A male patient aged 29yrs IT Professional feeling depressed since 1yr due to love breakup and having history of severe lethargy and weakness since 6m.he underwent tsh profile.Tsh 150 and t3 t4 below normal levels. Lipid profile revealed normal triglycerides and mild increase in cholesterol.he was started on eltroxin 100mcg and after 3m duration tsh 11.13 t3 11.3 t4 12.1 No statins were given. Tab eltroxin 100mcg was continued till date in view of any change in dose may lead to increase in tsh levels He had a history of epigastric discomfort and pain after having meat and burger 1 week back and left arm dragging pain since 3days.He was given dolo 650 tab meftal spas cap rabemac dsr and he felt discomfort relieved. ecg was attached which was done last night.Pls give your valuable suggestions on further management

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Everything seems to be normal. he is in depression . And depression may one of the cause for his APD. lets continue the same management and once psychiatrist's consultation.

WNL,, CONTINUE SAME TREATMENT AND PLZZ REFER HIM URGENTLY TO PSYCHIATRIST OTHERWISE ANYTHING CN HAPPEN,, DEPRESSION IS ITSELF A VERY MORBID CONDITION,,,

Ecg appears normal. Continue eltroxin with periodically doing thyroid profile. Depressed patients usually present with variety of symptoms. Sometimes the antidepressants may cause side effects. Rule out vital organ dysfunction when ever required

Continue the same t/t.Add antidepressant and counseling. If he is having dyspeptic symptoms for the first time better to do a TMT.

A case with normal ecg.might be suffering from morbid depression leading to apd

Increase the dose of Eltroxin to 125microgm 1-0-0. Repeat TSH after 3 months.

Good suggestion.
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I agree with Dr S Shinde

Thanku sir !!!
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LAD LAHB

Get Vit D3 level and Vitamin B 12 levels.

ECG normal Continue eltroxin Could be Stress induced APD Avoid junk foods Add tab.pantocid OD Tab.rexipra forte HS

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