Download FREE Practo app
Get ₹200 HealthCash
Hypothyroidism (8) & high HsCRP(10.64)
My wife , 33-year-old female with fatigue, weight gain and prolonged irregular spotting/clots.
Labs: TSH 11.48 µIU/mL with total T3 0.90 ng/mL (low-normal) and total T4 13.66 µg/dL (high-normal) , hypothyroid pattern despite Thyronorm (75mcg).
CBC shows microcytic anemia: Hb 10.7 g/dL, Hct 33.2%, MCV 69.3 fL, MCH 22.3 pg, RDW-CV 20.4%.
Iron studies: serum iron 58.8 (low), TIBC 381 (high-normal), transferrin saturation 15.4% (borderline).
Her Vitamin D 14.44 ng/mL (deficient),
Vit B12 217 pg/mL (low).
CRP 10.44 and hsCRP 10.64 (elevated).
Lipids: Triglycerides 217 (high), HDL 39.8 (low), LDL 96.
Glucose/HbA1c normal. We will be trying for pregnancy but need to get the Thyroid into normal range for that how to proceed.
Answers (13)
Get your queries answered instantly with Care AI FREE
20000+ health queries resolved in last month
Consult superspecialist like md physician
Answered
Flag this answer
2/2 people found this helpful
Was this answer helpful?
YES
NO
Didn't find the answer you are looking for?
Talk to experienced doctor online and get your health questions answered in just 5 minutes.
+105
If you want to discuss your problem in more detail, feel free to message me on WhatsApp at nine one one nine two five five six nine nine for a detailed free discussion
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
if despite thyronorm 75 for atleast 6 weeks with such report we need to increase dose
to 100 ug and then review after 8 weeks
kindly consult me on practo
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Your wife’s labs show classic primary hypothyroidism that is not yet adequately treated on Thyronorm 75 mcg:
• TSH 11.48 is clearly elevated → insufficient thyroid hormone replacement
• Total T4 high-normal but free T4 would likely be low-normal (total T4 can be misleading in pregnancy planning)
• Total T3 low-normal → possible poor T4→T3 conversion
Combined with:
• Microcytic iron-deficiency anemia (Hb 10.7, low MCV/MCH, low serum iron, high TIBC, borderline saturation) → common in hypothyroidism + heavy/irregular bleeding
• Vitamin D deficiency (14.44) + low-normal B12 (217) → both contribute to fatigue
• Elevated CRP / hsCRP → low-grade inflammation (can be from hypothyroidism itself, iron deficiency, or subclinical infection)
• Dyslipidemia (high TG, low HDL) → typical in untreated hypothyroidism
The prolonged irregular spotting/clots are very likely due to hypothyroidism-induced heavy/anovulatory bleeding. All of these issues improve significantly once TSH is brought into the optimal preconception range.
Next Steps
1. Urgent thyroid adjustment (preconception TSH target 1 g/dL, consider IV iron (safe pre-pregnancy).
3. Vitamin D & B12 correction
• Vitamin D: 60,000 IU weekly × 8 weeks, then 2,000 IU daily maintenance (or 50,000 IU weekly if preferred). Take with fatty meal.
• B12: methylcobalamin 1500 mcg daily (sublingual or oral) for 2–3 months, then 500–1000 mcg maintenance.
4. See specialists soon
• Endocrinologist (thyroid dose adjustment + preconception counseling)
• Gynecologist (evaluate irregular heavy bleeding — may need TVS ultrasound, endometrial assessment, or tranexamic acid/OCP short-term to control bleeding while thyroid normalizes)
Health Tips
• Fatigue & brain fog should improve noticeably within 4–8 weeks once TSH drops and anemia starts correcting.
• Weight gain is multifactorial (hypothyroid metabolism + fluid retention + fatigue) — expect gradual improvement with treatment.
• Preconception goal: TSH
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
I totally understand your concern. Before suggesting treatment, I would like to ask a few questions to ensure the correct management can be provided.
Contact me on Practo or WhatsApp chat.
92469306sevenfour
Dr. Harichandana,
MBBS, MD (General medicine)
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Continue thyronorm..consult your concerned doctor..usg abdomen..and pt aptt thyroid profile lipid profile and hormonal status..uterine abnormality shud be ruled out..endometrial disorders shud b ruled out..kindly consult your concerned doctor
Answered
Flag this answer
2/2 people found this helpful
Was this answer helpful?
YES
NO
Her TSH is clearly high — thyroid is not controlled, which can explain fatigue, weight gain and irregular bleeding. She also has iron-deficiency anemia, low B12 and Vit D, all of which affect cycles and fertility. With TSH ~11, pregnancy should be postponed till TSH is
Next Steps
1. Increase/adjust Thyronorm dose (needs repeat TSH after 6 weeks).
2. Start iron + B12 + Vit D replacement immediately.
3. Do anti-TPO antibodies + ferritin if not done.
4. Once TSH
Health Tips
Don’t attempt conception with uncontrolled thyroid — higher risk of miscarriage. This needs structured correction. You can book a consult with me — I’ll optimize thyroid + deficiencies and guide you step-by-step for pregnancy planning.
Answered
Flag this answer
2/2 people found this helpful
Was this answer helpful?
YES
NO
Need details of her symptoms, what have been her symptoms, when we're these tests done, since how long she is taking thyronorm?
Please share then I can advise further.
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
You need to correct all these things...before pregnancy..
Uncontrolled primary hypothyroidism (likely autoimmune) with iron deficiency anemia, vitamin B12 & D deficiency, secondary menstrual irregularity, and inflammatory dyslipidemia — currently NOT FIT for conception.
They can cause abortion and it can cause many complications for both mother and child...
You need some test more...and need start treatment for these problems
Consult for better and further treatment
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Dr. Sajid Ali
General Practitioner
4 yrs exp
Kanpur
Continue thyronorm
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Dr. Anuj Mothsra
General Physician
6 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Dr. Suraj Sharma
General Practitioner
4 yrs exp
Jaipur
Need some more details kindly consult
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Articles you may like
Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
The question asked on this page is a free question. You can ask a free health question by downloading the Practo app.
Articles you may like
Tell us what's troubling you
Tell us what's troubling you
Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.