27 yrs c/o primary infertility with frequent menses(17 to18 days) with TSH 9.20 nd Serum AMH 2.2 please suggest expert opinion
PCOS by USG Primary hypothyroidism by elevated TSH Correction of hypothyroidism Tt PCOS with tab ginnete or Krimson 35 6_7 cycles. LSM Wt reduction (must be fat as PCOS +hypothyroidism) Meanwhile check for tubal patency. Husband's semen analysis Follicular induction with CC 50 mg to start with after 6_7 cycles of Krimson. Follicular study. Start metformin 500 mg bd to 1000 along with other medicines,it will give wonderful results.
[3/9, 11:50 AM] : Thyroid function is measure base of the TSH range of TSH blood test. The normal thyroid levels for TSH used to be from 0.5 to 5.0. After clinical studies, in 2003, the TSH range has been revised to 0.3 - 3.0 as normal TSH levels. If you are trying to conceive, a normal level of TSH for conception should be lower than 2, that is what many reproductive endocrinologists prefer to see. Hypothyroidism is present when elevated TSH levels are present. Normal Thyroid Levels for T4 Total T4 levels should be approximately 4.5 to 12.5. A low T4 level with High TSH indicates hypothyroidism. Free T4 normal range is approximately 0.7 to 2.0. If the value is low, it indicates f hypothyroidism. Normal Thyroid Levels for T3 Total T3 levels should be approximately 80 to 220. Hypothyroidism is suspected when values are less than 80, while hyperthyroidism if over 220. Free T3 levels should be approximately 2.3 to 4.2. When values are less than 2.3, hypothyroidism is most likely. [3/9, 11:53 AM] : Normal Thyroid Levels During Pregnancy During a normal pregnancy, the thyroid TSH levels should be as follow. These value apply to those that do not present autoimmune antibodies and have sufficient levels of iodine. Normal TSH Levels during the first three months of pregnancy: 0.24 - 2.99. Normal TSH Levels during the second trimester of pregnancy: 0.46-2.95. Normal TSH Levels during the last three months of pregnancy: 0.43 - 2.78. [3/9, 11:54 AM] : The following are potential factors that prevent normal thyroid levels: 1. Exposure to enviromental toxins like chemicals, heavy metals, pesticides, electromagnetic radiation. Mercury fillings and drinking chlorinate and fluorinated water. Bromide/bromine present in food products like baked goods, can negatively affect the thyroid gland. An increase in plasma bromine, in fact, can cause an increase of TSH probably by inhibiting thyroid gland activity. 2. Genetic predisposition. 3. Mineral deficiency like iron, selenium, zinc, iodine, copper, calcium, magnesium, manganese, etc... 4. Autoimmune disorders. 5. High levels of stress. 6. Infections. 7. Adrenal insufficiency. 8. Estrogen dominance. 9. High levels of prolactin. 10. Diet high in refined grains, soy, alcohol, coffee, and hydrogenated oils. [3/9, 11:56 AM] : Women who suffer fromunderactive thyroid symptomsexperience heavy bleeding during menses, anovulatory cycles, fairly long cycles. In women where the levels of serum prolactin are high, as a result of low thyroid function ,symptoms of amenorrhea can be present. [3/9, 11:57 AM] : Hyperthyroidism Hyperthyroidism seems to affect fertility in causing frequent miscarriages even in normal menstrual cycles. Overactive thyroid symptoms are usually present when low TSH levels are present. The diagnosis of hyperthyroidism is made my measuring serum Thyroxine. What Is Euthryoid This is a medical term used to indicate that normal TSH levels are present but the woman is experiencing symptoms of thyroid disorder. This is also related to unexplained infertility cases. [3/9, 11:58 AM] : The natural thyroid diet e-book is a good way to start. This easy to follow program was developed by Louise O'Connor, a leading high profile Naturopath from Australia that is considered an authority on natural thyroid health. Reading these information can change your life by giving you vibrant health, energy and increase your chances of conceiving.
