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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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32 Year Old With Hypothyroidism And PCOS. On Synthroid And Metformin. Migraines, Dizziness And Breathlessness. Due To Anxiety?

Im a 32 year old female with a hypothyroid and PCOS . i take synthroid and metformin . im obese - 5 7 and 250lbs. I get migranes. Lately I ve been having spells where I realize I m not breathing, like I m accidentally holding my breath. I get dizzy. I had a few moments when my heart felt weird. I do t have health insurance and I can t afford hospital bills. Is this anxiety or something worse? I just had a baby 15 months ago, and I m concerned.
Mon, 2 Dec 2013
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General & Family Physician 's  Response
hello there!
thank you for asking
You have 3 issues.
1)hypothyroidism
needs continuous compliant thyroid medicine use. Over dosa and under dose will both complicate issues. You need euthyroid state.

2)Anxiety breathing issues , You need to lose weight. All weired feelings will vanish.

3)PCOS
Lifestyle modifications will be a good start and are considered first-line treatment for women with PCOS. Such changes include the following

Diet(A diet patterned after the type 2 diabetes diet has been recommended for PCOS patients) increase fiber; decrease refined carbohydrates, trans fats, and saturated fats; and increase omega-3 and omega-9 fatty acids.

Exercise regularly and minimum 45 minutes a day.

Take vitamin D as 75 5 cases of PCOS resulting infertility are corrected once low Vitamin D levels are corrected.

Weight loss is the most important thing you need.

Use following medications
Oral contraceptive agents (eg, ethinyl estradiol, medroxyprogesterone)

Antiandrogens (eg, spironolactone, leuprolide, finasteride)

Hypoglycemic agents (eg, metformin, insulin)

Selective estrogen receptor modulators (eg, clomiphene citrate)

Topical hair-removal agents (eg, eflornithine)

Topical acne agents (eg, benzoyl peroxide, tretinoin topical cream (0.02–0.1%)/gel (0.01–0.1%)/solution (0.05%), adapalene topical cream (0.1%)/gel (0.1%, 0.3%)/solution (0.1%), erythromycin topical 2%,
clindamycin topical 1%, sodium sulfacetamide topical 10%)

Good Luck
S Khan
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32 Year Old With Hypothyroidism And PCOS. On Synthroid And Metformin. Migraines, Dizziness And Breathlessness. Due To Anxiety?

hello there! thank you for asking You have 3 issues. 1)hypothyroidism needs continuous compliant thyroid medicine use. Over dosa and under dose will both complicate issues. You need euthyroid state. 2)Anxiety breathing issues , You need to lose weight. All weired feelings will vanish. 3)PCOS Lifestyle modifications will be a good start and are considered first-line treatment for women with PCOS. Such changes include the following Diet(A diet patterned after the type 2 diabetes diet has been recommended for PCOS patients) increase fiber; decrease refined carbohydrates, trans fats, and saturated fats; and increase omega-3 and omega-9 fatty acids. Exercise regularly and minimum 45 minutes a day. Take vitamin D as 75 5 cases of PCOS resulting infertility are corrected once low Vitamin D levels are corrected. Weight loss is the most important thing you need. Use following medications Oral contraceptive agents (eg, ethinyl estradiol, medroxyprogesterone) Antiandrogens (eg, spironolactone, leuprolide, finasteride) Hypoglycemic agents (eg, metformin, insulin) Selective estrogen receptor modulators (eg, clomiphene citrate) Topical hair-removal agents (eg, eflornithine) Topical acne agents (eg, benzoyl peroxide, tretinoin topical cream (0.02–0.1%)/gel (0.01–0.1%)/solution (0.05%), adapalene topical cream (0.1%)/gel (0.1%, 0.3%)/solution (0.1%), erythromycin topical 2%, clindamycin topical 1%, sodium sulfacetamide topical 10%) Good Luck S Khan