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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Pain Under Feet. Diagnosed With High Thyroxine Level. Has Lichen Plannus. Cure?

Hi, This is Biswajit.....
My age is 27 height 5' 6".
I was having pain under my feet for long time. Recently I have been diagonised with High Thyroxine level. My thyroxine level is 10.5. Is it a matter of concern? I was also suffering from Lichen plannus for about 3 years and now I have recovered very much. But again one new problem. Please advise.
Wed, 26 Jun 2013
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General & Family Physician 's  Response
HELLO,
Normal level of free T4 or free thyroxine is 0.7 to 2 and normal level of total T4 is about 4.5 to 12.5 , so if you have mentioned about free T4 then it is really a matter of concern and it goes toward the diagnosis of hyperthyroidism, but the level of your TSH is required for further diagnosis of hyperthyroidism whether it is due to primary disorder graves disease or secondarily due to increased TSH secretion from pituitary due to pituitary adenoma which will further need brain scan to diagnose it.
for treating it you can take tab. carbimazole(neomercazole) 30mg/day or propylthyouracil 450 mg/day. monitor T3 and T4 level after 6-8 weeks if still increased thyroxine level then repeat the same drug for same interval and repeat again T3 and T4.if still resistant then increase the level of neomercazole by 15mg/day maximum of 120mg/day of neomercazole or 1200mg/day of propylthyouracil can be taken.
If T3, T4 comes down to normal then tapper the dose of these drugs slowly over months to minium dose to mantain the euthyroid state.
Its better to be in contact with a doctor regularly for further management of thyroid dysfunction.
For lichen plannus inj. unidrol 80mg/2ml deep intragluteally once in 2-4 weeks for 2-3 injection, for itching levocetrizine 1 o.d., in chronic case inj.kenacort or wycort 10 mg intralesionally in localised lesions, flutivate cream HS, diprovate cream at night for 20 days then retino A cream plus diprovate cream for 1-2 months at night.
wishing all best for you.
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Have Pain Under Feet. Diagnosed With High Thyroxine Level. Has Lichen Plannus. Cure?

HELLO, Normal level of free T4 or free thyroxine is 0.7 to 2 and normal level of total T4 is about 4.5 to 12.5 , so if you have mentioned about free T4 then it is really a matter of concern and it goes toward the diagnosis of hyperthyroidism, but the level of your TSH is required for further diagnosis of hyperthyroidism whether it is due to primary disorder graves disease or secondarily due to increased TSH secretion from pituitary due to pituitary adenoma which will further need brain scan to diagnose it. for treating it you can take tab. carbimazole(neomercazole) 30mg/day or propylthyouracil 450 mg/day. monitor T3 and T4 level after 6-8 weeks if still increased thyroxine level then repeat the same drug for same interval and repeat again T3 and T4.if still resistant then increase the level of neomercazole by 15mg/day maximum of 120mg/day of neomercazole or 1200mg/day of propylthyouracil can be taken. If T3, T4 comes down to normal then tapper the dose of these drugs slowly over months to minium dose to mantain the euthyroid state. Its better to be in contact with a doctor regularly for further management of thyroid dysfunction. For lichen plannus inj. unidrol 80mg/2ml deep intragluteally once in 2-4 weeks for 2-3 injection, for itching levocetrizine 1 o.d., in chronic case inj.kenacort or wycort 10 mg intralesionally in localised lesions, flutivate cream HS, diprovate cream at night for 20 days then retino A cream plus diprovate cream for 1-2 months at night. wishing all best for you.