Brief Answer:
Re-check after thyroid function normalises

Detailed Answer:
Hello Mr XXXXXXX

Your symptoms of having low energy and cold intolerance are classical features of hypothyroidism. I am glad that you got yourself evaluated and was able to get diagnosed as such. Your lab results also indicate borderline iron deficiency and Vitamin D deficiency. It also indicates an abnormal lipid profile.

I am happy that you are already attempting to jog and I must congratulate you on not smoking.
Hypothyroidism does cause an abnormal lipid profile and I am sure as your thyroxine levels reach normal levels there will be substantial improvement in the same, especially since you have already started eating healthy and exercising.

Now addressing your questions regarding liver disease, You have a very mild elevation of enzyme levels. It is considered medically significant only if the elevations are more than twice the normal values and it will definitely be evaluated if the levels are elevated more than three times normal. In your case, the levels are very minimally elevated and we would not attach any significance to it. So to answer your first question, you DO NOT have liver disease based on your lab results.

Increase in TSH increases the lipid levels of the blood. Patients who have increased lipid levels in blood usually develop "Fatty Liver" where the fat droplets get accumulated in the liver. This is usually seen in patients who eat unhealthy, fat rich foods and don't exercise with a sedentary life style. In your case, you are eating healthy and jogging. So you have a very low chance of developing it. But since your enzyme levels are mildly elevated and since you are apprehensive about liver disease, I would suggest you to get a ultra-sonography of the liver which can diagnose fatty liver.

An FBS of 105 cannot be explained by TSH level as hypothyroidism should usually cause low blood sugar levels. One thing you have not mentioned about yourself is your height and weight. Patient's with increased BMI usually do develop a little insulin resistance (as evidenced by raised FBS). But I would again not attach too much significance to the result and repeat the same in two weeks after a strict diet and exercise regimen.

And like we discussed before the elevations in your SGPT and SGOT are not significant and cannot be attributed to TSH level.

In short, I would ask you to continue to eat healthy and exercise regularly. I would repeat all your tests in two weeks to a months time to see the trend (Also get an USG of liver to look for fatty liver). I would also advice you to take iron supplements and Multivitamin supplements to get your haemogram to normal.

Once your TSH levels normalise, I am sure you will start feeling much better.

Hope this discussion helped you and hope you start feeling better.

please do not hesitate to contact me for any further clarifications needed.

Have a pleasant day
Dr Suresh Raghavaiah

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Brief Answer:
Most common cause is iodine deficiency

Detailed Answer:
Hello Mr XXXXXXX
Thanks for getting back to me so quickly.
The most common.cause for hypothyroidism, in XXXXXXX especially is iodine deficiency. Iodine is the most important ingredient for synthesis of thyroxine. Increased thyroxine levels are required at certain times of our lives - During puberty, pregnancy, lactation and during times of stress. That is why hypothyroidism is much much more common in females compared to males. In your case, I would think your stress must have triggered the hypothyroidism, but one must remember that the exact cause for hypothyroidism cannot be found in most of the cases.
Ironically I am a south Indian(Bangalore) living in North XXXXXXX (Punjab) and one thing I can attest to is that south XXXXXXX food seems to be much more healthy compared to north XXXXXXX food( at least compared to Punjabi food).And it usually takes a long period of iodine deficiency to actually cause hypothyroidism. And as you were in XXXXXXX sea food is the richest source of iodine there is and I very much doubt that your dietary habits caused hypothyroidism. The Govt of XXXXXXX has also mandated that all salt is to be fortified with iodine and so just one days fast is not going to affect your health. The only causative factor might be the mental stress aagain remembering that the exact cause cannot be found in all cases.
Your indoor job definitely explains the vitamin D deficiency as the normal.skin makes enough vitamin D when we are exposed to sunlight, especially the early morning Sun.
So in all, I would not worry about what caused the hypotbgroidism. You can always get it evaluated if you develop any new symptoms, but for now I would advise you to continue your healthy habits and thyroxine tablets.

I believe you will be fine.
Please write back for clarifications
Dr Suresh Raghavaiah

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Brief Answer:
pleasure

Detailed Answer:
was indeed a pleasure interacting with you Mr XXXXXXX Hope you get well soon and thanks for writing to HCM. Have a great night.

Dr Suresh Raghavaiah.

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