. This is a case of subclinical hypothyroidism . order for FPG PPG HBA1C serum calcium, Hemoglobin look for thyroid goitre in neck CT scan of brain to rule out any pitutary abormalities Anti TPO antibodies FNAC /USG of thyroid nodule if present As per guidelines, there is no need to start treatment upto TSH 10 But in this case, the girl is 18 years ,obese, we can start with low dose of thyroxine 25mcg on empty stomach, to prevent further complications of hypothyroidism. Keep TSH below 5 . Monitor TSH once in 3 months until you get control. Give nutritional supplements Calcium and Vitamin D3 should be given Methyl cobalamine supplements stress more on LSM and TLC to reduce weight. Rule out Type 1DM as auto immune diabetes is associated with autoimmune thyroiditis.
Its a case of Sub Clinical Hypothyroidism...1) whether she is clinically euthyroid or not ? so,Check for All Symptoms & signs apart from what u have mentioned, consistent with hypothyroidism...if pt Clinically non euthyroid start treatment 2) check for anti-tpo antibodies if positive start treatment 3) Goitre present start treatment 4)progressively increasing TSH or TSH more than 8 on two occassions done 8 weeks apart 5) high cardiovascular risk...start treatment...check are fasting lipid profile and blood sugar levels...dosage of levothyroxine should be 1.6 MCG/kg of ideal body weight...if u are starting treatment...ideal target of tsh should be less than 3...monitor s.Tsh levels for every 8 weeks and titrate the dose till the target tsh is achieved....evaluate this pt for Pcos also...Not related to this case....treat subclinical hypothyroidism in cases of pregnancy, preconception and also infertility...
A case of subclinical hypothyroidism. Mostly at this age it is auto immune thyroiditis. Anti TPO antibodies are +ve in such cases. Menstrual irregularities are also common.l-thyoxine 25mcg should be started. TSH monitoring to be done after 3 months
Looking at the blood test for thyroide, pt is suffering from hypothyroidism. Treat with thyroxine 25mcg And monitor with frequent blood tests. Fortnightly or monthly and monitor the symptoms.
she is hvng hypothyroidism. vit d levels and iron deficiency anaemia, b12 deficiency to be ruled out and supplemented accordingly
This young lady has ocult hypothyroidism we should look for DM or any other endocrine abnormality.She should have serum cortisol levels X Ray skull for pituitary Tumor do fasting and post lunch. And HBa1c in treatment low dose of thyroxine after getting cortisol level
any how treating subclinical hypothyroidism and it's indications are already given by dr Sandeep but
Monitor after 3-wks. Hypothyroidism, Start Eltroxin 25 morning daily.
K.p 12 4 pills 7 days tds...
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35 yF vth anemia, ft3,ft4,TSH report attached.. plz discuss how to proceed..Hb-6.8,fbs-68,sr urea-25,cret-0.9.TLC-8400, DC-N73,L26. Thin built, 42 kgs....Dr. Santosh Sahu2 Likes18 Answers
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I saw a 17 year old girl 165 cm tall weighing 55 kg (BMI 20.2) - reasonably fit and energetic - doing well academically. She was diagnosed to have a subclinical hypothyroid state in 2017 (see reports) and was observed. Interim, she was diagnosed to have PCOD with minor menstrual irregularities. She has atopy with high IgE and sensitivity to dust and cold. A follow up TSH and FT4 done recently (see reports) showed slight worsening of values and anti-TPO came out to be rather high. She has a lowish Hb 12.3 of normocytic normochromic type. Does this girl need to be treated with replacement LT4? If no, how frequently should her TFT's be monitored? If yes, what dose of LT4 would you start with?Dr. Debashis Chatterjee1 Like4 Answers
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how can we explain both (clinically & lab report )??Dr. Kamal Thadhani1 Like22 Answers
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34 f married with no menses since 2 months...upt negative...no other complaints...thyroid profile with this results....took hormone replacement therapy from gyni doc with no effect as per patient...ur keen advice and management...Dr. Kamran Ghm2 Likes11 Answers
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21 Reasons Why You're Losing Your Hair southernliving.com Oct 23, 2017 5:16 AM ￼ 1 of 22 Why is my hair falling out? It's true that men are more likely to lose their hair than women, mostly due to male pattern baldness (more on that later). But thinning hair and hair loss are also common in women, and no less demoralizing. Reasons can range from the simple and temporary—a vitamin deficiency—to the more complex, like an underlying health condition. In many cases, there are ways to treat both male and female hair loss. It all depends on the cause. Here are some common and not-so-common reasons why you might be seeing less hair on your head. Watch the video: 8 Reasons Your Hair Might Be Falling Out ￼ Any kind of physical trauma—surgery, a car accident, or a severe illness, even the flu—can cause temporary hair loss. This can trigger a type of hair loss called telogen effluvium. Hair has a programmed life cycle: a growth phase, rest phase and shedding phase. “When you have a really stressful event, it can shock the hair cycle, (pushing) more hair into the shedding phase,” explains Marc Glashofer, MD, a dermatologist in New York City. Hair loss often becomes noticeable three-to-six months after the trauma. What to do: The good news is that hair will start growing back as your body recovers. 