My blood work showed a high TSH level. Kindly suggest medication.

Hi,

Welcome to icliniq.com.

Your TSH is high and T3, and T4 are normal. It is called subclinical hypothyroidism. You need to take Levothyroxine 25 mcg once daily before breakfast. Take for six weeks, then repeat TSH (thyroid-stimulating hormone). Your TSH target is 0.5 to 5. Let me know your result after six weeks. You also have prediabetes as your HbA1c (glycated hemoglobin) is over 5.7. You need to take care of it. Your HbA1c shows your average sugar over two to three months previously. Diabetes has many complications, so it is not just to bring down the numbers but to monitor and treat complications associated with diabetes.

Check your eyes for retinopathy, kidneys with urine, albumin, and creatinine ratio. Check your feet. Lifestyle modifications are the best for the treatment of diabetes and prediabetes. Take a low carbohydrate diet and no added sugar. No sugary juices, bread, rice, pasta, and potatoes. If you cannot stop, at least take as less as possible. Take more vegetables, salads, and fibers. Consume fruits only as a sweet dish. Do not take mango, grapes, and banana. Do not take apple more than one piece. Strawberries and other berries are fine, along with peach, apricot, and small amounts of plums.

Intermittent fasting will also help you to control your diabetes. You can fast for 16 hours, like taking your dinner at 7 PM and do not eat anything after that you can take breakfast at 11 AM. During fasting, drink water and green tea without sugar. You can extend fasting to 24 hours then 36 hours as your body adopts. You can do fasting two times a week, or as you feel comfortable, it will control your sugar. Drink more water. Sleep well. Exercise at least walk 30-40 minutes daily. The more you will practice these things. The better will be your control. Check your sugar frequently. Your fasting target should be less than 90. Two hours after eating should be less than 140, and HbA1c should be less than 5.7. These targets can vary in individual patient depending upon his diabetes duration and other relevant issues.

Hello,

Welcome back to icliniq.com.

No need to start any medications right now. Check your fasting sugar and after eating for two hours. Check your HBA1c after three months. I explained how to control your sugar in the previous message. Just follow those lifestyle modifications. Control your diet. Keep an eye on sugar levels and keep them below the level mentioned in the last message.