As TSH is raised a case of hypothyroidism. Need to control hypothyroidism. Take endocrinologist opinion. Tab. Tranexamic acid to stop bleeding. Weight reduction
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24yrs old with primary infertility 3yrs with pcod conceived after induction of ovulation in the 2nd month.LMP--18/9/16.Came c/o spotting p/v on 25/10/16.UPT was positive. Progesterone support , Folicacid given nd adv rest nd abstinence.Adv to come after 2wks for fetal viability scan.But she came late c/o pain lower abdomen, no spotting. Scan is showing subchorionic bleed.Wt-40kgs.Taking min dose of Eltroxin 12.5mcgms.Now TSH is normal. Discuss about the management.
Dr. Mustafa Ameena Parveen8 Likes19 Answers - Login to View the image
27 yr female,secondary infertility 1st child 5 yr old,thyroid function report no previous thyroid diseases,no symptoms of hypothyroidism,mild goiter,no exopthalmos,your comment s
Dr. Prakash Dharodiya5 Likes21 Answers - Login to View the image
Friends today I am discussing about female problem known as amenorrhoea. Amenorrhea (uh-men-o-REE-uh) is the absence of menstruation — one or more missed menstrual periods. Women who have missed at least three menstrual periods in a row have amenorrhea, as do girls who haven't begun menstruation by age 15. The most common cause of amenorrhea is pregnancy. Other causes of amenorrhea include problems with the reproductive organs or with the glands that help regulate hormone levels. Treatment of the underlying condition often resolves amenorrhea. Symptoms The main sign of amenorrhea is the absence of menstrual periods. Depending on the cause of amenorrhea, you might experience other signs or symptoms along with the absence of periods, such as: Milky nipple discharge Hair loss Headache Vision changes Excess facial hair Pelvic pain Acne When to see a doctor Consult your doctor if you've missed at least three menstrual periods in a row, or if you've never had a menstrual period and you're age 15 or older. Female reproductive organs Female reproductive system Amenorrhea can occur for a variety of reasons. Some are normal during the course of a woman's life, while others may be a side effect of medication or a sign of a medical problem. Natural amenorrhea During the normal course of your life, you may experience amenorrhea for natural reasons, such as: Pregnancy Breast-feeding Menopause Contraceptives Some women who take birth control pills may not have periods. Even after stopping oral contraceptives, it may take some time before regular ovulation and menstruation return. Contraceptives that are injected or implanted also may cause amenorrhea, as can some types of intrauterine devices. Medications Certain medications can cause menstrual periods to stop, including some types of: Antipsychotics Cancer chemotherapy Antidepressants Blood pressure drugs Allergy medications Lifestyle factors Sometimes lifestyle factors contribute to amenorrhea, for instance: Low body weight. Excessively low body weight — about 10 percent under normal weight — interrupts many hormonal functions in your body, potentially halting ovulation. Women who have an eating disorder, such as anorexia or bulimia, often stop having periods because of these abnormal hormonal changes. Excessive exercise. Women who participate in activities that require rigorous training, such as ballet, may find their menstrual cycles interrupted. Several factors combine to contribute to the loss of periods in athletes, including low body fat, stress and high energy expenditure. Stress. Mental stress can temporarily alter the functioning of your hypothalamus — an area of your brain that controls the hormones that regulate your menstrual cycle. Ovulation and menstruation may stop as a result. Regular menstrual periods usually resume after your stress decreases. Hormonal imbalance Many types of medical problems can cause hormonal imbalance, including: Polycystic ovary syndrome (PCOS). PCOS causes relatively high and sustained levels of hormones, rather than the fluctuating levels seen in the normal menstrual cycle. Thyroid malfunction. An overactive thyroid gland (hyperthyroidism) or underactive thyroid gland (hypothyroidism) can cause menstrual irregularities, including amenorrhea. Pituitary tumor. A noncancerous (benign) tumor in your pituitary gland can interfere with the hormonal regulation of menstruation. Premature menopause. Menopause usually begins around age 50. But, for some women, the ovarian supply of eggs diminishes