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Patient's Query
Hi doctor,
I have thyroid issues for the past three years. I got this when I was pregnant. I am taking Thyronorm 75 mcg tablet for the last three months. Recently, I have done the thyroid test and my T3 and T4 are normal and TSH is very low. It shows less than 0.01. What does it indicate? First, I was on 50 mcg and before three months I started 75 mcg as the TSH was approximately 6 at that time. Please explain.
Hi,
Welcome to icliniq.com.
This appears to be due to over treatment or iatrogenic hyperthyroidism. Here is a list of symptoms experienced due to over treatment. They are tachycardia, palpitations, nervousness, tiredness, headache, excitability, sleeplessness, tremors, anxiety and heat intolerance. If yes to any of the above, then the dose needs to be titrated. Can you upload your previous thyroid profile report? Keeping the point that the T3 and T4 are within the limits, I would advise dose reduction slowly and steadily along with TSH (thyroid-stimulating hormone) monitoring. Consult your specialist doctor, discuss with him or her and get the dosage altered. Take 50 mcg of the same medication and go for TSH testing six to eight weeks later. You need not panic.
Patient's Query
Thank you doctor,
I am having a very excessive hair fall. Can thyroid problem cause hair fall? I have misplaced my old report, sorry for that.
Hello,
Welcome back to icliniq.com.
There are many causes for hair loss. Is there any specific pattern of hair loss, such as receding hair line in the front or patchy hair loss? Yes, hypothyroidism, hyperthyroidism and even its medication are directly related to hair loss, but other causes need to be ruled out. Iron deficiency, use of antacids, low stomach acid, hormonal imbalance, PCOD (polycystic ovary disease) and thyroiditis are other causes. Did you check your hemoglobin recently? What is your age? Do you have any menstrual problems? I would advise you take a wholesome meal rich in biotin, zinc, antioxidants and essential fatty acids like egg, fish, carrot and beetroot. Drink warm water and lemon juice in the morning. I suggest Evening Primrose Oil 500 mg twice a day and tablet Trichoton forte once daily. You can see a definite change after six to eight weeks. Consult your specialist doctor, discuss with him or her and take the medicine with consent. It is a fact that people lose over 50-100 strands of hair each day. Take care.
Patient's Query
Hi doctor,
I had blood tests recently. The report is attached and still, the TSH is not in the normal range. In my last report, it was less than 0.01 and now it is 0.08. I started taking 50 mcg after consulting with you last month. The report shows the insufficiency of calcium, vitamins, and iron. I am facing the following issues currently: Excessive hair fall, high BP, headache, weight loss, backache especially spinal pain, and weakness in the body.
Currently, I am taking the below drugs:
Thyroid - 50 mcg Thyronorm - 1 tablet every morning before breakfast. High BP - Asomax AT 1/2 of 2.5 mg tablet every night after dinner. Please suggest the required medication so that I can feel relax.
Hello,
Welcome back to iciniq.com.
I have gone through the reports posted. There are minor issues that can be treated successfully. Your TSH rose from 0.01 to 0.08 which is a good development. I would advise you to decrease the dose to 25 mcg further daily early in the morning and get TSH tested after 12 weeks. You need to take tablet Centratex (multivitamin supplement) twice daily for correction of iron deficiency anemia. Iron deficiency may also lead to hair fall. Did you try evening primrose oil capsules? What kind of hair loss you have, either generalized or over any particular area?
For calcium and vitamin D deficiency, consume dietary supplementation with dairy products, cheese, fish, and yogurt. Sunlight exposure between 10 am to 3 pm just to attain reddish skin shade will help. An adequate blood level of vitamin D is 20 nanograms per milliliter, which can be achieved through daily skin exposure to sunlight. Take tablet Shelcal (calcium supplement) one tab daily with a proper balanced diet (not to be taken along with food). Take it 3 hours after meals.
Regarding vitamin B12 deficiency, are you a vegan? If so, then do eat lots of green leafy vegetables. Also, take tablet Folgard (multivitamin) once daily. As you do no have diabetes, you can be generous with your food servings. Enjoy all kinds of food with less salt to fight weakness as well as vitamin and mineral deficiency. Do follow the diet I have posted you earlier. All the best. Please repeat all the tests that are above or below normal after 12 weeks to know the progress.
Patient's Query
Hi doctor,
I have tried Rose Oil capsules but not regularly. Should I continue those as well with the medicines you suggested now? I have generic hair fall and it is not an area specific. I am not a vegan. I will be taking the medicines mentioned below from now onwards (I entered as per my understanding, please correct if I am wrong):
1. Thyronorm 25 mcg in the morning before breakfast.
2. Tablet Centratex - 1 after 1-2 hours of break fast and 1 in evening after snacks or 2 hrs before dinner. There should be gap of 6 hrs in both medicines.
