Suggest treatment for hypothyroidism
Please suggest on immediate next steps.Also there are ketones detected in report
Sugars very high, needs insulin. Hypothyroidism - needs thyroxine
Welcome to HCM. I have gone through your question and understand your concerns.
The problems with his reports
1. Diabetes - Uncontrolled, sugars high, HbA1C very high
Action needed: He needed to get hospitalised immediately and get started on insulin and intravenous fluids. The treatment of diabetes at this point will be only insulin as his weight loss, very high sugars and ketones in urine suggest insulin deficiency. Once sugars are controlled his weight and general condition will improve and can be tried with oral medicines for diabetes. Ketones are not very high. It will dissapear once insulin is started and fluid intake is increased.
2. Hypothyroidism - His thyroid function is showing high TSH. That means his thyroid is under active and not producing enough thyroid hormones
Action: He needs to be on thyroid medicines. Usually we start thyroxine at a dose of 100 mcg per day (thyronorm or eltroxin).
3. Vitamin D is deficient - vitamin D replacement (60,000 iu once in a week x 8 weeks) is needed. Not a serious problem at present.
4.Other blood parameters are probably abnormal due to dehydration in uncontrolled diabetes. Please repeat it once his blood sugars are controlled.
Since he is having lot of hormonal problems like diabetes, hypothyroidism and vitamin D deficiency, it is better to consult an endocrinologist.
Hope I have answered your question. If you have ant further questions I will be happy to help you.
Dr Ajish TP
The User accepted the expert's answer
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