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Suggest Treatment For Hypothyroidism

Posted on Thu, 18 Aug 2016

Question: Dear Sir,
Last 9 year I am working with BSLAMC, presently I am posted at XXXXXXX location as Branch Head, I am not able to bring my family along with me due to some family urgency, in the mean time my wife detected with Thyroid problem and her medication also started. She is suffering with various side effect for this. I am in very critical position because she need support of me but due to job responsibility I am not able to support her with my in person presence, only I can do emotional boost up and guidance over phone. Please help her with some medical support and counseling. I am looking forward for your proactive support.

Thanks & Regards,
XXXX
Branch Head- XXXX
0000

Answered by Dr. Om Lakhani (25 minutes later)

Brief Answer:
Please share the thyroid report

Detailed Answer:
Dear Mr. XXXXXXX

From what I understand from your report, your wife was diagnosed to have Hypothyroidism and started on T. Thyronorm. Her TSH was 10. I will need the following information before I can give you more advice:

1. Please share with me the latest thyroid function test report .
2. You have said 'She is suffering with various side effect for this'. Can you specify what side effects she is having ?
3. What is the dose of Thyronorm that she is taking ?

I will be able to help you better if you can share the above details.

Regards
Dr. Om XXXXXXX Lakhani, MD
Department of Endocrinology
Sir XXXXXXX XXXXXXX Hospital
New XXXXXXX

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Om Lakhani (3 hours later)

Thanks for promp reply
I will be sending you detail report for your better understanding, please check and revert to me.

Regards
XXXX

Answered by Dr. Om Lakhani (15 minutes later)

Brief Answer:
Yes please send the detailed reports

Detailed Answer:
Yes it would be most helpful if you can send the detailed reports.

Above answer was peer-reviewed by : Dr. Priyanka G Raj

Follow up: Dr. Om Lakhani (29 minutes later)

please check,
she is feeling palpetaion in Heart rate and some breathless XXXXXXX also some time forgetfull XXXXXXX pain in both legs.

Answered by Dr. Om Lakhani (16 minutes later)

Brief Answer:
Continue the same treatment

Detailed Answer:
I have gone through your reports. She has what is known as 'Subclinical hypothyroidism' . TSH >10 is an indication for treatment with Thyronorm. Your physician has given you the correct approach.

My advice is as follows:
1. Continue Thyronorm 25 mcg once a day
2. Repeat Thyroid function test- Free T4 and TSH. It seems the treatment was started in May 2016 according to the file. It would be a good idea to repeat the test since she continues to have the symptom
3. Revert back to me with the repeat thyroid function test.
4. Get done an ECG and Echocardiography.

Thyronorm can lead to Palpitations however, the dose prescribed to you is too small for her to have these side effects. Hence her symptoms may not be related to Thyronorm. Hence it is advised to get done a ECG and an Echocardiography.

You can get back to us with the reports advised above.

Regards
Dr. Lakhani

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Om Lakhani (1 hour later)

Thanks Doc,

i will get back to you as soon as I got the test report report.

Regards
XXXX

when she do the thyroid test, will she stop medicene before test or else do as usual?

Answered by Dr. Om Lakhani (28 minutes later)

Brief Answer:
Continue the medication till day of test. On day of test - see below

Detailed Answer:
She needs to continue the medication till the day of the test. On the day of the test- first give the blood sample and then take the medication for that day.

Regards
Dr. Lakhani.

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Above answer was peer-reviewed by : Dr. Vaishalee Punj