3. Shelcal - 3 hours after lunch. Can I take Shelcal and Centratex together?
4. Folgard - 1 hour after breakfast. Can I take Folgard and Centratex together?
5. Asomex AT - 1 daily before sleep.
6. Rose Oil capsules.
Is there any once in a week kind of powder or solution available which I can take for Calcium, Vitamin D , Vit B12 or Iron, just to reduce number of tablets to take everyday (currently it looks 8 tabs daily)? Also, I need to take the medicines of thyroid and BP daily. I have attached the images of hair-fall and consultation report from hair doctor as well herewith. Please have a look. Should I take Astaxanthin antioxidants tablets?
Hello,
Welcome back to icliniq.com.
Yes, you do have medium hair density. Hair loss in your case appears to be multifactorial i.e. nutritional (iron deficiency and other deficiency), thyroid, and hypertension. Is there any hereditary component too? Do you have moustache? Do you have any menstrual irregularities? How old are you? Is there a history of PCOD? I would suggest you to take a wholesome meal with less carb and more micronutrients, proteins and essential fatty acids like spinach, carrot, jaggery, fruits, veggies, lean meat, dark chocolate, and dairy products. Also that your HDL, good cholesterol, is low. You need to take food like whole grain food, olive oil, high fiber foods like apples, pears, nuts, fish and so on.
Yes, you may try capsule Evening primrose oil 500 mg twice daily that contains essential fatty acids and corrects any hormonal imbalance. With regard to the medication, tablet Thyronorm 25 mcg before breakfast. And, iron and calcium should not be taken together. Tablet Centratex 1-2 hours after breakfast (never with tea) and tablet Folgard can be taken together. Tablet Shelcal with dairy products like milk or buttermilk any time but not with major meals (can be skipped if sufficient dietary supplementation and exposure to sun is followed). Capsule Primrose oil twice daily (results assured only after 7-8 weeks of continuous use). Continue your BP medication as before.
For definitive increase in hair density you may try 2 % Rogaine lotion, a topical solution, and escalate it to 5 %. But let me tel you, hair fall recurs as and when you discontinue. Yes, you may take Astashine or get those antioxidants from the diet as laid below:
Vitamin C citrus fruits like oranges and lime, capsicum, broccoli, green leafy vegetables and tomatoes, vitamin E Nuts & seeds, whole grains, green leafy vegetables, selenium fish, shellfish, grains, eggs, carrot, and beetroot.
Once your vitamins and hormones are normalized, your hair loss will come to an end. Take care.
Patient's Query
Hi doctor,
I have started taking 25 mcg Thyronorm as per your suggestion. Please find the attached latest and old blood test reports. TSH has got increased a bit. Previously the level was low and therefore you suggested 25 mcg from 50 mcg. I am also having heavy hair fall. You can refer the thread if anymore information needed. Please advice.
Hello,
Welcome back to icliniq.com.
Good to see your Vit D and Vit B12 levels towards normal. As long as T3 and T4 remain in normal limits, you need not worry with regard to the rise in the TSH level. There are two options:
1) To wait till 12 weeks and repeat the test and react accordingly.
2) To add 12.5 mcg to the present dose and repeat the test in 12 weeks.
Do let me know your answers to the below queries.
1. Do you have any symptoms such as weight gain, constipation, lethargy, or fatigue? Do eat jaggery, dates, carrot, or beetroot?
2. Iron level is still to be corrected. What is the medication you are on now?
Patient's Query
Hi doctor,
I am taking the below medicines as of now:
1. Thyronorm 25mcg
2. For BP, Asomex AT, half tablet of 2.5 mg
3. For iron - Vitcofol 4. Vitamin D - D rise sachet once in a week since last five weeks.
And I do not have any such symptoms as you have mentioned. Currently I am facing three health issues - extreme hair fall, high BP and thyroid. I am not sure when my thyroid level will be normal and hair fall will stop. For how long do I need to continue Thyronorm medicine? Sometimes I feel tired after doing continuous work, but that seems normal.
Hello,
Welcome back to icliniq.com.
Please do not get disheartened by your health condition. All is well. Your thyroid profile will be normal soon. Take good diet and hair care. Your hair fall will also come down in coming days. With regard to BP, take low salt diet and regular medication. Go for yoga and healthy work out. Stay happy. Continue Thyronorm 25 mcg for a few more weeks and after 12 weeks from now go for TSH. If it rise further, then the Thyronorm dose can be raised. Continue the rest. Please let me know your latest BP reading. Take care. Have a great day.
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