Dr. Sagar Ramesh Makode
Cardiology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I am unable to clear my tummy entirely in the morning. It is happening for a couple of weeks. I thought that I have an infection. So I did a CBC. But the reports came fine. I have hypothyroidism, and I am taking Thyronorm 12.5 mg. A friend told me that it could be a colon or rectal cancer. Can I have cancer? Please suggest.
Hi,
Welcome to icliniq.com.
On considering your age, the possibility of having cancer is unlikely. There is nothing to worry. Constipation is a widespread problem, and the chance of cancer is doubtful to occur in this age group. So do not think about this disease. Cancer usually occurs at elder age with alternate constipation and diarrhea. It happens with blood in stools, weight loss, and abdominal pain. Their profile would be entirely different.
You can have hypothyroidism induced constipation. You should do a TSH to see the thyroid control. For that, you should eat a high fiber diet with fruits such as apple, banana, oranges, green leafy vegetables like spinach, and raw cucumber. Avoid taking refined food, fatty, and oily food. You should take plenty of fluids and do regular exercise. Take syrup lactulose 15 ml at bedtime to maintain your stool soft. Use it when there is a need.
Patient's Query
Thank you doctor,
I am relieved after reading your answer. I tried taking Isabgol. But there was no use. My last TSH was 0.0049 mIU/L when I was taking Thyronorm 62.5 mg. Hence, my doctor reduced my dose to 12.5 mg. I will repeat the test after a few days.
Hi,
Welcome back to icliniq.com.
Having a drastic change in dose leads to hypothyroidism symptoms. It is likely due to the thyroid only. You need a dose increment. TSH (thyroid stimulating hormone) always gets changed from four to six weeks. So do a TSH test after six weeks of a dose change. You can try Lactulose or Cremaffin plus (Liquid paraffin with Magnesium hydroxide) to get relief from constipation.
Patient's Query
Thank you doctor,
When my TSH was detected as 7.099 mIU/L, so I started taking Thyronorm 12.5 mg. My TSH got reduced to 4.5, and my dose was changed to Thyronorm 25 mg. After that, my TSH got increased, so my dose was adjusted to 62.5 mg. Since it came crashing down to 0.004, the dose was again changed to 12.5 mg. Now after a month, my current value is 0.011 mIU/L. What can I do now? I am trying to conceive, and these fluctuations make me depressed.
Hi,
Welcome back to icliniq.com.
Do not worry. First, TSH should be measured for at least six to eight weeks after a dose change. TSH takes time to attain a stable level. So after having four weeks of dose reduction, your TSH will get raised, and it will reach a plateau at six to eight weeks. So you should continue to take 12.5 mg and repeat TSH after three to four weeks. Most likely, you will get stabilized on a dose of 25 to 37.5 mg. The jump of dosage from 25 to 62.5 can make the problem. Do not conceive until the TSH gets normalized. Try to see an endocrinologist. Also, have a dose on a regular basis and take a tablet for at least 30 minutes before breakfast. Avoid taking it with other medicines like antacids.
Patient's Query
Thank you doctor,
I have a lot of pressure to conceive soon as we have been trying for nine months.
Hi,
Welcome back to icliniq.com.
It is essential to have a normal TSH to have a healthy baby.
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Cardiology
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