before age 40, and menstruation stops. Structural problems Problems with the sexual organs themselves also can cause amenorrhea. Examples include: Uterine scarring. Asherman's syndrome, a condition in which scar tissue builds up in the lining of the uterus, can sometimes occur after a dilation and curettage (D&C), cesarean section or treatment for uterine fibroids. Uterine scarring prevents the normal buildup and shedding of the uterine lining. Lack of reproductive organs. Sometimes problems arise during fetal development that lead to a girl being born without some major part of her reproductive system, such as her uterus, cervix or vagina. Because her reproductive system didn't develop normally, she can't have menstrual cycles. Structural abnormality of the vagina. An obstruction of the vagina may prevent visible menstrual bleeding. A membrane or wall may be present in the vagina that blocks the outflow of blood from the uterus and cervix. Risk factors Factors that may increase your risk of amenorrhea may include: Family history. If other women in your family have experienced amenorrhea, you may have inherited a predisposition for the problem. Eating disorders. If you have an eating disorder, such as anorexia or bulimia, you are at higher risk of developing amenorrhea. Athletic training. Rigorous athletic training can increase your risk of amenorrhea. Complications Complications of amenorrhea may include: Infertility. If you don't ovulate and have menstrual periods, you can't become pregnant. Osteoporosis. If your amenorrhea is caused by low estrogen levels, you may also be at risk of osteoporosis — a weakening of your bones. Homoeopathic medicines There are a variety of homeopathic medicines which can be taken for amenorrhea. That being said, it is important to keep in mind the fact that these medicines should only be made use of after a qualified homeopathic doctor has checked the patient and approved of the medicine. For mothers who have not experienced menses after they started breastfeeding their babies, Sepia is the medicine which is usually recommended. In a similar way, Pinus lamb is recommended for women whose menses are delayed. While these happen to be a couple of very specific or niche medicines, a general medicine for amenorrhea is Pulsatilla. In fact, it is widely considered by doctors to be very effective. When amenorrhea is caused on account of the suppression of menses due to a tumour which is present in the ovaries, most allopathic doctors would be very worried. However, homeopathic doctors would know that there is a solution designed for this very situation, which is known as Apis Mel.
Dr. Rajesh Gupta12 Likes14 Answers - Login to View the image
18 year girl short stature ,fat c/o giddiness,tingling numbness,gen weakness since 4 weeks.advise treatment.
Dr. Mohan Katageri2 Likes11 Answers - Login to View the image
Friends today I am discussion about Hormanal imbalance. Hormonal imbalances occur when there is too much or too little of a hormone in the bloodstream. Because of their essential role in the body, even small hormonal imbalances can cause side effects throughout the body. Hormones are chemicals that are produced by glands in the endocrine system. Hormones travel through the bloodstream to the tissues and organs, delivering messages that tell the organs what to do and when to do it. Hormones are important for regulating most major bodily processes, so a hormonal imbalance can affect a wide range of bodily functions. Hormones help to regulate: metabolism and appetite heart rate sleep cycles reproductive cycles and sexual function general growth and development mood and stress levels body temperature Men and women alike can be affected by imbalances in insulin, steroids, growth hormones, and adrenaline. Women may also experience imbalances in estrogen and progesterone levels, while men are more likely to experience imbalances in testosterone levels. Symptoms Hormonal imbalance in men and women Everyone experiences periods of hormonal imbalance at certain points in their life, but these can also occur when the endocrine glands are not functioning properly. The symptoms of a hormonal imbalance depend on which glands and hormones are affected. Symptoms associated with the more common causes of hormonal imbalances include: unexplained weight gain or weight loss unexplained or excessive sweating difficulty sleeping changes in sensitivity to cold and heat very dry skin or skin rashes changes in blood pressure changes in