Please suggest me treatment for thyroid and diabetes based on my reports.

Hi,

Welcome to icliniq.com.

Thanks for your query.

Your thyroid hormone levels are high, and your TSH (thyroid-stimulating hormone) level is very low. Your TSH target should be from 0.7 mIU/mL to 4 mIU/mL. If it is less than 0.7 mIU/mL, you need to decrease your dose, and if it is over 4 mIU/mL, you need to increase your dose. Right now, your TSH is 0.02 mIU/mL which is relatively low, and your thyroid hormone levels are also higher than the reference range. Please let me know if you need any other information. You need to decrease your Thyronorm dose to 50 mcg once daily before breakfast. Repeat the test after three months. If you can tell me more details about your sugar levels, I can suggest something to help. Your fasting sugar level is also high. Are you diabetic? If yes, are you taking any medication? You need to control your sugar levels. It will be better to check two hours after the meal. Also, check HbA1c.

Thanks.

Hi,

Welcome back to icliniq.com.

Thanks for your query.

I checked your reports (attachments removed to protect the patient's identity). There is a discrepancy in your report. The first report shows TSH to be 2.6 mIU/mL and the second report shows 12.6 mIU/mL. Please clarify the correct one. Your medication depends upon the exact level of TSH. Your sugar levels are in control. Suppose your TSH (thyroid-stimulating hormone) is 12.71 mIU/mL; you need to increase your Thyronorm to 100 mcg once daily before breakfast. Recheck your TSH after six to eight weeks. Your TSH should be within 0.5 mIU/mL to 5 mIU/mL. If it is higher than 5 mIU/mL, you need to increase the dose, and if it is less than 1 mIU/mL, you need to decrease the dose. If HbA1c is more than 6.5 %, you have borderline diabetes, and the best treatment is lifestyle modifications. Diabetes has many complications, so it is not to bring down the numbers but to monitor and treat complications associated with diabetes. Check your feet, eyes for retinopathy, and kidney (urine albumin creatinine ratio).

1. Follow a low carbohydrate diet and avoid sugar. No sugary juices. No bread, rice, pasta, and potatoes. If you cannot stop, at least take as little as possible.

2. Include more vegetables, salads, and fibers.

3. Limit the intake of fruits. Do not take mango, grapes, and banana. Apple not more than one piece. Strawberries and other berries are fine, along with peach, apricot, and a small amount of plum.

3. Intermittent fasting will also help you control your diabetes. You can fast for 16 hours. Take your dinner at 7 PM and do not eat anything after that. The next day you can take breakfast at 11 AM. While fasting, drink only water and green tea without sugar. You can extend fast to 24 hours then 36 hours as your body adapts. You can fast two times a week or however, you feel comfortable. It will control your sugar. Drink more water and sleep well.

4. Exercise or at least walk 30 to 40 minutes daily.

The more you practice these things, the better will be your control. Check your sugar levels frequently. Your target is fasting glucose levels should be less than 100 mg/dL, and two hours post-meal should be less than 140 mg/dL. HbA1c level should be less than 6 %.

Regards.