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Hypothyroid - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: Thyroid Problem and Hormonal Problems
Answered by

General & Family Physician
Practicing since : 2004
Answered : 40 Questions
Doctor :   hi
Doctor :  
how can I help you?
User :   hello
User :   i want to ask u about hypothyroid
Doctor :  
ok, Plz proceed
User :   recently i had tested my wifes blood for T3,T4,and TSH where she had low t3 and T4 but high TSH
User :   TSH is 99.52
Doctor :  
thats the signs
User :   now what is the treatment ?
Doctor :  
the treatment is
User :   report came yesterday
Doctor :  
thyroid hormone replacement
Doctor :  
does she have the swelling
User :   ya
User :   leg
Doctor :  
in the neck
User :   face
Doctor :  
okay but no thyroid swelling in the neck
User :   no
Doctor :  
only swelling of the face leg
User :   ya
Doctor :  
okay is there swelling of the abdomen
User :   ya little bit
Doctor :  
okay is she fine with her day to day activity
User :   not feeling well
User :   feeling very lazy
Doctor :   what is her age and complaints
Doctor :  
now
User :   32
User :   constipation,swelling
Doctor :  
how about her periods
Doctor :  
are they regular now
User :   last time was very heavy
Doctor :   yes
Doctor :  
as i thought
Doctor :  
does she feel very tired
User :   ya
Doctor :  
and blank most of the time
User :   ya
Doctor :  
can she tolerate cold
Doctor :  
now like cold water face wash
User :   ya but feel cold than me
Doctor :  
okay
Doctor :  
does she have any other problems like diabetes ,TB , etc
User :   no not at all sugar is 74 mg/dl
Doctor :  
okay thats good
Doctor :  
as her treatment with thyroxine tablets started
User :   ya from today she took her first dose
User :   25MCG
Doctor :  
okay this is the fist tablet in her life
User :   ya
Doctor :  
okay
User :   is it right dose?
Doctor :   yes we star with this dose
Doctor :  
and wait for the response
User :   but she is feeling like angina like symptoms
Doctor :  
and according to the body response we alter or maintain the dose
User :   ya
User :   chest discomfort is due to medicine?
Doctor :  
okay is it pain or feeling the heart beat
Doctor :  
or difficulty in breathing
User :   just feeling but not always
User :   sometimes feeling dizziness
Doctor :   if the symptoms persist or if you think something is wrong immediately consult your doctor he will examine her for the signs of overdose if present he will alter the dose.

Doctor :  
because these two symptoms can fit into over and lower dose
Doctor :  
if there is feeling of heart beat
User :   ya
Doctor :  
sweating
User :   sometimes
Doctor :  
hurried breathing
User :   no
Doctor :  
increased anxiety which was not there previously
User :   no
Doctor :  
cannot tolerate heat as previously
User :   no
Doctor :  
more active
User :   ya
Doctor :  
increased body temperature
User :   no
Doctor :  
than before
User :   temp is normal
User :   BP was low 100/70
Doctor :  
all this things which i asked now are
Doctor :  
the symptoms of overdose
User :   ya
Doctor :  
first time there will be these symptoms
Doctor :  
but mild
User :   today she took 25 mcg in the morning
Doctor :  
as the body as recived suddenly more of hormones
Doctor :  
if these symptoms are not mild
Doctor :  
then the dose is made to 12.5 mcg
Doctor :  
but since as you have said that swelling are there
User :   major problem is little angina like discomfort
Doctor :  
it is due to the stimulation of the heart by the hormone
User :   should i reduce the dose to 12.5?
Doctor :   no
User :   ok
Doctor :  
since the swelling is there the doctor as started her on 25
User :   ya
Doctor :  
which is the effective in this stage
Doctor :  
she is taking only one per day right
User :   what is the starting dose in this conditions?
User :   ya
User :   in empty stomach
Doctor :  
when there is mild syptoms in early stages it is 12.5mcg per day
Doctor :  
but when the symptoms are more 25
User :   ya
Doctor :  
if not controlled can be increased appropriately according to the need
User :   ya
Doctor :   Thryoid medicine works best on an empty stomach and when taken 1 hour before any other medications. Do NOT take thyroid hormone with calcium, iron, multivitamins, alumin hydroxide antacids, colestipol, or other medicines that bind bile acids, or fiber supplements.

