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Dr. Andrew Rynne

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Does hypothyroidism cause ovarian cyst?

Answered by
Dr.
Dr. Minal Mohit

Endocrinologist

Practicing since :1998

Answered : 808 Questions

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Posted on Fri, 3 Aug 2018 in Thyroid Problem and Hormonal Problems
Question: Hello Dr,

This is a long story but I'll be as precise as possible.

In mid-2014, my presently 64yo mom went for a full body health checkup at Saifee hospital and was diagnosed hypothyroid, but after starting thyroxine 25mg for first 2-3 days and feeling very dizzy/fainty, we stopped it and didn't bother about taking it again. No health checkup for next 3.5 years either.

Last week, she went for another full body health checkup and during the pelvic/abdominal USG, she was diagnosed with 2.9x2.3x2.5cm cystic lesion with internal echoes and few septae in right adnexa and similar lesion 3.9x3.6x2.5cm in left adnexa, both ovaries not seen separately. No evidence of free fluid or mass in pouch of XXXXXXX This has left us terrified because she has a family history of her sister dying of OVCA 30 years ago at the age of 36. Despite normal CA-125 levels and no evidence of metastasis in the CT scan, our gynecologist is recommending a total hysterectomy with bilateral oophorectomy via laparotomy as soon as possible due to family history and rarity of complex septated bilateral cysts in postmenopausal women.

We're very devastated as we were supposed to be flying to US on the 30th to visit my dad who's a US citizen. But now, we're in two minds based on different opinions - whether to wait/watch the cysts, or be precautionary and get the surgery done.

However, amidst all this chaos, I've been reading stuff online and there seems to be a link between hypothyroidism and ovarian cysts, but I'm not sure if it applies to postmenopausal women. Her thyroid tests show Free T3 4.85, Free T4 9.17 and TSH 9.85 which is again, untreated hypothyroidism.

Is there any possibility that the hypothyroidism is causing these ovarian cysts? Before taking the decision for surgery, should I consider re-starting thyroid and wait/see what happens? I also don't want to regret just in case there's any early malignancy that can be fully cured via surgery right now vs possibly metastasizing due to a 2-3 month delay.
doctor
Answered by Dr. Minal Mohit 8 hours later
Brief Answer:
treat both, hypothyroidism and ovarian mass.

Detailed Answer:
Dear xxxxxx, hi! i can understand your concerns and your guilt.
1. do not regret , hypothyroidism has not led to ovarian mass.
2. treating hypothyroidism is important , more so before surgery.
3. treating hypothyroidism will not resolve the mass, but normalizing thyroid balance before surgery or otherwise is important.
4. now whether to operate and how urgently, is a gynecologist's perspective , i am no one to comment. but general medicine knowledge tells me surgery will be required.
regards!
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Minal Mohit 2 hours later
Hi Dr XXXXXXX . I remember chatting with you last time about mom’s hypothyroid problem.. wish we started the thyroid meds back then itself..

But doctor, if we have to do the ovarian surgery right now, how can we correct the thyroid so soon? If I’m not wrong, thyroid correction can take several weeks because we first start on a los dose then keep increasing every 4-6 weeks till blood reports show normal values correct?
doctor
Answered by Dr. Minal Mohit 6 hours later
Brief Answer:
please start thyroxine now.

Detailed Answer:
Dear sir/madam, yes i remember having discussed earlier. by gones are gone. let us start now, yes you are correct thyroxine needs time, it is slowly corrected. but for surgery , 15 days are sufficient to normalize the balance. we may start with adequate dose of 1 mcg / kg per day. take it early morning , empty stomach and do not take anything over it for another 30 minutes, no food, no beverage, no medicine.
regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Minal Mohit 3 minutes later
Hi Dr. XXXXXXX

Thanks for your reply. 1 mcg/kg per day means 52mcg for her. Last time, when she started just 25 mcg and in 2-3 days, she felt super dizzy/fainting. Can we start with a little less please?Also, can she take it 1 hr after dinner at night instead and then not eat anything for another 1 hr?? Easier to remember that way.
doctor
Answered by Dr. Minal Mohit 2 minutes later
Brief Answer:
time is a constrain in your case.

Detailed Answer:
Dear sir, yes i remember, we could do that . start with 25 and go to 50 but then that will require at least 6 weeks before surgery can be taken up.
regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Minal Mohit 1 hour later
Can we just do the surgery first then before starting the meds? What are the risks exactly?

She had also gone through hip replacement surgery in 2016 while hypothyroid, and everything was okay.
doctor
Answered by Dr. Minal Mohit 11 hours later
Brief Answer:
Not sure how u got PAC cleared

Detailed Answer:
Dear Sir, I don't know how anaesthetist and surgeon got the physician clearance and not sure of the risks now involved. your decision again sir.
REGARDS
Above answer was peer-reviewed by : Dr. Nagamani Ng
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