It is a sudden onset obesity. It is not related to hypothyroidism as such weight gains,of 11 kg do not occur in hypothyroidism. It also doesn't look like a case of ROHHAD disease ( rapid onset obesity with hypothalamic dysregulation , hypoventilation autonomic dysregulation ) . Get her investigations done 1.Lipid profile 2 CBC 3.LFT 4 Ultrasonography of abdomen. 5.HbA1C Treatment- 1.Dietary control - a low carbohydrate , low fat diet is recommended with plenty of water , high fibre in diet 2 Excercise - Regular work out is indicated including home tread mill if possible 3.Tab Orlistatin 120 mg B.D for at least 3 months 4.This change in life style should continue- otherwise once you stop orlistatin - again weight may be put on
Hypothyroidism causes all problems. It leads to obesity and even osteoporosis and thus hair loss. Line of treatment can be vamana in the first place for sroto shodhana. For vamana the mixture of Madanphala Pippali Churna, Vacha Churna, Madhu and Saindhava mixed in the quantity of 6 gms, 3 gms, 10 gms and 1.5 gms respectively can be diluted in 200 ml Yastimadhu Phant and given. Then you can give Tablet Gayatarin 1-0-1, Tablet Nirocil 1-0-1, Trayodashanga Guggulu 2-0-2. Yoga for abdomen perticularly can be given - pavanamukta-asana; ushtraasana, shashanka asana, etc. Avoid grams, curd. Brisk walking can be advised. Ask her not to take tension and remain calm
Mam Rule out also family history Navak guggulu 1tds Medohar guggul 1tds Agnitundi vati... 1bd Triphla churna... 2 tbspn At night aft meal Noni juice.... 15ml wd same quantity of Wtr twice a day And changes lazy life styles and avoid hot oily and fatty foods items. Take adequate quantity of Wtr and high fiber rich contain vegetables foods item Suggest one hour exercise a day for eg. cardio exercises for eg.. Skipping, walking. ..otherwise join in gym. And yoga also beneficial in such cases. Thank for tagging me @Dr. Sweety Aggarwal mam
Thank you @Dr. Sweety Aggarwal mam, most important part is Nidana parivarjana. Pathya apathy guidance. Yogasana and pranayam. Regards.
रोगी मेद वृद्धि से पीड़ित है। चिकित्सा संबंधी योग,,,, सप्ताह में दो दिन 18 घंटे तक उपवास रखें। सुबह को सूरज निकलने से पहले तेज चलने वाले कार्य लगातार रोजना करें। मेदोहर गुगल 2 वटी सुबह शाम जल से सेवन कराएं। लौह रसायन 5 ग्राम सुबह-शाम खाने से पहले दें। निश्चित रूप से लाभ होगा। योग परिक्षित है। पिछले 40 वर्ष से प्रयोग कर रहा हूं। नोट,,, लौह रसायन आप को स्वम् निर्माण करना होगा। इस का निर्माण कार्य करने का विधान चक्रदत्त के मेद रोग अध्याय में मिल जायेगा। मैं तो स्वम् निर्माण करता हूं।
TFN 34 2caps Twice daily Before Food. Wheat grass Tab 2 Tab Morning And Evening Twice daily. Along With Her Routine Medicines. Within 60 Days Gaining Of Weight Will Be Arrested. With These Medicines Please Give Her Perfect Diet Chart Advice Her For 1/2 To One hr Morning Walk And Other Exercises.
Weight gain due to harmonal imbalance Apple cidar vinegar with luckwarm water Green tea to increase metabolism Lemon and honey water Eat more protein in diet Eat fiber food Avoid processed food , sugary food Plan the meal Do cardio exercise daily , yoga and meditation Avoid stress Take sleep well Keep gut clear Kanchnar guggulu, medohar guggulu
Dear Dr. Sweety Aggarwal ma'am, Advice for the case. Continue previous treat and add as bellow. Tab. Kanchanar Guggulu 1tds. Tab. Medohar Guggulu 1 tds. Tab. Trifala guggulu 1 tds. Avoid Divaswap.