User :   for constipation what is the good drug for her?
Doctor :   how lon is it there
Doctor :  
mean long
User :   ya since last one weak
Doctor :  
okay then she can take tab dulcolax one at night for 2 days
User :   ya
Doctor :  
that will clear it
User :   ya
User :   any b cmplex?
Doctor :  
can be taken but avoid taking in the morning
User :   ya at night
Doctor :  
the thyroxine acts best when alone in empty stomach
Doctor :  
others later
Doctor :  
comp at afternoon is best
User :   she is taking at 9 am
Doctor :  
which thyroxune
Doctor :  
sorry thyroxine
User :   thyroxine sodium
User :   brand name is THYROX-25
Doctor :  
thyroxine action early in the morning before food best if taken in half an hour after waking up
User :   is it right?
Doctor :  
yes
User :   ya she wake up at 6 am everyday
Doctor :  
the around 6:30 if she takes it is good
User :   ya
Doctor :  
bcoz the action is best
Doctor :  
and she feel good
Doctor :  
soon
Doctor :  
it should become an rule for life
User :   after walking up?
Doctor :  
no after getting up from the sleep
User :   any diet at night?
Doctor :  
okay
Doctor :  
but she that fiber content should be in limit
Doctor :  
not too much
User :   ya
Doctor :  
especially in morning
Doctor :  
avoid fiber as uch as possible
Doctor :  
bcoz it interacts with the thyroxine
Doctor :  
and delays it absorption and action
User :   as she had started medicines will it be any problem in her periods?
Doctor :   it will take time to get corrected
User :   ya
Doctor :  
as the level is maintained in blood
User :   will it be heavy this time?
Doctor :  
almost all the symptoms will be corrected
Doctor :  
if it more than 15 days of medication
Doctor :  
it will not be heavy
User :   how manydays it will take to correct all clinical symptoms?
Doctor :  
minimum of a month and the maximum depnds on individual variation
User :   ya
Doctor :   okay any other quiries
User :   any other medicines needed for this conditions?
User :   can the baby take mothers milk at this stage?
Doctor :  
not necessary this condition is specific and that is sufficient . baby can be breast fed
User :   with this hormone therapy?
Doctor :  
yes
User :   ya
Doctor :  
it is safe for the baby
Doctor :  
no worries
User :   any other suggetions?
Doctor :  
to follow up regularly with your doctor
Doctor :  
regular t3 t4 tsh prfile
User :   why this thing happened after delivery?
Doctor :  
atleast once in 3 months in starting
Doctor :  
and later for 6 months
Doctor :  
and normal day to day activities to be maintained
User :   ya
Doctor :  
and healthy food habbits reduce fibers espcially cabbage cauliflower
Doctor :  
and mustard
Doctor :  
and reduce calcium rich food
User :   ya
User :   milk at night?
Doctor :  
others are same as for other patients
Doctor :  
okay
Doctor :  
thats not a problem at night
User :   what will be the morning diet?
Doctor :   any cereal or staple with less or no fiber & calcium

User :   and during lunch time?
User :   rice is good or not?
Doctor :  
its god
Doctor :  
good
Doctor :  
not a problem with rice
User :   cereal and staple is dal or something else?
Doctor :  
staple is the regular diet
Doctor :  
which you take
User :   her weight was 52kg now it is 61
Doctor :  
it is due to the swelling
User :   how many days it will take to reduce?
Doctor :  
it will come down with medication
Doctor :  
it will be slow bcoz other methods are not effective now
Doctor :  
the chnges will take place soon
User :   ya
Doctor :  
and if regular by one month
User :   actually why this condition happened to her after child delivery?
Doctor :  
it would have started before but mild
User :   ya but is it 100% curable with medicines?
Doctor :  
wouldnt have come to the notice later in pregnancy
Doctor :  
it as come to light thats it
Doctor :  
it is just hormone replacement
Doctor :  
so taking tablet life long is the cure
User :   throughout lifelong?
Doctor :  
yes only few cases doesnt require
Doctor :  
like due to viral infection
User :   ya does it happen due to cold?
Doctor :  
but majority lifelong
Doctor :  
that is rare due to cold
User :   as they have no family history of hypothyroid
Doctor :  
it ca be sporadic one
User :   what type of salt can she take?
Doctor :  
she can take normal salt or iodised
User :   what type of yoga can she be allowed to do?
Doctor :  
she can perform all soon
User :   sir thank u very much for ur kindly information
Doctor :   please fill the feed back form before leaing
User :   ya sent
Doctor :  
and feel free to log into our paid service anytime we are here 24hrs/7days
User :   if any necessary i will take ur help
User :   right?
Doctor :   thanks we are at your service
User :   thank u goodnight,God bless u
Doctor :   good night

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