Concluded Case

How to manage Hyperthyroidism?

33 year old female with complaints of loss of weight, anorexia, tremors, regular menstrual cycles but minimal flow. No other complaints. BP is 130/80 Heart rate is around 90/min. Reports suggestive of Hyperthyroidism. Blood and Thyroid scan results attached. kindly suggest management.

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Concluded answer
It looks like a case of hashitoxicosis or graves disease Difference between two as follows Hashitoxicosis. Graves disease Anti TSH Receptor. Absent. Present Antibody Thyroid scan. Decreased. Increased Uptake. Uptake Adv Tablet neomercazole 10 mg twice a day, dose to be titrated upward or downward based on response to treatment - till TSH is in normal range Tab. Propranolol 10 mg three times a day - target pulse rate 60 - 70 Keep monitoring pulse, blood pressure and TSH level
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It looks like a case of hashitoxicosis or graves disease Difference between two as follows Hashitoxicosis. Graves disease Anti TSH Receptor. Absent. Present Antibody Thyroid scan. Decreased. Increased Uptake. Uptake Adv Tablet neomercazole 10 mg twice a day, dose to be titrated upward or downward based on response to treatment - till TSH is in normal range Tab. Propranolol 10 mg three times a day - target pulse rate 60 - 70 Keep monitoring pulse, blood pressure and TSH level
Thank you for detailed information
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Carbimazole. Beta blocker.. Iodized salt restricton. Watch her for fine tremor and pulse rate during sleep. Treatment is important to prevent thyroid storm, thyrotoxicosis, and other complications. Subacute thyroiditis is a rare type of thyroiditis that causes pain and discomfort in the thyroid. People with this condition will also have symptoms of hyperthyroidism and later develop symptoms of hypothyroidism.  So advisable..Anti TPO / Radio active Iodine test.
Thank you doctor
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Clinical hyperthyroidism It may be due to thyroditis or grave diseae Look for orbitolopathy, dermatology and neck swelling Investigation-usg neck,thyroid scan,anti Trab antibodies Treatment - give propanolol 40 mg till symptoms Gate proper diagnosis with help of investigation Or repeat TSH after 6 week
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Start with Propranalol 10mg TID Review after 2-3mths as FT3, FT4 n TSH If still not euthyroid, then add Neomercazole 10mg TID
SUGGESTIVE. OF .. HYPERTHYROIDISM ADVISABLE... NEEDS. FURTHER. INVESTIGATION CARBIMAZOLE PROPRANOLOL
Thank you doctor
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Hyperthyroidism Anti TPO antibody FNAC Tab Carbimazole 10mg od Tab Propranalol 10mg tds
Thank you doctor
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START TAB NEOMERCAZOLE 10 MGM 1 TAB TDS AND WHAT ABOUT BLOOD PRESSURE AND HEART RATE
Sir BP is 130/80 Heart rate is around 90
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Neomercazole 10 mg tds Betacap TR 40 mg 1 od Ad USG neck RAIU studies FNAC
Thank you doctor
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