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Showing Symptoms Of Hypothyroidism. Having Frequent Headache And Sensitive To Cold. Experiencing Hair Loss And Dry Skin. Suggest

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Posted on Wed, 5 Jun 2013
Question: Dear Doctor,

My wife has started to show some symptoms of hypothyroidism since about the past 9 months.

We got married about a year ago, and her weight has gone up from 59 to 66 in the past 9 months. She normally eats quite healthy food, and we exercise about 3 days in a week. She gets frequent headaches, and she's oversensitive to cold. She's also been experiencing hair loss and is having dry skin.

We did our annual medical tests, and:

1. Her thyroid levels were slightly elevated
2. Her testosterone levels were higher too
3. Her periods are mostly regular, but recently the flow is lesser than normal
4. She gets hyper acidity sometimes, and experiences acid reflux frequently

We consulted with a local endocrinologist, but he suggested that everything is alright. I feel that his diagnosis was improper, and I need a second opinion. I've attached reports with this query.

Please advise on what tests or procedure should we do in order to correctly diagnose what her problem is, and how to solve it.
doctor
Answered by Dr. Om Lakhani (2 hours later)
Hi XXXXXXX

I have gone through your reports. Your wife has what is known as Subclinical hypothyroidism. What we need to do is to do a test known as Anti-TPO antibody. If this is positive then we need to start on low dose of Thyroid hormone. If it is negative we can repeat the thyroid function after 6 weeks

As far as higher testosterone is concerned , I would suggest the following additional tests for your wife

1. Serum Estrogen
2. SHBG
3. FSH
4. LH
5. Ultrasound of Pelvis (to look for ovaries)

The symptoms you have suggested and the slightly higher testosterone is suggestive of PCOS (Polycystic ovarian syndrome). We would be able to rule it our from the above tests. PCOS could possible affect fertility in future.

Please have these tests done an revert back. Glad to help

With Warm regards
Dr. Om Lakhani, MD, MACE (Member of American college of Clinical Endocrinology)
Endocrinologist.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Om Lakhani (1 hour later)
Dear doctor,

Thanks for your answer.

May I know if there are any conditions under which these tests are to be performed? For example, empty stomach, early morning, on the 4th day of period, etc.

Thanks,
XXXXXX
doctor
Answered by Dr. Om Lakhani (5 minutes later)
Hi

You need to get done these tests on day 2 of menstrual cycle. USG must be done immediately after periods are over.

Regards
Dr Om Lakhani.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Om Lakhani (2 hours later)
Dear Doctor,

Thanks for the information.

Are there any additional conditions like fasting while the blood sample is taken? Should the sample be taken during empty stomach, or so?

Thanks very much for your help.

Regards,
XXXXXX
doctor
Answered by Dr. Om Lakhani (3 minutes later)
Hi

No fasting is not required for the blood tests. Some labs insist on it but not strictly required. For USG fasting gives better results

Regards
Dr. Om Lakhani.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Om Lakhani (10 hours later)
Dear doctor,

Her periods are approximately a week away, and since the tests are to be performed during that time, I am going to accept this query as answered with 5 stars.

Do you mind if I directly post a question to you after the test results come?

Many thanks,
XXXXXX
doctor
Answered by Dr. Om Lakhani (2 hours later)
Dear Mr XXXXXXX

You are more than welcome to post a question to me once a reports come. I will be glad to follow up with you when the reports come.

With Warm Regards
Dr. Om Lakhani.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Om Lakhani

Endocrinologist

Practicing since :2004

Answered : 319 Questions

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Showing Symptoms Of Hypothyroidism. Having Frequent Headache And Sensitive To Cold. Experiencing Hair Loss And Dry Skin. Suggest

Hi XXXXXXX

I have gone through your reports. Your wife has what is known as Subclinical hypothyroidism. What we need to do is to do a test known as Anti-TPO antibody. If this is positive then we need to start on low dose of Thyroid hormone. If it is negative we can repeat the thyroid function after 6 weeks

As far as higher testosterone is concerned , I would suggest the following additional tests for your wife

1. Serum Estrogen
2. SHBG
3. FSH
4. LH
5. Ultrasound of Pelvis (to look for ovaries)

The symptoms you have suggested and the slightly higher testosterone is suggestive of PCOS (Polycystic ovarian syndrome). We would be able to rule it our from the above tests. PCOS could possible affect fertility in future.

Please have these tests done an revert back. Glad to help

With Warm regards
Dr. Om Lakhani, MD, MACE (Member of American college of Clinical Endocrinology)
Endocrinologist.