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Suggest Treatment For Hypothyroidism
Question: One of my maid 's daughter is 17 years old and has been diagnosed with hypothyroidism with TSH level of 400. she is anemic ( Hb: 7.8) and has fluid accumulation around heart. What should be the mode of treatment. Can she perform regular household work or needs bed rest?
Brief Answer:
Early treatment required.
Detailed Answer:
Hi XXXXXXX,
I have read your query and understand your concern.
This individual,has very severe form of hypothyroidism with 400 iu. with fluid accumulation around the heart called as pericardial effusion.
This can lead to a state of Myxedema coma/crises if not promptly treated.
This state is characterised by abnormal mental changes finally lapsing into comatose state.
The treatment consists of external oral supplementation of thyroid hormone -T4 at dose of 75-100 mcg for 6 weeks initially to calculate the exact dose requirements followed by continuation of revised dose for 6-12 months until the TSH levels are normalised.
She needs immediate medical attention with absolute bed rest for 2 weeks after initiation of therapy.
Post your further queries,if any
Thank you.
Early treatment required.
Detailed Answer:
Hi XXXXXXX,
I have read your query and understand your concern.
This individual,has very severe form of hypothyroidism with 400 iu. with fluid accumulation around the heart called as pericardial effusion.
This can lead to a state of Myxedema coma/crises if not promptly treated.
This state is characterised by abnormal mental changes finally lapsing into comatose state.
The treatment consists of external oral supplementation of thyroid hormone -T4 at dose of 75-100 mcg for 6 weeks initially to calculate the exact dose requirements followed by continuation of revised dose for 6-12 months until the TSH levels are normalised.
She needs immediate medical attention with absolute bed rest for 2 weeks after initiation of therapy.
Post your further queries,if any
Thank you.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
If thyroxine medicine is given regularly, than fluid around heart will dry itself or it has to be drained by a doctor.
Brief Answer:
Spontaneous absorption is expected in your case.
Detailed Answer:
Hi Madam,
In most cases the fluid around the heart is absorbed with thyroxine therapy when combined with drugs like NSAID's ex Aspirin.
This can be monitored on serial 2 dimensional echocardiography of the heart which can accurately estimate the fluid around the heart in mL along with its cardiovascular disturbances if any.
Surgical drainage is needed when -
1.when there are associated sudden symptoms like low blood pressure and breathlessness.
2.Greater than 20 mm echo free space found on echocardiogram.
3.Failure of medical therapy with Thyroxine and Aspirin.
4.Distress caused by Greater than 200 mL fluid collected around the heart.
In my opinion the effusion in your case is going to resolve spontaneously with Thyroxine correction.
Post your further queries,if any.
Thank you.
Spontaneous absorption is expected in your case.
Detailed Answer:
Hi Madam,
In most cases the fluid around the heart is absorbed with thyroxine therapy when combined with drugs like NSAID's ex Aspirin.
This can be monitored on serial 2 dimensional echocardiography of the heart which can accurately estimate the fluid around the heart in mL along with its cardiovascular disturbances if any.
Surgical drainage is needed when -
1.when there are associated sudden symptoms like low blood pressure and breathlessness.
2.Greater than 20 mm echo free space found on echocardiogram.
3.Failure of medical therapy with Thyroxine and Aspirin.
4.Distress caused by Greater than 200 mL fluid collected around the heart.
In my opinion the effusion in your case is going to resolve spontaneously with Thyroxine correction.
Post your further queries,if any.
Thank you.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Thanks a lot for ur advice. Iam quiet satisfied with the answer. Otherwise the girl looks normal and has no complains or problems. I don't see any weight gain in her that is associated with hypothyroidism.Is thyroid in such young age common.As per ur advice, we will get a echo done also as till now only Xray and usg was done.
Brief Answer:
Hypothyroidism can affect the young as well.
Detailed Answer:
Hi Madam,
Yes hypothyroidism can affect anyone from 15-70 yrs.Its also more frequent in women overall.
Weight gain in hypothyroidism can be a feature in only 40-60% individuals affected with hypothyroidism.
Hence it may not be seen in all individuals.
Ok then please get ahead with the 2 dimensional Echo.
Wishing you and your entire family a very good health.
Thank you
Hypothyroidism can affect the young as well.
Detailed Answer:
Hi Madam,
Yes hypothyroidism can affect anyone from 15-70 yrs.Its also more frequent in women overall.
Weight gain in hypothyroidism can be a feature in only 40-60% individuals affected with hypothyroidism.
Hence it may not be seen in all individuals.
Ok then please get ahead with the 2 dimensional Echo.
Wishing you and your entire family a very good health.
Thank you
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Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
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