Question

Melina is a 36-year-old female with complaints of excessive fatigue, muscle aches, difficulty sleeping, weight gain, and hair loss in the past six months. She recently lost her job as a clerk and is under a lot of stress. She denies taking any medication and denies any medical history. She is crying at the clinic today and tells you that she does not feel right. Her labs demonstrate that her TSH is significantly elevated at 8.

How will you approach and manage her complaints?

What discussion will you have with the patient regarding her therapy going forward?

Answer 1

After listening carefully to Melina complaints and seeing her lab reports of high TSH hormone level i can say that she is having a hypothyroidism let me explain in detail

Hypothyroidism - In which thyroid is not making enough hormones so that Thyroid stimulating hormone that is TSH levels are increased

Symptoms include - fatigue ,dryskin , wieghtgain ,muscle weakness

Explan about the causes that are surgery or radiation to thyroid gland,hashimotos disease, thyroiditis, certain medication such as amiodarone

Educate about the disease that it may increase the low density lips and that leads to heat disease , complications like myxedema and motivate her to stay strong and can be cured by changes in diet and having proper medication  

Because she as low Thyroid hormone that slow down the heart rate so suddenly jumping into excerisee program can be harmful wait upto hormone level stabilize and ask doctor and start excerisee

Medication should be taken at morning with empty stomach so that food doesn't interfere with medication

If she as hashimotos disease then she have to take low amount of iodine

Treatment and management - treatment goals for hypothyroidism are reverse clinical progression and correct the medical derangements

Thyroid hormone can be administered to suppliment endogenous production

In general the hypothyroidism is treated by levothyroxin ,can be given in full dose in young and otherwise healthy people