2 of 22 Physical stress ￼ Pregnancy is one example of the type of physical stress that can cause hair loss (that and hormones). Pregnancy-related hair loss is seen more commonly after your baby has been delivered rather than actually during pregnancy. “Giving birth is pretty traumatic,” says Dr. Glashofer. What to do: If you do experience hair loss, rest assured that your hair will grow back in a couple of months. “It’s a normal thing and it will work its way out,” Dr. Glashofer says. 3 of 22 Pregnancy ￼ Overdoing vitamin A-containing supplements or medications can trigger hair loss, according to the American Academy of Dermatology. The Daily Value for vitamin A is 5,000 International Units (IU) per day for adults and kids over age 4; supplements can contain 2,500 to 10,000 IU. What to do: This is a reversible cause of hair loss and once the excess vitamin A is halted, hair should grow normally. 4 of 22 Too much vitamin A ￼ If you don't get enough protein in your diet, your body may ration protein by shutting down hair growth, according to the American Academy of Dermatology. This can happen about two to three months after a drop in protein intake, they say. What to do: There are many great sources of protein, including fish, meat, and eggs. If you don't eat meat or animal products, here are the 14 Best Vegan and Vegetarian Protein Sources. 5 of 22 Lack of protein ￼ About two out of three men experience hair loss by age 60, and most of the time it's due to male pattern baldness. This type of hair loss, caused by a combo of genes and male sex hormones, usually follows a classic pattern in which the hair recedes at the temples, leaving an M-shaped hairline. What to do: There are topical creams like minoxidil (Rogaine) and oral medications such as finasteride (Propecia) that can halt hair loss or even cause some to grow; surgery to transplant or graft hair is also an option. 6 of 22 Male pattern baldness ￼ Female-pattern hair loss, called androgenic or androgenetic alopecia, is basically the female version of male pattern baldness. “If you come from a family where women started to have hair loss at a certain age, then you might be more prone to it,” says Dr. Glashofer. Unlike men, women don't tend to have a receding hairline, instead their part may widen and they may have noticeable thinning of hair. What to do: Like men, women may benefit from minoxidil (Rogaine) to help grow hair, or at least, maintain the hair you have, Dr. Glashofer says. Rogaine is available over-the-counter and is approved for women with this type of hair loss. 7 of 22 Heredity ￼ Just as pregnancy hormone changes can cause hair loss, so can switching or going off birth-control pills. This can also cause telogen effluvium, and it may be more likely if you have a family history of hair loss. The change in the hormonal balance that occurs at menopause may also have the same result. “The androgen (male hormone) receptors on the scalp becoming activated,” explains Mark Hammonds, MD, a dermatologist with Scott & White Clinic in Round Rock, Texas. “The hair follicles will miniaturize and then you start to lose more hair.” What to do: If a new Rx is a problem, switch back or talk to your doctor about other birth control types. Stopping oral contraceptives can also sometimes cause hair loss, but this is temporary, says Dr. Hammonds. Don't make your problem worse with hair-damaging beauty regimens. 8 of 22 Female hormones ￼ Emotional stress is less likely to cause hair loss than physical stress, but it can happen, for instance, in the case of divorce, after the death of a loved one, or while caring for an aging parent. More often, though, emotional stress won't actually precipitate the hair loss. It will exacerbate a problem that's already there, says Dr. Glashofer. What to do: As with hair loss due to physical stress, this shedding will eventually abate. While it's not known if reducing stress can help your hair, it can't hurt either. Take steps to combat stress and anxiety, like getting more exercise, trying talk therapy, or getting more support if you need it. Watch the video: Yoga Poses for Less Stress and Better Sleep 9 of 22 Emotional stress ￼ Almost one in 10 women aged 20 through 49 suffers from anemia due to an iron deficiency (the most common type of anemia), which is an easily fixable cause of hair loss. You doctor will have to do a blood test to determine for sure if you have this type of anemia. What to do: A simple iron supplement should correct the problem. In addition to hair loss, other symptoms of anemia include fatigue, headache, dizziness, pale skin, and cold hands and feet. 10 of 22 Anemia ￼ Hypothyroidism is the medical term for having an underactive thyroid gland. This little gland located in your neck produces hormones that are critical to metabolism as well as growth and development and, when it’s not pumping out enough hormones, can contribute to hair loss. Your doctor can do tests to determine the real cause What to do: Synthetic thyroid medication will take care of the problem. Once your thyroid levels return to normal, so should your hair. 11 of 22 Hypothyroidism ￼ Although relatively uncommon in the U.S., low levels of vitamin B are another correctible cause of hair loss. What to do: Like anemia, simple supplementation should help the problem. So can dietary changes. Find natural vitamin B in fish, meat, starchy vegetables, and non-citrus fruits. As always, eating a balanced diet plentiful in fruits and vegetables as well as lean protein and “good” fats such as avocado and nuts will be good for your hair and your overall health. 