Dr. Arpit Varshney
General Medicine
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Patient's Query
Hello doctor,
I am 29-years-old. I delivered my baby eight months back, and till now, my health condition has not properly recovered. Recently, I was diagnosed with hypothyroidism, for which I have been given Thyronorm 75 mcg (four months course) with other nutritional supplements. But after two months, I suddenly started to feel pain in the joints of my legs (knees, foot, and ankles) with swelling in the knee and ankle area. Currently, I am taking Cefuroxime 250, Mobiswift, Evamore, Neurokind gold, Folic acid, and Calcium tablets.
The doctor advised conducting a full body checkup which showed improvement in the thyroid levels but with borderline fasting blood sugar (107 mg/dL), high ALP (116.6), and high WBC (13380). The doctor prescribed antibiotics, Diabecon, and a few nutritional supplements for muscle strength and relaxation. Since my baby is only eight months old and I still breastfeed him, my doctor refused to give me strong medicines that can be harmful to him. But now, even after taking these, my problem of swelling and muscle or joint pain has still not resolved. Doctor, please suggest if the treatment is going on the right track. I have attached blood test reports and prescriptions for your reference.
Hello,
Welcome to icliniq.com.
I have read your concern in detail and will surely help you out.
First of all, multiple body aches can commonly be associated with hypothyroidism. It is a very common occurrence. So I suggest you continue Thyronorm (Thyroxine) and get thyroid-stimulating hormone (TSH) levels repeated after one month.
Multiple joint pains or body aches can also be commonly due to some autoimmune diseases like rheumatoid arthritis and Sjogren's syndrome. For these, there are special tests to diagnose, and once the diagnosis is made, treatment-oriented to the disease is required. A high white blood cell count (WBC) has no significance if you do not have any fever. You should ignore it. Also, alkaline phosphatase (ALP) is also borderline high. This high is common. It is significant when levels go beyond 350.
So, in my opinion, your only major concerns are hypothyroidism and joint pains.
So I suggest you do the following tests:
1. Repeat thyroid-stimulating hormone (TSH) to ensure thyroid treatment is going in the right direction.
2. Rheumatoid arthritis (RA) factor.
3. C-reactive protein - quantitative (CRP-q).
4. Anti-nuclear antibody (ANA) immunofluorescence.
Apart from this, I suggest the following medicines:
1. Tablet HCQS (Hydroxychloroquine) 200 mg twice daily.
2. Tablet Etos (Etoricoxib) 60 mg twice daily for five days.
3. Tablet Wysolone (Prednisolone) 20 mg once a day for five days, then 10 mg once a day for five days.
You can follow up with the reports with me or your local doctor. I understand that you are breastfeeding. So the best solution, in this case, is to take the medicines after you have breastfed the baby.
I hope this helps. Kindly revert back in case of further queries. Thank you.
Patient's Query
Hello doctor,
Thank you so much for your prompt response.
Hello,
Welcome back to icliniq.com.
I am always happy to help. Take care.
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General Medicine
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