heart rate brittle or weak bones changes in blood sugar concentration irritability and anxiety unexplained and long-term fatigue increased thirst depression headaches needing to go to the bathroom more or less than usual bloating changes in appetite reduced sex drive thinning, brittle hair infertility puffy face blurred vision a bulge in the neck breast tenderness deepening of the voice in females Causes Everyone will experience natural periods of hormonal imbalance or fluctuations at particular points in their life. But hormonal imbalances can also occur when the endocrine glands are not functioning properly. Endocrine glands are specialized cells that produce, store, and release hormones into the blood. There are several endocrine glands located throughout the body that control different organs, including the: adrenal glands gonads (testis and ovaries) pineal gland pituitary gland hypothalamus gland thyroid and parathyroid glands pancreatic islets Several medical conditions are known to impact some, or several, of the endocrine glands. Certain lifestyle habits and environmental factors may also play a role in hormonal imbalances. Causes of hormonal imbalances include: chronic or extreme stress type 1 and type 2 diabetes hyperglycemia (overproduction of glucagon) hypoglycemia (more insulin produced than there is glucose in the blood) underactive thyroid (hypothyroidism) overactive thyroid (hyperthyroidism) over- or underproduction of the parathyroid hormone poor diet and nutrition being overweight hormonal replacement or birth control medications abuse of anabolic steroid medications solitary thyroid nodules pituitary tumors Cushing's syndrome (high levels of the hormone cortisol) Addison's disease (low levels of cortisol and aldosterone) benign tumors and cysts (fluid-filled sacks) that affect the endocrine glands congenital adrenal hyperplasia (low levels of cortisol) endocrine gland injury severe allergic reactions or infections cancers that involve endocrine glands chemotherapy and radiation therapy iodine deficiency (goiters) hereditary pancreatitis Turner syndrome (females with only one functioning X chromosome) Prader-Willi syndrome anorexia phytoestrogens, naturally-occurring plant estrogens found in soy products exposure to toxins, pollutants, and endocrine disrupting chemicals, including pesticides and herbicides Hormonal imbalances in women Hormonal imbalance occurs during pregnancy Women experience several periods of hormonal change in their lifetime, primarily during puberty, menstruation, pregnancy and menopause. Women naturally experience several periods of hormonal imbalance throughout their lifetime, including during: puberty menstruation pregnancy, childbirth, and breast-feeding perimenopause, menopause, and postmenopause Women are also at risk of developing different types of hormonal imbalance disorders than men because they have different endocrine organs and cycles. Medical conditions causing irregular hormonal imbalances in women include: polycystic ovary syndrome (PCOS) hormone replacement or birth control medications early menopause primary ovarian insufficiency (POI) ovarian cancer Symptoms of hormonal imbalances in women include: heavy, irregular, or painful periods osteoporosis (weak, brittle bones) hot flashes and night sweats vaginal dryness breast tenderness indigestion constipation and diarrhea acne during or just before menstruation uterine bleeding not associated with menstruation increased hair growth on the face, neck, chest, or back infertility weight gain thinning hair or hair loss skin tags or abnormal growths deepening of the voice clitoral enlargement Bioidentical hormones: How are they used? Bioidentical hormones: How are they used? Hormone therapy and birth control pills both use bioidentical hormones. Learn more about them here. Hormonal imbalances in men Men also experience natural periods of hormonal imbalance during their lifetime. Natural causes of hormonal imbalances in men include: puberty aging Men are also at risk of developing different hormonal imbalances than women because they have different endocrine organs and cycles. Medical conditions causing hormonal imbalances in men include: prostate cancer hypogonadism (low testosterone) Symptoms of hormonal imbalances in men include: reduced sex drive erectile dysfunction (ED) low sperm count reduced muscle mass reduced body hair growth overdevelopment of breast tissue breast tenderness osteoporosis Treatment Treatment for hormonal imbalances may