18 year girl short stature ,fat c/o giddiness,tingling numbness,gen weakness since 4 weeks.advise treatment.



. 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.

For vit. D deficiency use calcitonin granules once a wk. For three months rpt. Test. Iron deficiency anaemia don't Co exist. As one microcytic other is macrocytic.

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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

but can subclinical hypothyroidism leads to all those symptoms mentioned is questionable and even the short stature is also against this in this patient we need to do a neurological examination and get a calcium profile done

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Monitor after 3-wks. Hypothyroidism, Start Eltroxin 25 morning daily.

K.p 12 4 pills 7 days tds...

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