It is the case of hypothyroidism.It is not necessary sudden excecive weight gain is due to hypothyroidism. ...Rule out the cause. Investigations required... CBC LFT Lipid profile Hb1Ac PTH Till then follow above prescribed advices.
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44 yr old lady ,not a k/c/o DM/HT/Dyslipidemia c/o dyspnoea on exertion for the past 3 yrs along with 10% weight gain. On examination bilateral pitting pedal edema present more so on the right leg (photo attached) vitals are stable and all the systemic examinations normal. Also attaching the photo of her dry,coarse skin,mostly due to hypothyroidism P.s:Can pedal edema be severe enough to cause medial deviation of the toes??(photo attached) If not what are the reasons for it??Dr. Vaibhav Suresh5 Likes26 Answers
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Pitting oedema in legs prominent veins are seen with complain of low bp no complain of diabetes, low hemoglobin level 6 gm/dl. There is patches also present on whole body patches are centrally silvery and peripheral erythematousShubham Gour2 Likes21 Answers
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CUSHING'S SYNDROME. Cushing's syndrome is a hormonal disorder caused by prolonged exposure of the body's tissues to the high levels of hormone cortisol.It is also known as HYPERCORTISOLISM.It commonly affects adults aged 20-50. Too much cortisol in the body,regardless of the cause is called CUSHING'S SYNDROME. Pituitary gland tumour which produces excess ACTH leading to hypercortisolism is called CUSHING'S DISEASE. Hypercortisolism due to excess ACTH produced by a tumour elsewhere in the body is called ECTOPIC CUSHING'S SYNDROME. Cushing's syndrome caused by taking excess steroid medications is called EXOGENOUS CUSHING'S SYNDROME. SIGNS AND SYMPTOMS. Patients with Cushing's syndrome have upper body obesity and slender arms and legs. Most people with Cushing's syndrome have Round ,red, full face like a moon. moon facies Truncal obesity,supraclavicular fat pads,buffalo hump,weight gain. SKIN CHANGES. Atrophy, Purple striae. Easy bruising. Hirsutism. Acne, Pigmentation MUSCLE AND BONE CHANGES. Proximal muscle wasting and weakness Bone pain or tenderness. Rib and spine fractures caused by thinning of bones. Osteopenia or osteoporosis. PSYCHOLOGICAL PROBLEMS. Depression Cognitive function. Emotional lability. Diabetes or impaired glucose tolerance. Thirst,polydipsia,polyuria. Hypertension. Nephrolithiasis. Gonadal dysfunction,reduced libido,erection problems. Irregular periods. Growth restriction in a child. Destruction of anterior pituitary may cause hypothyroidism and amenorrhoea. Patients with ACTH producing tumours may develop headache,visual problems and galactorrhea. WHAT CAUSES CUSHING'S SYNDROME. Tasks of cortisol. *Helps maintain blood pressure and cardiovascular function. *Reduces the immune system's inflammatory response. *Balancing the effects of insulin *Regulates the metabolism of carbohydrates,proteins and fats. 1) Most common cause of cushing's syndrome is exogenous intake of steroids.like Prednisone for asthma,rheumatoid arthritis,lupus.Glucocorticoids taken to suppress immune system after transplantation to keep the body from rejecting the new tissue or organ. 2)Next common cause is PITUITARY ADENOMAS. 3) ECTOPIC ACTH SYNDROME. Benign or malignant tumours that arise outside the pituitary can produce ACTH.They are lung tumours especially all cell lung cancer,carcinoid tumours,thymomas,pancreatic islet cell tumours and medullary carcinomas of the Thyroid. 4) ADRENAL TUMOURS. Adrenal adenomas or adrenocortical cancers can cause Cushing's syndrome. DIAGNOSIS. The three most common tests used to diagnose Cushing's syndrome are. 1)24 HOUR URINARY FREE CORTISOL LEVELS. >>>50 - 100 if /day suggests Cushing's syndrome. 