vary depending on the cause. Every person may require different types of treatment for hormonal imbalances. Treatment options for women with hormone imbalances include: Hormone control or birth control. For those who are not trying to get pregnant, medications containing forms of estrogen and progesterone can help regulate irregular menstrual cycles and symptoms. People can take birth control medications as a pill, ring, patch, shot, or an intrauterine device (IUD). Vaginal estrogen. People experiencing vaginal dryness associated with changes in estrogen levels can apply creams containing estrogen directly to vaginal tissues to reduce symptoms. They can also use estrogen tablets and rings to reduce vaginal dryness. Hormone replacement medications. Medications are available to temporarily reduce severe symptoms associated with menopause, such as hot flashes or night sweats. Eflornithine (Vaniqa). This prescription cream may slow excessive facial hair growth in women. Anti-androgen medications. Medications that block the predominately male-sex hormone androgen can help limit severe acne and excessive hair growth or loss. Clomiphene (Clomid) and letrozole (Femara). These medications help stimulate ovulation in people with PCOS who are trying to become pregnant. Those with PCOS and infertility may also be given injections of gonadotropins to help increase the chances of pregnancy. Assisted reproductive technology. In vitro fertilization (IVF) may be used to help those with PCOS complications get pregnant. Treatment options for anyone with hormonal imbalances include: Metformin. A medication for type 2 diabetes, metformin can help manage or lower blood sugar levels. Levothyroxine. Medications containing levothyroxine, such as Synthroid and Levothroid, can help improve symptoms of hypothyroidism. Treatment options for men with hormonal imbalances include: Testosterone medications. Gels and patches containing testosterone can help reduce symptoms of hypogonadism and other conditions that cause low levels of testosterone, such as delayed or stunted puberty. Natural remedies Some natural supplements can help hormonal imbalance Some natural supplements can be used to reduce symptoms. People have used natural supplements to treat hormonal imbalances for thousands of years. However, there are no natural remedies that have been consistently proven in clinical studies to treat hormonal imbalances and their causes, aside from lifestyle changes. Natural supplements commonly used for the reduction of symptoms associated with hormonal imbalances include: black cohosh, dong quai, red clover, and evening primrose oil for hot flashes caused by menopause ginseng for irritability, anxiousness, and sleep disturbances caused by menopause ginseng, and maca for ED Lifestyle changes that may help reduce the likelihood and symptoms of hormonal imbalances include: maintaining a healthy body weight eating a nutritious and balanced diet exercising regularly practicing good personal hygiene, focusing on washing areas with a lot of natural oils, such as the face, neck, back, and chest using over-the-counter acne washes, rinses, and medicated creams or gels for minor to moderate acne avoiding triggers that cause hot flashes, such as warm weather and spicy, rich, or hot foods and drinks reducing and managing stress practicing yoga, meditation, or guided visualization limiting sugary foods and refined carbohydrates avoiding packaged foods replacing older non-stick pans with ceramic pans using glass containers to store and heat foods and drinks restricting the use of cleaning products that contain toxic chemicals, such as bleach buying fruits and vegetables that have not been sprayed with pesticides or ripening chemicals not microwaving foods and drinks in plastics Outlook Nearly everyone experiences at least one or two periods of hormonal imbalance during their lifetime. Hormonal imbalances are more common during puberty, menstruation, and pregnancy. But some people experience continual, irregular hormonal imbalances. Many hormonal imbalances are caused by external factors, such as stress or hormone medications. However, hormonal imbalances can also be caused by any medical condition that impacts or involves the endocrine system or glands. A person should speak to a doctor about long-term unexplained symptoms, especially those that cause pain, discomfort, or interfere with everyday activities.
Dr. Rajesh Gupta9 Likes9 Answers
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