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What are the tests to be done to treat completely deteriorated health? - Online Doctor Chats

Date : 25-Mar-2014
User rating for this question
Very Good Posted in: Thyroid Problem and Hormonal Problems
Answered by

General & Family Physician
Practicing since : 2002
Answered : 106 Questions
User:My mother is in a nursing home for rehab, she was discharged from the hospital not strong enough to come home. Upon entry in hospital they found thyroid med should be increased from 75 to 100, her magnesium was low, which seems to be an ongoing problem, her electrolytes were diminished. I went to se her yesterday and she is like a zombie, I spoke w nurses this morning and they said her blood work is good. I believe her thyroid has been so bad for so long, it is killing her. I don't know what to recommend they do as far as testing and getting her the care she needs to get back on track. Can you help me with recommendations.
User:Are you collecting your thought
Doctor:I have read your query
User:Are you versed with thyroid especially in elderly
User:What do you suggest
Doctor:Thyroid can be easily ruled out with a blood test
Doctor:Was the blood test done?
User:I've read the basic thyroid test can show normal so there are more tests than the basic. Yes it was it showed normal
Doctor:Does she have swollen thyroid gland?
User:I don't know
Doctor:Swollen eyes are a symptom of goiter
Doctor:It can be due to iodine deficiency
Doctor:It may present with normal thyroid hormones
Doctor:Just the size of thyroid gland is increased
Doctor:The doctor can examine and recommend an ultrasound of the thyroid gland
User:I want to request they do more than the basic test to get proper medication before she stops talking
Doctor:For thyroid tsh, T3 and T4 are the tests
Doctor:further tests are done if something comes up on these tests
User:She does not have swollen eyes though. They are constantly watering
Doctor:For example antibodies to the some component of thyroid gland can be tested
User:What does that do
Doctor:Antibodies attack the gland and reduce the formation of thyroid hormone
Doctor:for example anti-tpo antibpdies
Doctor:A proper work-up is needed to find the diagnosis
User:Can a person's health deteriorate so rapidly, well an elderly person. I'm feeling they are just looking at it as old age. I don't think she's ever had a thorough thyroid investigation. She just stares ahead and if I ask her if she is ok she says yes. So unresponsive
Doctor:It seems like gRAVES ophthalmopathy
User:What is that?
Doctor:Graves ophthalmopathy happens due to hyperthyroidism
Doctor:when the thyroid hormones are in excess
User:I'm confused, they increased the med because blood work indicated deficiency
Doctor:From your description it seems that she was hypothyroid and her hormone dose was increased
Doctor:I think a visit to an ophthalmologist should also help
User:I'm not a doctor,, I'm just desperate to help my mother. She is still young but just a shell it seems. The eye issue has been ongoing she has seen various doctors for that, even had tubes put in
Doctor:It can also some swelling behind the eyes for some other reason
User:So all of the symptoms, severe itchiness years ago, never diagnosed
Doctor:itching can just be from dry skin
User:Headaches, vertigo, weakness, trouble swallowing lately, and now not able to communicate verbally very much, also loss of hearing
Doctor:Loss of hearing and weakness may be age related
User:This itchiness was non stop,saw dermatologist, used all kinds of tropical, and even some meds, I believe
Doctor:I think for itching on skin she may take cleaner water to drink as it may be fungal infection
User:Have you knowledge of elderly people failing due to thyroid.
User:What would you do for your mother if you were me
Doctor:Not just elderly even young people detriorate on thyroid
Doctor:Unless some lifestyle changes take place
User:She does not have stickiness now
Doctor:I understood the nature of the problem she is facing
User:She always ate well, does not take many medications.
Doctor:Is she taking enough proteins nowadays
User:What do you suggest, the above tests and seeing if thyroid is enlarged
Doctor:Since protein deficiency may also give the look of protruding eyes
User:She does not have protruding eyes.
User:Any more suggestions before I go
Doctor:Actually in this case it may just be low diet
Doctor:You need to check on her regularly and se what she is eating
Doctor:She needs to take a complete diet
Doctor:A balanced diet is a must
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