2) MEASURE MID NIGHT PLASMA CORTISOL AND LATE NIGHT SALIVARY CORTISOL. Cortisol production is normally suppressed at night ,but in Cushing's syndrome,this suppression doesn't occur . Cortisol levels of >>50 nmol/L , Cushing's syndrome is suspected. 3)LOW DOSE DEXAMETHASONE SUPPRESSION TEST.. (LDDST ).Here patient is given a low dose of dexamethasone ,by mouth every 6 hours for 2 days.Steroids signal the pituitary to release less of ACTH.So the normal response after taking dexamethasone is a drop in blood and urine cortisol levels.If cortisol levels do not drop,cushings syndrome is suspected. TESTS TO FIND THE CAUSE OF CUSHING'S SYNDROME. Once Cushing's syndrome is diagnosed,certain tests are done to locate the exact abnormality that leads to excess cortisol production. 1)CRH STIMULATION TEST. Injection of CRH causes a rise in ACTH and cortisol levels in patients with pituitary adenomas.But this response is not seen in adrenal tumours or ectopic ACTH producing tumours. 2)HIGH DOSE DEXAMETHASONE SUPPRESSION TEST (HDDST.) High doses of dexamethasone suppresses cortisol levels in people with pituitary adenomas but not ectopic ACTH producing tumours. 3)CT AND MRI. TREATMENT. Treatment depends on the exact cause of excess cortisol. PITUITARY ADENOMAS. Trans sphenoidal adenomectomy is most widely used surgery. For patients not suitable for surgery,radiation to the pituitary gland is given over a 6 week period. Cortisol inhibiting drugs like ketoconazole,mitotane,aminoglutethimide and methadone are also used. ECTOPIC ACTH SYNDROME Ectopic ACTH producing tumours or cancerous tissue is treated by surgery //radiation //chemotherapy //immunotherapy. ADRENAL GLAND TUMOURS. Surgery is the mainstay of treatment for benign and cancerous tumours off the adrenal glands. Primary pigmented micronodular adrenal disease and inherited Carney complex -primary tumours of the heart which cause Cushing's syndrome are treated by surgical removal of adrenal glands. POINTS TO REMEMBER. CUSHING'S SYNDROME IS A DISORDER CAUSED BY PROLONGED EXPOSURE OF THE BODY'S TISSUES TO HIGH LEVELS OF THE HORMONE CORTISOL. TYPICAL SYMPTOMS ARE UPPER BODY OBESITY,ROUND FACE,SKIN THAT BRUISES EASILY AND HEALS POORLY,WEAKENED BONES,ACNE AND MENSTRUAL IRREGULARITIES IN FEMALE,DECREASED FERTILITY IN MEN. IIATROGENIC CUSHING'S SYNDROME IS CAUSED BY EXPOSURE TO GLUCOCORTICOIDS. HYPERCORTISOLISM IS ALSO CAUSED BY PITUITARY TUMOURS OR LUNG TUMOURS. SEVERAL TESTS ARE DONE TO DIAGNOSE CUSHING'S SYNDROME AND IDENTIFY THE CAUSATIVE PATHOLOGY. TREATMENT DEPENDS ON THE CAUSE.THEY ARE SURGERY,RADIATION,CHEMOTHERAPY OR CORTISOL INHIBITING DRUGS.Dr. Suvarchala Pratap23 Likes23 Answers
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A obese patient age 40 yrs,weight 113kg has a following report. plz suggest a remedy for the patient for losing his weight and get rid from the obesityDr. Astha Agarwal1 Like32 Answers
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A case of bachache investigated and found to suffering from hypothyroidism, severe type of Dyslipidaemia, hyperuricaemia and vitamin D deficiency. He has been in fact no severe problems. He has been put on couple of medicine according to abnormalities. He had also visited different superspeciality hospital including CMC velore. The duration of treatment has been about 6 years more or less control of hypothyroidism, hyperuricaemia but poor control of Dyslipidaemia esp triglycerides and total cholesterol and ldl. Now patient become frustrated with treatment has stopped the treatment for 3 month. Presently patient presented with swelling of Rt foot between 1st and 2nd toes and no other problems. He is nondiabetic and non hypertensive. Below are his reports. How to manage and what is the cause of such severe Dyslipidaemia? Treatment given previously were Rosumac F, thyronorm 125 microgm, CCM 250 2×2,D3 Must 60 k 1 tab weekly .Dr. Deepak Ambastha3 Likes13 Answers