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What Does My Thyroid Test Report Indicate?
Question: My TSH level is 1.09 micro IU/ml
FT3 is 1.29 ng/100 ml
FT4 is 2.97 pg./ml
I have pituitary adenoma for which i am taking cabergoline 0.25mg twice a week since 2 years.
Presently my prolactin level is 24.65 ng/ml
I am presently taking thyronorm 50 mcg and i am having very severe hair fall. So is it because of the thyroid dose which is not correct may be?
FT3 is 1.29 ng/100 ml
FT4 is 2.97 pg./ml
I have pituitary adenoma for which i am taking cabergoline 0.25mg twice a week since 2 years.
Presently my prolactin level is 24.65 ng/ml
I am presently taking thyronorm 50 mcg and i am having very severe hair fall. So is it because of the thyroid dose which is not correct may be?
Brief Answer:
Your dose is correct
Detailed Answer:
Hi,
Welcome to HCM. I have gone through the question and understand your concerns.
Please share with me your initial thyroid function reports and prolactin values before starting treatment.
1. While on treatment of pituitary adenoma with cabergoline we will try to keep the prolactin value as low as possible. So in your case it is high normal and dose is low. So you can probably increase the dose of cabergoline to 0.5 mg twice a week.
2. In pituitary adenoma we monitor thyroxine replacement based on T4 values. Your T4 is normal and you can continue with same dose of thyroxine.
The hair loss is unlikely to be due to thyroid problem. Check your blood routine for anaemia and vitamin D levels.
Hope I have answered your questions. If you have any further queries I will be happy to help you
Regards,
Dr Ajish TP [MD,DM]
Consultant Endocrinologist
Your dose is correct
Detailed Answer:
Hi,
Welcome to HCM. I have gone through the question and understand your concerns.
Please share with me your initial thyroid function reports and prolactin values before starting treatment.
1. While on treatment of pituitary adenoma with cabergoline we will try to keep the prolactin value as low as possible. So in your case it is high normal and dose is low. So you can probably increase the dose of cabergoline to 0.5 mg twice a week.
2. In pituitary adenoma we monitor thyroxine replacement based on T4 values. Your T4 is normal and you can continue with same dose of thyroxine.
The hair loss is unlikely to be due to thyroid problem. Check your blood routine for anaemia and vitamin D levels.
Hope I have answered your questions. If you have any further queries I will be happy to help you
Regards,
Dr Ajish TP [MD,DM]
Consultant Endocrinologist
Above answer was peer-reviewed by :
Dr. Sonia Raina
Dear Doctor,
I have attached all recent medical reports that i had got done. I have attached 2 MRI reports of pituitary gland. One was done in sept 2013 when it was detected, the other one i had got done in feb 2015 which shows that the tumor has melted. I was cabergoline 0.5mg once a week for 1 year and after that cabergoline half of 0.25mg every 10 days. I am also thalasemia minor and i have pcos so i am on cetapin xr 1000mg. My TSH recently got to 6 that is why i started thyronorm 50mcg. Yesterday i sent you the latest thyroid and prolactin blood reports. I have already taken too much of iron tablets even though i am thalasemia minor and have take D3 and B12 medicines as well. Please tell me how to stop my hair fall is it the thyroid medicine may be i am taking high or low dose or cabergoline because of which i am having severe hair fall. Or may be because of metformin which i am taking. I really dont know what to do as my hair is just falling out and i am almost getting bald. I am also taking revilus but no help! Please let me know if you want any details
Thank you
XXXX.
I have attached all recent medical reports that i had got done. I have attached 2 MRI reports of pituitary gland. One was done in sept 2013 when it was detected, the other one i had got done in feb 2015 which shows that the tumor has melted. I was cabergoline 0.5mg once a week for 1 year and after that cabergoline half of 0.25mg every 10 days. I am also thalasemia minor and i have pcos so i am on cetapin xr 1000mg. My TSH recently got to 6 that is why i started thyronorm 50mcg. Yesterday i sent you the latest thyroid and prolactin blood reports. I have already taken too much of iron tablets even though i am thalasemia minor and have take D3 and B12 medicines as well. Please tell me how to stop my hair fall is it the thyroid medicine may be i am taking high or low dose or cabergoline because of which i am having severe hair fall. Or may be because of metformin which i am taking. I really dont know what to do as my hair is just falling out and i am almost getting bald. I am also taking revilus but no help! Please let me know if you want any details
Thank you
XXXX.
