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Need help in assessing the thyroid test report. Treatment options?

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General & Family Physician
Practicing since : 1980
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I need advice on thyroid.
My Wife has been detected as Thyroid positive after having tests done.
Following are the reports:
T3 : 110.25, T4 : 7.70 and TSH : 5.71
Anti-Thyroid Peroxidase Antibodies : 59.40
Thyroglobulin Antibodies (ATA) : 14.76
Reports are also attached. Kindly suggest us the needed treatment.
Posted Tue, 26 Jun 2012 in Thyroid Problem and Hormonal Problems
 
 
Answered by Dr. Rahul Tawde 36 minutes later
Dear XXXXXXX
Your wife's reports are suggestive of subclinical hypothyroidism, a mild form of hypothyroidism. Subclinical hypothyroidism usually doesnt cuse any symptoms and there are thre defimite indications for treatment. first if thyroid gland is enlarged(presence of goitre). second-if TPO ab levels are high. third if pregnant or pregnancy is being planned. if answer to all three is no then no treatment is reqd-just serial f/up of TSH every 6-12 mon.
Your wife's TPO levels are not high. so if she has goitre or preg is being planmed then treatment is necessary.if not then nothing is reqd just repeat TSH every 6 mon. during pregnancy tsh has to be less than 2.5 so whenever it is planned she needs to be treated.
Regards,
Shivaprasad
Above answer was peer-reviewed by
 
Follow-up: Need help in assessing the thyroid test report. Treatment options? 2 hours later
Thanks Sir,
We have following queries:
1. How to check if thyroid gland is enlarged(presence of goitre) or not. We have checked for external indications (there is no swelling around my wife's throat).
2. TPO is 59.40 while the lab reports says that the range is < 60 that means it is on the verge of crossing the safe range, is this worrisome?
3. Value of Thyro-globulin Antibodies is 14.76, what is the significance of this?
4. According to our doc Thyro-globulin Antibodies value is very much high and is the main reason to start the medicines now. He has told us that medicines will need to be taken for life long.
5. We will plan for our first baby after 3-4 months, so should we start medicines now?
6. My wife generally has low BP(100/65 to 110/70 ), feels weak, stressed quite often and get tired very soon.
7. Doc has prescribed following medicines for her :
1) T. Thyronorm 25 (1 tab for mon to Friday and 2 tab for sat-sun)
2) C. Thyrpwel (1 cap once a day for next 40 days)
We have not still started the medicines.
 
 
Answered by Dr. Rahul Tawde 14 hours later
1. It needs to be checked by doctor
2. Not worrisome. We see values in 100s and 1000s commonly
3. Nothing much. No relevance
4. I don't agree . Regarding lifelong medication probably yes - but call can be taken later on- post delivery, depending on the prevailing thyroid status.
5.Yes
6. These are unrelated to thyroid problem
7. Start the prescribed medications - before conception and during pregnancy TSH must be less than 2.5. Once it is close to that you can concieve, dosage may further need to be increased during pregnancy.
Above answer was peer-reviewed by
 
Follow-up: Need help in assessing the thyroid test report. Treatment options? 2 days later
1. What are the symptoms that can be observed for Sub-clinical hypothyroidism?My Wife weight is under 45Kg, and this is varying between 42 to 46 for last two year. Is this a effect of hypothyroidism?
2. Can you suggest some good Thyroid doctor in Pune or Mumbai Area (preferably in Pune) so that we can get the regular checkup and treatment.
3. Our family doctor told us that for now we can take Thyrowel only and there is no need to start Thyronorm as of now. After starting thyrowel we need to check TSH level after every three weeks and then decision can be taken accordingly.

We are very confused and worried, Your suggestion will be very helpful for us.
Can you give us your contact number so that we can get your advice in case of urgency.
 
 
Answered by Dr. Rahul Tawde 1 hour later
1. By definition Sub-clinical hypothyroidism will hardly have any specific symptoms. Variation in weight is not due to hypothyroidism, but related to diet and lifestyle.
2. There are a lot of excellent endocrinologists in Pune and Mumbai. Atleast 15 -20 of them in both places combined. It would not be appropriate for me to take names. Search in google.
3. Take thyronorm since your planning preganacy in near future. Decision on long term medication can be taken later on- post delivery, depending on the prevailing thyroid status.
There is absolutely nothing to worry about. I have personally seen untreated patients with TSH values as high as 150 seen 1st time during pregnancy. Your wife is having mildest form of hypothyroidism - so where is the question of concern and worry.
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