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What Does My Thyroid Test Report Indicate?

Posted on Mon, 28 Sep 2015

Question: Hi,
I currently live in Seoul and I am thinking of getting Lasek for my eyes however, I just saw online that if you have an auto-immune disease it`s not recommended. I have Hashimoto disease. Here are my readings
TSH receptor Ab 0.52
T3 94.6
Free T4 0.9
TSH 1.44
Anti-TPO ab 197.1
Anti-thyroglobulin Ab 136.2
Ana Positive
I had gotten these test done on XXXXXXX 26th 2015.
What do you recommend? I asked the Dr who will be performing my surgery and he said that thyroid has nothing to do with the surgery. If I had some other auto-immune disease like Lupus or something else that's when it would matter. When they examined my eye they said I have a thick cornea and no dry eyes. What do you recommend?

Thanks

Answered by Dr. Binu Parameswaran Pillai (1 hour later)

Brief Answer:
Hypothyroidism not a contraindication for LASEK.

Detailed Answer:
Good day.
Noted your concern. Your blood reports are suggestive of auto immune thyroid disease. However, this is not a contraindication for Lasek treatment.. You may be misled by looking at dubious websites. Trust your doctor and talk to him in detail.
Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (17 hours later)

Thanks for your response. So from what I understand I can go ahead with the surgery. I am particularly concerned as auto-immune disease causes slow healing and or complications. I am hoping this should not be a problem?

Answered by Dr. Binu Parameswaran Pillai (3 hours later)

Brief Answer:
Steroids may impair healing

Detailed Answer:
You may proceed with Lasek if yoir eye doctor is confident. It is true that some of the auto immue diosrders cause impaired healing. this is especially true if we use steroids to treat those auto immune conditions.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (50 minutes later)

Which are the autoimmune disease that impairs healing due to steroids? My eye doctor says its ok to go ahead with the surgery but because I have an autoimmune disorder I am being over precautious. Since the eye doctor is not an expert in autoimmune disease I am consulting with you. Is there a chance that the steroids which complicate things for me?

Answered by Dr. Binu Parameswaran Pillai (53 minutes later)

Brief Answer:
Auto immune hypothyroidism ( hashimoto's thyroiditis) doesnt need steroids

Detailed Answer:
If you are currently on steroids or cytotoxic drugs ( like cyclophosphamide, methotrexate etc), do not do the eye surgery.
Auto immune and connective tissue disorders like Rheumatoid arthritis, autoimmune uveitis, SLE, Mixed connective tissue disorder, Myaesthenia gravis, etc need use of steroids or other cyto toxic drugs. But auto immune HYPOthyroidism or hashimoto's thyroiditis doesn't need any steroid except in rare situation which cause severe hypothyroidism called as myxedema coma or encephalopathy. ( Auto immune HYPERthyroidism which is called Grave's disease, may some times need steroids and you do not have that as per the history).

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (6 hours later)

Thanks once again. I do not take any steroids however, I do apply these prescription cream on my eye due to white patches. The patches have 98% gone. The creams I apply are Elidel (pimecrolimus cream 1%) and Clocortolone Pivalate cream 0.1%. I believe these are steroids. I can stop applying them now as my surgery is scheduled for Friday and not use until my eye recovers completely? Please advice.

Also post surgery I will be asked to take steroids for healing. Will that be ok?

Answered by Dr. Binu Parameswaran Pillai (6 hours later)

Brief Answer:
Issue only with open surgeries

Detailed Answer:
Very tricky situation. You are on small dose topical immuno suppresent creams. They may not affect healing process negatively after LASEK. Regrding the post surgical steroid dose. It depeds on the dose used. Generally, only in open surgeries it matter much. LASEK is largely a non invasive/minimally invasive procedure. However, you need to discuss about it with ophthalmologist

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar