Concluded Case

Thyroidism

38 yrs female Diabetes and HTN patient has complaints the chronic motion sickness since from 1 year She was hypo Thyroidism patient using throx 75 mcg od since from 6 months Chief Complaints Motion sickness Weakness Mild stomach pain History Taking amlong 5 mg Telma40 mg Metformin 500 mg SR Vitals Normal Physical Examination Weakness Motions 4-5 times per day Investigations Cbc shows normal Hb 11.9 Electrolytes imbalence ESR rised to 60mm/hr Diagnosis TSH levels has been reduce from 8.20 to 0.07 within 1 year Management How can we manage thyroid patient. Is this hypo Thyroidism ? Or Hyper Thyroidism ? How can we manage motion sickness also .... Kindly do Dx or Rx ......

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Concluded answer

Low TSH indicate hyperthyroidism Thyroid disorders are known to shift between hypothyroidism to hyperthyroidism and hyperthyroidism to hypothyroidism In this case the patient was initially hypothyroid as TSH was high, but now the patient is hyperthyroid as TSH is low. please do Anti TSH receptor antibody Thyroid peroxidase antibody Thyroglobulin antibody for further analysis

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Low TSH indicate hyperthyroidism Thyroid disorders are known to shift between hypothyroidism to hyperthyroidism and hyperthyroidism to hypothyroidism In this case the patient was initially hypothyroid as TSH was high, but now the patient is hyperthyroid as TSH is low. please do Anti TSH receptor antibody Thyroid peroxidase antibody Thyroglobulin antibody for further analysis

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Thyroid Hormone Therapy: patients with hypothyroidism are most often treated with Levothyroxine in order to return their thyroid hormone levels to normal. HBA1c: Hemoglobin A1c is a blood test done to diagnose diabetes and monitor control in patients with diabetes... you have already been diagnosed with thyroid disease or diabetes, weight management is considered among the most effective strategies for the prevention of the other condition. Maintaining close control over your glucose and thyroid hormone levels can help prevent diabetes if you have thyroid disease... T2DM reduces thyroid-stimulating hormone levels and impairs the conversion of thyroxine (T4) to triiodothyronine (T3) in the peripheral tissues. Poorly managed T2DM can lead to insulin resistance and hyperinsulinaemia, which causes thyroid tissue proliferation and increases nodule formation and goitre size.

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38\F..k\c\o:DM..HTN.. reports were noted down. thyroid:sub clinical hypothyroidism converted in to hyperthyroidism. continuaton of levothyroxine drugs caused above changes. when tsh-0.9 medication should have stopped. Motion sickness:its due to severe electrolyte imbalance. red flags r seen in this case. since from ur above case presentation fluid loss history not present. cause of such electrolyte imbalance need to be evaluated. need to check kidney and adrenal gland functioning. do ECG..2decho..urine r/m..Sr ketones. what abt other reports. Advise: hospitalise the ptn. kesol need to be started. increase salt intake diet. with hold thyroid drugs.. repeat FT3..FT4..TSH..after 6 weeks. cardiac monitoring must. recorrection of electrolytes motion sickness may stop.

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HYPOTHYROIDISM CASE?? SUSPECTED STREPTOCOCCUS PNEUMONITIS ??. STARTS THE MEDICATION , RX , TAB - OFLOXACIN BD PC TAB - LEVOCET 5Mg BC TAB - Thyroxine 100mcg BD AC BEFORE FOOD.

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Reduced dose of throxin control diabetes

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Dose of Eltroxin should be reducedto 12.5 mcg repeat thyroid profile after 3 month ESR raised give inj Ceftrax TzIv Bd for 5days Inj Metron Iv Tds for 3 days Inj Ns3% iv Bd 2days then do serum Eletrolyte ,pt Na is 120m mol/ lit Tab Vizylac 500mg TDs for 15 days

Reports suggestive of hypothyroidism Start with 25 mcg of Eltroxin

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Hypothyroidism

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Hypothyroidism

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