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    What causes abdominal swelling when TSH level is 17.14 mIU/l?

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Posted on Mon, 10 Jul 2017 in Digestion and Bowels
Question: Dear Doctor.
Before 2 months I realise that left side of my abdomen is slight swelled and then my usg show, liver is mildly enlarged show mild diffuse increased parenchymal echopattern. No focal mass lesion is noted. Walls are echofree. Portal vein is normal.
An accessory spleen is noted in size 13.3×10.5 mm at splenic hilum.
Bladder shows mild diffuse mucosal thickening. Thickness 2.7 mm.
After 1 month of usg my abdomen is slight more swelled. I also noticed that my hand and feet and face also slight swelled and place of swelling there are a little sensitivity losses in skin. I noticed that I have an afebrile on left elbow and 20 or 25 liver spot on whole body.Doctor said My liver function test, blood cbc, urine test and kidney renel function test is normal. My doctor gave some vitamin and antibiotics tabs and on using that my swelling were squized but not the abdomen. But after stoping the antibiotic my hand feet and face is started to swell again.. Now I have mild gas type pain in my left side of the abdomen and again my abdomen is a little swelled I feel. But I have no vomiting. But I feel fullness without any meal. I have psoriasis also for 18 years and I have not taken any medicine earlier. Recently my doctor has gave me two medicine. And my TSH level is 17.14.
Some times I feel the external side of my throat is stiffed but not internally. An ENT specialist said on examination there is no problem in inside of throat.
Please tell me is this mean that my liver going down damage and I going to lost myself.
doctor
Answered by Dr. Ramesh Kumar 55 minutes later
Brief Answer:
Cardiac evaluation should be done.

Detailed Answer:
Hi xxxxx,
Thanks for choosing HealthcareMagic for your query.
I am a Gastroenterologist and would be answering your query.
Have gone through your details and reports and i appreciate your concerns.
As per your query answers are-

Whenever there is recurrent edema in any part of body(especially if bilateral involving both side) three major organs are tested.
1)Liver
2)Kidney
3)Heart

As far as liver is concerned Milf fatty liver is a age related change and is absolutely normal.As our age progresses various organs of body starts ageing this deposition of fat is also a feature of this normal ageing process.Mild fatty changes and mild bladder thicking has nothing to do with his problems.

As other liver function tests and Renal functions are normal we are just left with heart.Heart is a organ whose function is to pump blood to various organs in body.left side of heart pumps blood into the whole body but some times due to problem with walls and valves of heart this blood refluxes back into the right side which is connected to liver stomach etc.Constant increase in pressure of fluid causes it to collect below fat spaces in body hence causing edema.Due to increased fluid load on right side jugular vein pressure is also increased which lies in vicinity of neck and jaw area so may be causing increased tightness.

So i would recommend a test called 2d echo initially to see if heart functions and valves are normal.

Possibility 2) Your TSH is very high and thyroxine therapy should be started asap initially take 50 mcg eltroxin daily and after 21 days increase it to 100 mcg daily.Remember to take the medicine empty stomach and dont take even water one hour after taking this medicine.

Mild swelling of adomen(ascitis) with pain in left side can be a sign of defect with heart.So thorough investigation should be done initially.Abdominal fullness can also be explained(As space is occupied by fluid).

Suggestion-
Go for 2d echo Asap.
Start Eltroxin 50 mcg once daily.
Follow up with reports.

Thanks!

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Ramesh Kumar 2 days later
I have submitted my x ray and ECG report for your further information. I am a very thin person but my abdomen is look like a very fat person. Is this possible due to fatty liver. I feel always very tired. My bowel movement is normal as per my meal. Is there is anything life threatening? One thing I am taking thyronorm 50 mcg for last 1month. Now should I stop thyronorm and to take the medicine advised you me.
doctor
Answered by Dr. Ramesh Kumar 4 hours later
Brief Answer:
Follow up.

Detailed Answer:
Hi again,
Thanks for follow up.
Have gone through e.k.g and x ray both are normal.
However E.k.g is just a baseline test of cardiology and most of the times changes related to cardiac problems are not captured by it.
So i would suggest you to go for a 2d echo as suggested earlier.

Reports attached by you are almost normal as explained above mil fatty liver changes are age related and have nothing to do with your problems.
Your TSH is very high you are having Severe hypothyroidism.
Extreme fatigue malaise lassitude weakness etc are because of low levels of thyroxine hormone.

Increase the doses pf thronorm 50mcg to 100mcg per day.Remember to take the medicine empty stomach and dont take even water one hour after taking this medicine.Your centripetal obesity(at tummy) can also be explained by severe deficiency of thyroid hormone.
I don't feel that its life threatening at present however go for a 2d echo(at a good centre) to evaluate your cardiac functions.

Follow up with reports of 2d echo.

Thanks.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Ramesh Kumar 3 days later
Dear Sir.
Due to heavy flood the transportation is totally stopped since few days and I couldn't go for echo 2d. But I will whenever the flood will remove.
But recently from two days I have increase a high fever which was mild low grade fever earlier approximately for 5 months. And my right side of neck is swelled and hard distended small vein is noticed. I have no swallowing problem but some water colour bumps are on tongue. Some times I feel a small pinch in the distended vein not for long time only for a minute 5 to 6 times in a day.
And Sir. My doctor gave me sincerest tablets for fever earlier. And I took only a tablet for increases of fever yesterday also but my fever is not gone downward and a mild pain I felt on both side of my back abdomen after
taking the tablet. So I stopped to have more tablets. Along with high fever I have dizziness,headache and blur vision.
Is all of this can be due to hypothyroidism or anything more serious.
Please advise me some medicine for high fever which will be appropriate as per my kidney function. I am sending you my kidney function test report.
doctor
Answered by Dr. Ramesh Kumar 3 hours later
Brief Answer:
Follow up.

Detailed Answer:
Hello again,
Mild low grade fever for 5 months on and off with lymph nodes involvement can be due to tuberculosis also.
I would suggest you to go for TB gold and sputum test to rule out possibility of T.B
Recurrent fever is suggestive of infection in body. So just taking paracetamol etc will not help neither is it a good policy.
Instead its better to rule out the cause of problem.
Just take Paracetamol 500 mg when fever is high.
Follow up with Reports of tests adviced.
Most likely fever has no relation yo thyroid problems.

Regards!
Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
Dr.
Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2441 Questions

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