Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Iam A Physician My Daughter Has Been Recently Diagnosed With
Question: iam a physician
my daughter has been recently diagnosed with PCOS with multiple cysts on one ovary and the other ovary shows a follicle
she has severe hypothyroidism since 10 yrs requiring 250 mcg of thyroxine daily
her initial symptoms 10 yrs ago were severe depression and anxiety with hypothyroidism
and severe weight gain
recently progressed to PCOS
She had been treated with antidepressants for may years and recently her moods are slightly stable with ecitalopram and aripiprazole
the main problem is LACK OF ENERGY ALWAYS
she wants to study and achieve her goals but lack of energy hinders her progress and some time she doesn't even have energy to do with daily chores
is there any solution?
her periods have recently become irregular with inter menstrual spotting but are corrected by hormone pills
she does not have cushings and her cortisol is normal
could there be some adrenal insufficiency also
my daughter has been recently diagnosed with PCOS with multiple cysts on one ovary and the other ovary shows a follicle
she has severe hypothyroidism since 10 yrs requiring 250 mcg of thyroxine daily
her initial symptoms 10 yrs ago were severe depression and anxiety with hypothyroidism
and severe weight gain
recently progressed to PCOS
She had been treated with antidepressants for may years and recently her moods are slightly stable with ecitalopram and aripiprazole
the main problem is LACK OF ENERGY ALWAYS
she wants to study and achieve her goals but lack of energy hinders her progress and some time she doesn't even have energy to do with daily chores
is there any solution?
her periods have recently become irregular with inter menstrual spotting but are corrected by hormone pills
she does not have cushings and her cortisol is normal
could there be some adrenal insufficiency also
Brief Answer:
About pcos treatment;
Detailed Answer:
Hello and thank you for asking!
I can understand your concern regarding to your daughter's health, especially being a parent physician.
Taking contraceptive pills at the same time with levothyroxine first, can alter the need for levothyroxine (causing imbalance of the thyroid hormone levels) secondly can cause further weight
gain and once contraceptive pills are stopped the menstrual cycle get worse.
You need to encourage her to lose weight and check fasting glucose with insulinemia to judge about insulin resistance that is very common in overweight women with PCOS.
If insulin resistance is confirmed, she can benefit from metformine or inositol supplements ( dikirogen) that will improve her hormonal profile and help to loose a bit weight and probably improve her general wellbeing.
Regarding to adrenal insufficiency, if there are symptoms suggesting for it (if lack of energy is not explained by thyroid hormone imbalance, it means that it persists even in periods when TSh is normal, tendency for low blood pressure, symptoms of hypoglycemia, electrolyte disturnaces such as hypokalemia ect) a synacten stimulation test would confirm the diagnosis.
You should know that she has a higher probability for autoimmune diseases (if Hashimoto thyroiditis is the cause of hypothyroidism) such as; type 1 Diabetes, XXXXXXX disease, celiac disease and should be under close monitoring for these pathologies.
You may discuss with her treating endocrinologist about the above exams and treatment.
Hope the information will help.
Best wishes,
Dr.Mirjeta
About pcos treatment;
Detailed Answer:
Hello and thank you for asking!
I can understand your concern regarding to your daughter's health, especially being a parent physician.
Taking contraceptive pills at the same time with levothyroxine first, can alter the need for levothyroxine (causing imbalance of the thyroid hormone levels) secondly can cause further weight
gain and once contraceptive pills are stopped the menstrual cycle get worse.
You need to encourage her to lose weight and check fasting glucose with insulinemia to judge about insulin resistance that is very common in overweight women with PCOS.
If insulin resistance is confirmed, she can benefit from metformine or inositol supplements ( dikirogen) that will improve her hormonal profile and help to loose a bit weight and probably improve her general wellbeing.
Regarding to adrenal insufficiency, if there are symptoms suggesting for it (if lack of energy is not explained by thyroid hormone imbalance, it means that it persists even in periods when TSh is normal, tendency for low blood pressure, symptoms of hypoglycemia, electrolyte disturnaces such as hypokalemia ect) a synacten stimulation test would confirm the diagnosis.
You should know that she has a higher probability for autoimmune diseases (if Hashimoto thyroiditis is the cause of hypothyroidism) such as; type 1 Diabetes, XXXXXXX disease, celiac disease and should be under close monitoring for these pathologies.
You may discuss with her treating endocrinologist about the above exams and treatment.
Hope the information will help.
Best wishes,
Dr.Mirjeta
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. Prasad
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
