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Thyroid Problem, Low Energy Level, Frequent Headaches, Weight Gain. How To Get Cure?
Question: A 21-year-old woman presents to your practice with a number of complaints that have become increasingly problematic over the last several weeks. This patient is new to your practice. She has been having frequent headaches, has been having increasing difficulty getting out of bed in the morning, and feels that “something is terribly wrong” with her. She has gained more than 5 lbs. in the past month, which also upsets her. She thinks she has a thyroid problem. Her energy level is low and she has not enjoyed her usual activities for over a month. However, concurrently she has noticed feelings of anxiety when she leaves her house.
CC: “There is a history of thyroid problems in my family. I think that is what is wrong. And I need something for these headaches I keep having.”
Her physical exam is essentially normal except for the noted 5-lb. weight gain over the past month. Vital signs are all within normal limits. The patient seems rather distracted and has difficulty following directions in some situations.
What other subjective and objective data may be important for you to gather to more effectively diagnose this patient’s problem/s? What other laboratory tests and/or imaging might be appropriate for this patient?
What screening tools are available and how valid and reliable are they? Which ones would be important for you to use with this patient?
How would you manage this patient (plan of care)? Would you treat her headaches?
Identify some community resources available for the patient.
CC: “There is a history of thyroid problems in my family. I think that is what is wrong. And I need something for these headaches I keep having.”
Her physical exam is essentially normal except for the noted 5-lb. weight gain over the past month. Vital signs are all within normal limits. The patient seems rather distracted and has difficulty following directions in some situations.
What other subjective and objective data may be important for you to gather to more effectively diagnose this patient’s problem/s? What other laboratory tests and/or imaging might be appropriate for this patient?
What screening tools are available and how valid and reliable are they? Which ones would be important for you to use with this patient?
How would you manage this patient (plan of care)? Would you treat her headaches?
Identify some community resources available for the patient.
Brief Answer:
May be migraine or psychiatric problem.
Detailed Answer:
Hello,
I have studied your case.
First possibility as per presentation of your symptoms is migraine.
Migraine usually involves half part of your head and associated with nausea.
Is she having pain of severe type? And aggravated by triggering factors like irritant smell, travelling? Is she having normal sleep? Undergoing any stress?
Another possibility of complain related to psychiatric illness. For which she may need to consult psychiatrist.
When such patient comes to my hospital we usually do routine blood investigation like complete blood count, ESR, CRP, MRI brain will be useful in her case along with hormone levels like thyroid and prolactin.
Blood investigations are useful tool for screening but there are nonspecific tools available.
Management will depend on clinical examination and investigation reports .Plan will go like this, if headache is of migraine variety
medications for migraine like sumatriptans can started consulting your doctor.
If there is some hormone imbalance then hormone supplement with symptomatic treatment.
Some medication like muscle relaxant and analgesic [paracetemol] will reduce pain, you can take them consulting your treating doctor.
After clinical examination, Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.
Wishing you good health.
Take care.
May be migraine or psychiatric problem.
Detailed Answer:
Hello,
I have studied your case.
First possibility as per presentation of your symptoms is migraine.
Migraine usually involves half part of your head and associated with nausea.
Is she having pain of severe type? And aggravated by triggering factors like irritant smell, travelling? Is she having normal sleep? Undergoing any stress?
Another possibility of complain related to psychiatric illness. For which she may need to consult psychiatrist.
When such patient comes to my hospital we usually do routine blood investigation like complete blood count, ESR, CRP, MRI brain will be useful in her case along with hormone levels like thyroid and prolactin.
Blood investigations are useful tool for screening but there are nonspecific tools available.
Management will depend on clinical examination and investigation reports .Plan will go like this, if headache is of migraine variety
medications for migraine like sumatriptans can started consulting your doctor.
If there is some hormone imbalance then hormone supplement with symptomatic treatment.
Some medication like muscle relaxant and analgesic [paracetemol] will reduce pain, you can take them consulting your treating doctor.
After clinical examination, Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.
Wishing you good health.
Take care.
Above answer was peer-reviewed by :
Dr. Shanthi.E
would you not consider anxiety or depressive disorder
Brief Answer:
Yes a mentioned that as 2 nd differential
Detailed Answer:
Hello again,
As I already mentioned in previous answer my 2 nd differential is- possibility of complain related to psychiatric illness. For which she may need to consult psychiatrist.
Psychiatric consultation is required to label as anxiety or depressive disorder, there may be some more component associated with it.
Take care.
Yes a mentioned that as 2 nd differential
Detailed Answer:
Hello again,
As I already mentioned in previous answer my 2 nd differential is- possibility of complain related to psychiatric illness. For which she may need to consult psychiatrist.
Psychiatric consultation is required to label as anxiety or depressive disorder, there may be some more component associated with it.
Take care.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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