age group and only postmenopausal (and pregnant)women need to take the supplements.
Calcium supplements have their own side effects like nausea,vomiting,anorexia,mood swings,bone pain,headache,muscle pain,lethargy and fatigue.

Stay healthy.
Regards

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Brief Answer:
hypothyroidism

Detailed Answer:
Am sorry for that.

FT4 is low so you have an impending clinically overt hypothyroidism.
Kindly start levothyroxine tablets.
They are used to treat an underactive thyroid and would suppliment thyroid hormone, produced by your thyroid gland.
Commercially,they are available in strengths like 12.5,25,50,75,100,125,150,175 and 200 microgram tablets in plastic bottles(pack of 60)

Start with a dose of 25 microgram once daily ,empty stomach in the morning.

Procure FT3,FT4,TSH after 3 months and dose would be titrated accordingly.
Happy living.
Regards.

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