Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
thyroid harmons
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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thyroid harmons

Dear Dr.
              My wife having thyroid problem, which is detected 1 month back. She is 29 years old with no children. Now she is facing menstruation cycle problem. My family Dr. suggested for the following leb test which is written below with results.

UPPER G.I. ENDOSCOPY-
Premedication:Xylocaine jelly 2%+viscous
Endoscopy:Pentax-FG-29V
A.  OESOPHAGUS:- Gastro-esophageal junction at 37 cms. from incisors.Mucosa normal over upper+middle third;mucosa hyperaemic towards lower end upto 4cm from GE junction;No ulcer,hiatus or varix seen.Lower esophageal sphincter(LES)incompetent.
B.STOMACH:-Lumen clear.
Normal.
C.DUODENUM:-D1,D2-Normal.
RUT:-negative at 2 hours
IMPRESSION:-Reflux oesophagitis(grade I)

U.S.G.-Norml.
Hematology-Mild hypochromis and microcytic platelet-----adequate.
Biochemistry-
      Globulin-3.2gm/dl
SGPT-64u/l
SGOT-88u/l
ALK PHOSPHATE-343u/l
U.S.G.   T.V.S.-Bilateral P.C>O. with nebothian folicles.


Hb-10.70
             TC-8000
              DC-71.25
             ESR-48/84
             FBS-105
             Creatimine-0.9
             Cholesterol-199
             TG-165
             SGPT-22
             T4-8.35
              TSH-7.90
             Urine(Routine)-Normal
            HBS    A9-Negative(99.07)


     Medicines advised by Dr.- Eltroxin(50)
                                           Pantodac DSR
                                           Softoren z.
Sir, plz tell me that Is medicine advised by my Dr. adequate? Will be any problem in pregnancy? When we should plan for a child? Any affect of this will lead for coming child? What is the normal range of T4 & TSH?
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97953_tn?1193367871
it appears she has hypothyroidism - normal TSH is usually under 4.  We often repeat TSH in six weeks to confirm hypothyroid before committing to treatment.  Would consider testing thyroid antibodies to confirm that this is hashimotos.  the 50mcg start dose is reasonable.

thyroid does not explain the whole picture.  she also appears to have PCOS with insulin resistance and the elevated TG of 8000 is severe and the elevated SGOT-SGPT at one point suggest fatty inflitrate of the liver which is consistent with this.  This (PCOS) is likely the main cause of the menstrual problems and may decrease fertility.

would suggest an endocrine consult to confirm these thoughts and focus on treatment options of PCOS-insulin resistance syndrome.
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