Q: I am a 27 years old woman suffering from hypothyroidism for the last 11 years. I also have polycystic ovaries syndrome (PCOS) and Coeliac disease. My weight is 123 kg and height is 5.3 feet. I never had a blood pressure problem. The doctor advised certain tests : thyroid hormones - TSH, FT4; fertility hormones - FSH, LH, prolactin, testosterone (free); cortisol at 8 AM; ACTH; 25(OH) Vitamin D; urine analysis - MicroAlb/ creatinine, Ratio (MCR); urinary free cortisol 24 hrs; calcium total; calcium ionised; lipid profile (F); glucose fasting & PP; LFT; and renal panel – I. All the results were fine except: ionised calcium (serum) - 4.0 (Ref:4.4 - 5.28mg/dl), cholesterol HDL - 35 (Ref : < 40 = low); cholesterol / HDL ratio - 5.0 (Ref : 4.5 - 7.0 = average risk); LDL / HDL ratio - 3.6 (Ref : 3.1 - 6.0 = moderate risk); glucose fasting - 104 (Ref : 74 - 100 mg/dl); calcium serum - 8.0 (Ref : 8.5 - 10.1 mg/dl); 25 - Hydroxy Vitamin D - 4.53 (Ref : <20 = deficiency); 24 hours urine, cortisol - 231.5 (Ref : 28.5 - 213.7). On checking the reports, the doctor prescribed me: Eltroxin 100 mcg (taking for last 11 years), Aldactone, Cytomid 250, Calcimax Forte, Obirax 15, Lipocut 60 mg. I haven’t had my periods for the last 3 months. I have earlier taken Ginnette 35 / Janya and got melasma. Why are Aldactone and Cytomid being prescribed? Do any of the medicines have side effects, especially the weight loss medicines?

A:Please note the root cause of all problems is obesity which needs urgent attention. This much obesity will need surgical intervention. Please give a thought to it. It may change your life on positive side. Most of your problems are related to obesity including PCO, irregular cycles. You too have vitamin deficiency for which along with Calcimax you should take Calcirol sachet once a week for next 8 weeks follwed by monthly dose. Low calcium levels are due to vitamin D deficiency. Aldactone and Cytomid has been prescribed to you for irregular cycles which is due to obesity and PCOD. Metformin rther than aldactone may be a better choice for PCOD. For high cortisol level get serum cortisol at 8.00 am after ingestion of 1 mg decadron/dexona at 11.00 am (previous night).