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Dr. Andrew Rynne

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What do these lab reports indicate?

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Dr. Mirjeta Guni

Endocrinologist

Practicing since :2006

Answered : 2158 Questions

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Posted on Wed, 23 May 2018 in Thyroid Problem and Hormonal Problems
Question: i have been gone through the medical healthch check-up.I need your input over the attached reports.
Please answer the following of my concerns :

1. What could be the reason for TSH.
2. It is always hereditary or could be developed anytime in life.
3. Are there some serious implications if TSH.
4. Is treatment normal for TSH
5. Do i need to visit the doctor for TSH.
doctor
Answered by Dr. Mirjeta Guni 1 hour later
Brief Answer:
About Your reports;

Detailed Answer:
Hello and thank you for asking!
I have gone carefully through your reports.

The thyroid is in under function and the most common cause is an autoimmune disease (Hashimoto thyroiditis that is confirmed by checking AntiTPO and AntiTg antibodies) that means; Your body produces some antibodies that destroy the thyroid gland and as a result it does not produce enough hormones.
In these cases the treatment consists in taking the hormone by mouth.
It can be developed at anytime in life, but there is a hereditary predisposition to develop Hashimoto thyroiditis.

The most serious complication of underactive thyroid is the increase of cholesterol level, increasing the cardiovascular risk. It may also cause a decrease of testosterone level.
This high TSH level should be corrected (your physician will recommend levothyroxine 50 mcg) and you should know that the treatment is long life, because ince the thyroid gland is destroyed, it does not regain its function any more.

After 6 weeks of treatment with levothyroxine , you need to check the TSH level again to judge about the dose given, is it the right one or should it be increased?.

If you do not have other pathologies there is no need to see a physician. You can start 50 mcg levothyroxine fasting, with empty stomach and for 1 hour you should not eat or drink anything.
from the reports i can also notice a slight tendency for high glucose level and your BMI is 26, so you need to modify your lifestyle (more physical activity and a diet with less calories).
The lipid profile will probably improve after the correction of TSH.

Will be a pleasure to help you in the future for further queries.
Best wishes,
Dr.Mirjeta



Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Mirjeta Guni 3 days later
Thanks doctor for the detailed answers.Please address my follow-up questions :

1.I am very very prone to cold, cough and allergies. Does in anyway cold/cough/allergies contributed to Thyroid or vice-versa.
2. What are the reasons for developing Thyroid issues.
3. When you say that the treatment is lifelong , does it means it is not curable and i have to take medicines for the rest of my life to control the TSH level.Exercise and Diet would not help here.
4. As you are recommending , do i need to take tablet levothyroxine 50 mcg for 6 weeks and then get the Thyoid tested or first i need to get test done (Hashimoto thyroiditis that is confirmed by checking AntiTPO and AntiTg antibodies)).
If suppose after 6 weeks my THS level is in control then what next i need to do i.e continue with the tablet (But how long) or do i need to visit the doctor.
5. FYI my mother also diagnosed with Thyroid recently although when she got the Thyroid tested some time back(twice) , Thyroid was not present.However this is the first time that i have Thyroid tested so i do not know since when i got Thyroid issues.
6. If it is hereditary then it should be there by birth or it could develop anytime in life (and still we called it as hereditary).
doctor
Answered by Dr. Mirjeta Guni 19 minutes later
Brief Answer:
About your questions:

Detailed Answer:
Welcome back!

Let me explain the situation again.
First, you need to confirm the diagnosis by checking the above-mentioned antibodies.
Once it is confirmed, treatment with levothyroxine should be started.

Hashimoto thyroiditis has a genetic predisposition, it means that you have a genetic predisposition to develop these antibodies at a certain time of your life.

The antibodies destroy the thyroid gland and as a result, it does not produce enough hormones, at this point you have to take the hormone by mouth in order to keep normal thyroid hormones in the blood.

Once the gland is destroyed, it is irreversible. It can not get the normal function anymore. There is no absolute cure to bring it back to normal. That's why the treatment consists in maintaining the normal hormonal level in blood. And that is why you need to check TSH after 6 weeks to be sure that the dose given is the right one or it should be increased or decreased.

If it is confirmed normal, it means that the dose is the right one and you should continue with the same dose for other 6 months.

Allergies or cold are not caused by hypothyroidism.

Hope I have answered your queries.
Best wishes.
Dr.Mirjeta



Above answer was peer-reviewed by : Dr. Arnab Banerjee
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