Brief Answer:
PCOD Thyroid

Detailed Answer:
Most endocrine conditions are fairly complex and require a thorough in-person examination and regular follow up to provide proper care.

Kindly note:

1 The diagnosis of PCOD can be challenging. New criteria have recently been issued and are best applied by endocrinologists in making the diagnosis correctly.
Some elements include blood tests for testosterone and prolactin, and an ultrasound examination of the ovaries

2 Regarding the thyroid, one needs to ascertain first if you truly have an under active thyroid that necessitates the use of thyronorm for life. Once that question is answered, the next step is to ensure you get ideal doses to make feel best and have optimal pregnancy outcomes

3 For the above, blood tests such as
TSH
Free T4
Anti TPO (thyroid peroxidase) antibodies
Anti TG (thyroglobulin) antibodies
are very helpful. None of these require fasting, and can be done at any time.

4 If your menstrual cycles are regular and because you are not overweight, there is no compelling reason to be on Metformin unless your blood tests show a tendency for developing diabetes. This is called pre diabetes. There is a simple blood test for this called HbA1c. It does not require fasting and can be done at anytime of the day or night. The best test however, is a 75 gram Oral glucose tolerance test.

5 PCOD is a complex condition and there are few absolute answers. So whether it is curable or not and whether your hormones will normalize depends from person to person on a host of factors. These are discussed individually based on the findings on personal examination and overall detailed evaluation

6 Your work out regimen seems reasonably good to me. Again there is no time cut offs recommended specifically for individuals. If a person with PCOD is overweight or obese, she is advised to try to lose at least 5 to 10% body weight by starting with at least 150 minutes of physical activity per week along with eating healthier

7 To the best of my knowledge, there is no PCOD - specific diet. A balanced diet is enough. It is difficult to strictly adhere to a tight diet. We are all human and once in a while we will feel tempted to eat a snack of our choice.

8 Before you proceed to any surgery a comprehensive assessment by an endocrinologist is required.
I understand you wish to seek my continued consultation but unfortunately this is neither possible nor the purpose of this online forum. We are here to address specific queries only. There are well qualified MD DM Endocrinologists in XXXXXXX who can attend to you on an ongoing long term basis.

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Brief Answer:
Follow up

Detailed Answer:
It does not really matter much but it is preferred that you do not have the blood sample taken right after taking thyronorm that day. So if you intend to have the test done in the morning then that one day you may wish to take your thyronorm later instead of first thing in the morning fasting. It is acceptable to do so once on the day of the test.
If you are going later in the evening, it would be fine to take the thyronorm the usual way.

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Brief Answer:
Second follow up

Detailed Answer:
I dont see any attached report.Kindly ask the moderator to assist us

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Brief Answer:
Third follow up

Detailed Answer:
I have reviewed the reports. Even though the anti thyroglobulin antibodies are placed in the equivocal range by the lab parameters, the TPO antibodies are categorically positive.
TPO antibodies are the ones commonly associated with permanent hypothyroidism. Typically individuals who are positive for this develop an inder active thyroid that requires thyroid medication for life.
However, there are a couple exceptions:

1 Sometimes individuals have positive thyroid auto antibodies but normal thyroid function as evidenced by normal TSH and free T4 without any medication ie at baseline.
This means that at least at that point in time, their thyroid is functioning fine. But they should undergo periodic TSH check at annual intervals or more often if symptoms of hypothyroidism seem to occur. Kindly see list at the bottom for some symptoms of hypothyroidism.
Such individuals may never develop hypothyroidism or it could occur at any time in life. The best way to handle this is to undergo regular TSH checks for life

2 A small minority of normal people have positive thyroid autoantibodies. This is sometimes referred as 'false positive' ie they are not at risk for developing hypothyroidism but due to laboratory/artifactual/testing limitations their blood tests positive for these.
Such individuals are extremely unlikely to develop hypothyroidism.

Symptoms of hypothyroidism (an under active thyroid) include:
Weight gain despite low appetite
Difficulty losing weight
Dry skin
Feeling colder than others
Hair loss
Puffy face
Swollen legs
Tiredness
Heavy flow during menses
Neck swelling
Mood, memory, concentration problems
Constipation

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