12 of 22 Vitamin B deficiency ￼ This is also called alopecia areata and basically is a result of an overactive immune system. “The body gets confused,” says Dr. Glashofer. “The immune system sees the hair as foreign and targets it by mistake.” What to do: Steroid injections are the first line of treatment for alopecia areata, which appears as hair loss in round patches on the head. Other drugs, including Rogaine, may also be used. The course of the condition can be unpredictable, with hair growing back then falling out again. 13 of 22 Autoimmune-related hair loss ￼ Other autoimmune diseases such as lupus can also cause hair loss. Again it’s a case of mistaken identity: overzealous immune cells attack the hair. Unfortunately, hair loss of this type is “scarring,” meaning the hair will not grow back, says Dr. Hammonds. What to do: If the hair loss is mild, you might want to try a new hairstyle to camouflage the damage. Short hair, for instance, is stronger than long hair and may hide bald patches better. 14 of 22 Lupus ￼ Sudden weight loss is a form of physical trauma that can result in thinning hair. This could happen even if the weight loss is ultimately good for you. It’s possible that the weight loss itself is stressing your body or that not eating right can result in vitamin or mineral deficiencies. Loss of hair along with noticeable weight loss may also be a sign of an eating disorder such as anorexia or bulimia. What to do: "Sudden weight loss seems to shock the system and you’ll have a six-month period of hair loss and then it corrects itself,” says Dr. Hammonds. 15 of 22 Dramatic weight loss ￼ Some of the drugs used to beat back cancer unfortunately can also cause your hair to fall out. “Chemotherapy is like a nuclear bomb,” says Dr. Glashofer. “It destroys rapidly dividing cells. That means cancer cells, but also rapidly dividing cells like hair.” What to do: Once chemotherapy is stopped, your hair will grow back although often it will come back with a different texture (perhaps curly when before it was straight) or a different color. Researchers are working on more targeted drugs to treat cancer, ones that would bypass this and other side effects. In the meantime, Here's How to Deal With Thinning Hair During Chemo. 16 of 22 Chemotherapy ￼ Polycystic ovary syndrome (PCOS) is another imbalance in male and female sex hormones. An excess of androgens can lead to ovarian cysts, weight gain, a higher risk of diabetes, changes in your menstrual period, infertility, as well as hair thinning. Because male hormones are overrepresented in PCOS, women may also experience more hair on the face and body. What to do: Treating PCOS can correct the hormone imbalance and help reverse some of these changes. Treatments include diet, exercise, and potentially birth control pills, as well as specific treatment to address infertility or diabetes risk. 17 of 22 Polycystic ovary syndrome ￼ Certain other classes of medication may also promote hair loss. More common among them are certain blood thinners and the blood-pressure drugs known as beta-blockers. Other drugs that might cause hair loss include methotrexate (used to treat rheumatic conditions and some skin conditions), lithium (for bipolar disorder), nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen, and possibly antidepressants. What to do: If your doctor determines that one or more of your medications is causing hair loss, talk with him or her about either lowering the dose or switching to another medicine. 18 of 22 Antidepressants, blood thinners, and more ￼ Vigorous styling and hair treatments over the years can cause your hair to fall out. Examples of extreme styling include tight braids, hair weaves or corn rows as well as chemical relaxers to straighten your hair, hot-oil treatments or any kind of harsh chemical or high heat. Because these practices can actually affect the hair root, your hair might not grow back. What to do: In addition to avoiding these styles and treatments, the American Academy of Dermatology recommends using conditioner after every shampoo, letting your hair air dry, limiting the amount of time the curling iron comes in contact with your hair and using heat-driven products no more than once a week. 19 of 22 Overstyling ￼ Trichotillomania, classified as an “impulse control disorder,” causes people to compulsively pull their hair out. “It’s sort of like a tic, the person is constantly playing and pulling their hair,” says Dr. Glashofer says. Unfortunately, this constant playing and pulling can actually strip your head of its natural protection: hair. Trichotillomania often begins before the age of 17 and is four times as common in women as in men. What to do: Some antidepressants may be effective, but behavioral modification therapy is another option. 20 of 22 Trichotillomania ￼ It’s not uncommon to see hair loss or thinning of the hair in women as they enter their 50s and 60s, says Dr. Glashofer. Experts aren’t sure why this happens. What to do: Experts don't recommend that this condition be treated, says Dr. Hammonds. That leaves women with cosmetic approaches such as scarves, wigs and hair styled so as to cover up thin spots. That said, there are also plenty of tricks to prevent hair breakage and ways to keep your hair looking shiny and healthy in your 50s and above. 21 of 22 Aging ￼ If you take anabolic steroids—the type abused by some athletes to bulk up muscle—you could lose your hair, according to the American Academy of Dermatology. Anabolic steroids can have the same impact on the body as polycystic ovary disease (PCOS), as the mechanism is the same, says Dr. Hammonds. What to do: This should improve after going off the drug. 22 of 22 Anabolic steroidsDr. Tapan Kumar Sau1 Like8 Answers