Brief Answer:
See detailed answer
Detailed Answer:
Hi
Welcome back.
I have gone through the reports. Please ignore my previous answer. The clinical picture is different
1. You don't have a significant micro adenoma now. So you can stop treatment as the duration now is more than 2 yrs.
2. Hypothyroidism is not related to adenoma, and it is well controlled on Thyronorm 50 mcg. Continue the dose.
3. Now for hair loss the possible reasons are many:
- vitamin/ mineral deficiencies : Vitamin D, calcium, zinc, iron etc
- local skin problems - dandruff
- hormonal - hypothyroidism, high testosterone etc
- stress, decreased sleep, chemicals in bathing water etc.
So treatment also varies. Eat good food, regular exercise, head massage, vitamin supplementations etc can be tried. If no improvement consult a dermatologist and do further work up.
The hair loss is unlikely to be due to thyronorm, prolactin or metformin. It is worth doing testosterone levels in blood if the hair loss is male pattern.
Regards
Dr Ajish TP
See detailed answer
Detailed Answer:
Hi
Welcome back.
I have gone through the reports. Please ignore my previous answer. The clinical picture is different
1. You don't have a significant micro adenoma now. So you can stop treatment as the duration now is more than 2 yrs.
2. Hypothyroidism is not related to adenoma, and it is well controlled on Thyronorm 50 mcg. Continue the dose.
3. Now for hair loss the possible reasons are many:
- vitamin/ mineral deficiencies : Vitamin D, calcium, zinc, iron etc
- local skin problems - dandruff
- hormonal - hypothyroidism, high testosterone etc
- stress, decreased sleep, chemicals in bathing water etc.
So treatment also varies. Eat good food, regular exercise, head massage, vitamin supplementations etc can be tried. If no improvement consult a dermatologist and do further work up.
The hair loss is unlikely to be due to thyronorm, prolactin or metformin. It is worth doing testosterone levels in blood if the hair loss is male pattern.
Regards
Dr Ajish TP
Above answer was peer-reviewed by :
Dr. Prasad
Doctor
I have been told to take cabergoline for another 2 years from the date of second MRI which shows that the tumor has melted. So what dose should i take further or according to you i dont need any cabergoline although my prolactin test latest one is 24.65 so what should i do?
I have been told to take cabergoline for another 2 years from the date of second MRI which shows that the tumor has melted. So what dose should i take further or according to you i dont need any cabergoline although my prolactin test latest one is 24.65 so what should i do?
Brief Answer:
See details
Detailed Answer:
Hi,
Welcome back.
The treatment duration varies. Most guidelines say the treatment duration as 1 1/2 to 2yrs. So I prefer this. Some doctors prefer to continue treatment for 4 yrs,especially in reproductive age.
So if you are continuing treatment keep it at the lowest dose of 0.25mg weekly. You can retest every 6 months for serum prolactin.
Regards
Dr Ajish TP
See details
Detailed Answer:
Hi,
Welcome back.
The treatment duration varies. Most guidelines say the treatment duration as 1 1/2 to 2yrs. So I prefer this. Some doctors prefer to continue treatment for 4 yrs,especially in reproductive age.
So if you are continuing treatment keep it at the lowest dose of 0.25mg weekly. You can retest every 6 months for serum prolactin.
Regards
Dr Ajish TP
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Ok doctor can you please give me any suggestion to stop my hair loss. I am really concerned about that. It is the only problem that i have. I am also having a lot of dandruff which is sticky on my scalp so please tell me how to remove it and how to stop my hair fall. Is there any shampoo or dandruff shampoo which you suggest?
Brief Answer:
Try ketoconazole shampoo
Detailed Answer:
Hi,
If you have excess dandruff in your hair, then it could be the reason for hair loss.
Try anti dandruff shampoo which contain ketoconazole like Nizoral or Clear 2% daily . You can continue vitamin supplements.
regards
Dr Ajish Tp
Try ketoconazole shampoo
Detailed Answer:
Hi,
If you have excess dandruff in your hair, then it could be the reason for hair loss.
Try anti dandruff shampoo which contain ketoconazole like Nizoral or Clear 2% daily . You can continue vitamin supplements.
regards
Dr Ajish Tp
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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