Suggest Treatment For Severe Hair Loss And Irregular Menstruation
Need to increase dose of Thyronorm.
Detailed Answer:
From the information you have sent , I have derived the following
1. Your wife is having an underactive thyroid (hypothyroidism) with TSH which is high in the range of 10-15 mIU/l
2. she is on Thyronorm 50 mcg
3. She continues to have abnormal periods and hair-fall
It clearly seems in this case that the Thyrornorm dose is grossly inadequate. In people suffering from Hypothyroidism (underactive thyroid) we generally start thyroid hormone in the dose of 1.6 ug/kg. If you wife is 50 kgs in weight, she would require a minimum starting dose of around 75 mcg of Thyronorm per day. On starting Thyronorm we generally re-check the TSH every 6 weeks till TSH is under control (I generally keep TSH <2.5 mIU/l) for most symptomatic benefit) and once it is under control , we check it every 3-6 months.
It seems that you wife is suffering from hypothyroidism which is inadequately treated. I would advice you to increase the dose of Thyronorm to 75 mcg per day and repeat Free T4 and TSH 6 weeks after increasing the dose of thyroid hormone. I would advice you to seek a prescription from you local physician for the higher Thyronorm dose.
Hairfall and abnormal periods are common in uncontrolled hypothyrodism. Once the TSH falls to range of <2.5 mIU/l, these symptoms should resolve.
Hope this was helpful. Good luck.
Regards
Dr. Om J Lakhani, MD
Department of Endocrinology
Sir XXXXXXX XXXXXXX Hospital, New XXXXXXX