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Request for Second Opinion on Thyroid an
Dear Doctor,
I am a 32-year-old male (5'2", 67.7 kg). My initial reports showed TSH 8.02 mIU/L, Total Cholesterol 269 mg/dL, LDL 152 mg/dL, HDL 37 mg/dL, and Triglycerides 399 mg/dL.
After about 10 days of Thyronorm 25 mcg, Fibator, and strict lifestyle changes, my repeat reports were: TSH 5.44 mIU/L, FT3 2.36 pg/mL, FT4 1.06 ng/dL, Total Cholesterol 203 mg/dL, LDL 128 mg/dL, HDL 49 mg/dL, and Triglycerides 130 mg/dL.
My doctor feels both Thyronorm and cholesterol medication may be lifelong. My mother has hypothyroidism, diabetes, and high cholesterol.
Could you please advise:
1. Does this appear more like subclinical or permanent hypothyroidism?
2. Is it too early to conclude Thyronorm will be lifelong?
3. Is lifelong lipid-lowering therapy usually required in such cases?
4. Could the improvement be due to both medication and lifestyle changes?
5. Would Anti-TPO, thyroid ultrasound, HbA1c, or other tests help guide long-term treatment?
Thank you.
Answers (11)
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You can consult with me online on Practo or whatsapp on eight three one eight four six nine eight eight six for proper diagnosis, conclusion and management
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Avoid fried and spicy food
Avoid sugar rice potatoes
Fiber meal more
Green leafy vegetables more
Walk
Do connect and consult
Will help you
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Hi, your TSH has come down well from 8 to 5.44 on a low 25mcg dose, which is good and means it's not fully permanent. Lipids have also improved nicely with lifestyle and Fibator. Repeat tests in 8 weeks. Feel free to consult for further guidance.
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The dramatic improvement in your lipid profile â especially triglycerides dropping from 399 to 130 in 10 days â reflects the combined effect of thyroid treatment (hypothyroidism itself causes high triglycerides), medication, and your lifestyle changes, all working together. Your TSH is still mildly elevated at 5.44 even on thyronorm, suggesting the thyroid needs continued support. It is too early after just 10 days to decide if thyronorm will be lifelong â this is better reassessed after 3-6 months of stable treatment with repeat TSH. An Anti-TPO antibody test would help identify if this is autoimmune thyroid disease, and an HbA1c is wise given your family history.
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Please consult me directly on Practo for a detailed evaluation and guidance on which additional tests would help guide your long-term treatment plan.
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It is subclinical hypothyroidism
Consult physician directly for proper examination and management.
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Subclinical hypothyroidism. Lifestyle modifications is good for hyperlipidemia and iys under control according to your report.
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1)It appears to be subclinical hypothyroidism but need to see patient
2)yes
3)not necessarily
4)yes
5)yes
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Need to visit the physician for clinical assessment
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My advice would be to get tested for Vitamin D3 levels, often Vitamin D3 deficiency correction can normalise TSH levels.
While you are at it, get Anti TPO tested as well.
Improve lifestyle in terms of diet and exercise, will also improve your lipid profile.
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Connect for a detailed consultation.
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lifelong may not be needed
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Dr. Ravi Kumar Nadella
General Physician
18 yrs exp
Hyderabad
Needs meds
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Dr. Shweta Ramesh Rawale
General Physician
4 yrs exp
Parbhani
It might be subclinical/hypothyroidism for that need complete symptomatic profile
Thyronorm has to take lifelong
Lifestyle modifications with medication require for improvement
Need further history and do reports for clear picture
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Dr. Anuj Mothsra
General Physician
6 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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