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Case study of Thyroid problems.

  • Thyroid
  • Read Time - 4 Min

Palpitations, trembling hands, fatigue, get tired very quickly, got a TSH test and found thyroid toxicity. Took Propyl and Tapazole, after 3 months I had hyperthyroidism again and received propyl and propanolol, stopped tapazole after than gradually reduced proply until successfully quitted. For propanolol only took when there was palpitation. The TSH result found an increased TSH = 1.8 but reduced T3 = 78. The latest blood test last month, TSH value reduced to = 0.545 but T3 increased to = 102.80

Im afraid the symptoms will be the same like before.
Summary of examination resulted in a diagnosis of hyperthyroidism. Prescribed medicines were as above and the latest blood test accompanied with symptoms of fever, tiredness. I will analyzed as followed. 
1. The above symptoms is hyperthyroidism / secondary hypothyroidism / tertiary hypothyroidism or others, or not?
    Answer: These symptoms are not all these three because the final blood test showed normal result. Doctors call it euthyroid which mean TSH and T3 are not low while secondary / tertiary hypothyroid is when there is a disease in the brain that decreased TSH production, the thyroid gland will also reduce a production of thyroid hormone.
2. If it is the secondary / tertiary hypothyroidism. How would negative effects could be if the doctor prescribed these hyperthyroidism medications (propyl for 2 years and 7 months)?
    Answer: You don’t have hypothyroidism, so there is no effect. Don’t worry. 
3. Scheduled a blood test again in May 2010, should I wait or have it checked elsewhere? And what do I need to check? Now I are exhausted and have high temperature for about 1-2 weeks (the hospital allow to use the social security rights but whenever asks, the doctor rarely answers)

It is up to you, I think that the same team of doctors took care of you correctly. If you change doctors, the continuation of treatment will be disturbed. As for the social security system / the thirty baht system I think it's the best health care system in the world. And the fact that your doctor rarely answered may be because he or she is afraid that the next waiting queue will be checked late unless other queues are gone, he or she has more time then probably answer.

Important advices your doctor would want you to take and get tested
•    Assessment of fatigue symptoms in 3 issues:
1) resting time, whether enough sleep, tight sleep or not, are there any sleeping pills usage?
2) Exercise regularly? If not, the body will be deficient of endorphins, anyhow you will get exhausted.
3) Stress. Are there any accumulated stress? Did you get any relaxation? There should be a good way to manage stress.
•    Evaluate the symptoms of high temperature clearly by getting a mercury thermometer to measure the fever. If the temperature is higher than 37 degrees and is chronic, record and take it to the doctor.
•    Assess the heartbeat whether it beats too fast or not? Try measuring it. If you heart beat is less than 72 beats per minute, you pass. How is the rhythm, any sign of inconsistency? If the beats are weird, it can be a complication from hyperthyroidism that need an urgent treatment.
•    Record blood pressure, if it is more than 140/90 mmHg, it is considered too high, treatment is required.
•    Measure your weight, which direction the weight go, increase or decrease. If the weight decreases, it means that the hyperthyroidism cannot be controlled.
•    Check blood sugar because a person with hyperthyroidism often have diabetes. These two diseases are best friends.
•    Check the bone mass because the bones will get porous (osteoporosis) if you have hyperthyroidism..ใ. 
•    If you want to have children, fertility assessments must be performed. Because hyperthyroidism will make it difficult to have children. You should directly consult a fertility doctor.

I’m afraid that it will come back again.
    I will tell you not to be afraid. Eventhough, the drug only helps around 25-30%, but if it comes back, you can get treated with radioactive iodine (l-131). This is very popular in America. It is safe, worry-free and also has a cure rate as high as 75-100% and more importantly, it will not cause sterility or cancer as afraid of. There is only one downside which is a need to take thyroid hormone replacement forever. 
    At this point, anyone who is worried about the thyroid, I thinks you may have understanded this problem better. Initially, the symptoms are exactly the same, so let’s go and get checked. Prevention is better than fixing for a sake of your own better health. 

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