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Recommend Treatment For Thyroid Issues
dear doctor shahzad topiwala shahib.
salam.i m Dr.junaid .i have the need of ur experts openion.the case is that one of my patient aged 20 male presented with symptoms and signs of thyrodism.i did his lab analysis having T3 is 4.13.T4is 4.17 and Tsh is 0.1. which treatment will be best for him.and is the treatment can affact his future.i strongly need ur experts openion. thanks.
salam.i m Dr.junaid .i have the need of ur experts openion.the case is that one of my patient aged 20 male presented with symptoms and signs of thyrodism.i did his lab analysis having T3 is 4.13.T4is 4.17 and Tsh is 0.1. which treatment will be best for him.and is the treatment can affact his future.i strongly need ur experts openion. thanks.
Mon, 12 Jun 2017
Anonymous's Response
Anonymous's
Response
Hello,
T3 is normal, T4 is low, but I am not sure can you give the reference range of the kits used. TSH is low suggestive of subclinical toxic range.
Different possibilities include:
• Subclinical toxicity on treatment with antithyroid drugs.
• Recovery phase of subacute thyroiditis. You rule out this by asking for toxic features: tremors, weight loss, palpitations, thyroid pain, and raised ESR.
• If the patient was not on thyroid replacement this could suggest central hypothyroidism. Check free T4 and fasting for 8 a.m. serum cortisol.
Currently no need of any treatment. Kindly reassure the patient and do free T4 and serum cortisol. If both the tests are normal kindly repeat TSH, free T4, and total T3 after 6 weeks.
Hope I have answered your query. Let me know if I can assist you further.
Regards
T3 is normal, T4 is low, but I am not sure can you give the reference range of the kits used. TSH is low suggestive of subclinical toxic range.
Different possibilities include:
• Subclinical toxicity on treatment with antithyroid drugs.
• Recovery phase of subacute thyroiditis. You rule out this by asking for toxic features: tremors, weight loss, palpitations, thyroid pain, and raised ESR.
• If the patient was not on thyroid replacement this could suggest central hypothyroidism. Check free T4 and fasting for 8 a.m. serum cortisol.
Currently no need of any treatment. Kindly reassure the patient and do free T4 and serum cortisol. If both the tests are normal kindly repeat TSH, free T4, and total T3 after 6 weeks.
Hope I have answered your query. Let me know if I can assist you further.
Regards
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