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Suggest Treatment For Difficulty Hearing In A Patient With Thyroid Disorder
Question: Hi!
This is regarding my uncle, aged 57, currently undergoing treatment in ICU for Thyroid. His both Kidneys are damaged for which he was getting treatment for the last 2 years.
Around 10 days back, he was feeling very cold, his entire body got swollen and he had a problem with speaking, hearing. That's when he got admitted to a hospital.
He has been given Dialysis as well as Levothyoxine Sodium injections 100 mcg/vial for thyroid since he was not responding to other medicines. Even then, his condition remains to be critical.
Please suggest how should we proceed and what best can be done?
Also wanted to notify that blood platelets (AB+) have also being given on regular basis - last count was 23000
Thanks a lot for your help in advance and looking forward to hearing from you.
This is regarding my uncle, aged 57, currently undergoing treatment in ICU for Thyroid. His both Kidneys are damaged for which he was getting treatment for the last 2 years.
Around 10 days back, he was feeling very cold, his entire body got swollen and he had a problem with speaking, hearing. That's when he got admitted to a hospital.
He has been given Dialysis as well as Levothyoxine Sodium injections 100 mcg/vial for thyroid since he was not responding to other medicines. Even then, his condition remains to be critical.
Please suggest how should we proceed and what best can be done?
Also wanted to notify that blood platelets (AB+) have also being given on regular basis - last count was 23000
Thanks a lot for your help in advance and looking forward to hearing from you.
Brief Answer:
Probably Myxedema coma
Detailed Answer:
Hi XXXXXXX
Welcome to HCM. I had gone through your question and understand your concerns.
Your Uncle is probably having a condition called Myxedema coma. This is a condition with severe hypothyroidism (thyroid is not producing any thyroid hormones) and patient goes to a comatose stage, usually precipitated by some infections.
All our vital organs like heart, kidney, liver, brain and lungs need thyroid hormone for its functions. When heart pumping decreases the blood flow to kidney decrease and will result in renal failure requiring dialysis. The precipitating infection or multi organ failure result in low platelets.
The treatment is:
1. For thyroid
Intravenous thyroxine, till he can take orally. This will take some time to act and normal thyroid hormone function will take up to 10-14 days.
2. Supportive treatment
Treatment of infection that may be responsible for low platelet count. All other treatment is supportive - cardiac pumping drugs, dialysis, mechanical ventilation through ventilator etc., may be needed.
Survival chance depends on the response of the patient in first 2-3 days. Once the patient is showing signs of improvements the chance of complete recovery is good.
Hope I have answered your question. If you have any further questions I will be happy to help.
Wishing him speedy recovery.
Regards
Dr Ajish TP
Consultant Endocrinologist
Probably Myxedema coma
Detailed Answer:
Hi XXXXXXX
Welcome to HCM. I had gone through your question and understand your concerns.
Your Uncle is probably having a condition called Myxedema coma. This is a condition with severe hypothyroidism (thyroid is not producing any thyroid hormones) and patient goes to a comatose stage, usually precipitated by some infections.
All our vital organs like heart, kidney, liver, brain and lungs need thyroid hormone for its functions. When heart pumping decreases the blood flow to kidney decrease and will result in renal failure requiring dialysis. The precipitating infection or multi organ failure result in low platelets.
The treatment is:
1. For thyroid
Intravenous thyroxine, till he can take orally. This will take some time to act and normal thyroid hormone function will take up to 10-14 days.
2. Supportive treatment
Treatment of infection that may be responsible for low platelet count. All other treatment is supportive - cardiac pumping drugs, dialysis, mechanical ventilation through ventilator etc., may be needed.
Survival chance depends on the response of the patient in first 2-3 days. Once the patient is showing signs of improvements the chance of complete recovery is good.
Hope I have answered your question. If you have any further questions I will be happy to help.
Wishing him speedy recovery.
Regards
Dr Ajish TP
Consultant Endocrinologist
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Hi Dr Ajish,
Thank you for your prompt response.
Since the condition of the patient is not improving for the last 10 days and Levothyoxine Sodium injections are very hardly availbale in XXXXXXX can you recommend some alternative medicines?
Regards,
XXXXXXX
Thank you for your prompt response.
Since the condition of the patient is not improving for the last 10 days and Levothyoxine Sodium injections are very hardly availbale in XXXXXXX can you recommend some alternative medicines?
Regards,
XXXXXXX
Brief Answer:
No alternatives available
Detailed Answer:
Hi,
XXXXXXX XXXXXX,
The treatment option for this condition is only injectable levothyroxine or T3 (Tab cytomel). T3 is an option only when the patient starts taking orally. Cytomel is unfortunately not available in XXXXXXX
Injectable thyroxine is expensive and not freely available. It is currently available in Narayanappa Pharmacy in XXXXXXX who deals with all rare medicines. You can contact them if in need.
Regards
Dr Ajish TP
No alternatives available
Detailed Answer:
Hi,
XXXXXXX XXXXXX,
The treatment option for this condition is only injectable levothyroxine or T3 (Tab cytomel). T3 is an option only when the patient starts taking orally. Cytomel is unfortunately not available in XXXXXXX
Injectable thyroxine is expensive and not freely available. It is currently available in Narayanappa Pharmacy in XXXXXXX who deals with all rare medicines. You can contact them if in need.
Regards
Dr Ajish TP
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Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
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