Q: I am a 39 year old male. I had some muscular problem (cramps) 4 years back along with weight gain & was diagnosed as a hypothyroid patient. I took Eltroxin 100 for 2 years (1 tab daily, empty stomach). After 2 years, my physician asked me to stop Eltroxin since my blood reports were normal. 1 year back, I had the same problem & weight gain. Again I consulted another physician, who took all tests and my TSH was found to be 10.44. He diagnosed me as a Syndrome X case & prescribed Thyronorm 50 one tablet per day & Glycomet (Metformin 500) 1/2 tab twice a day. I am not a diabetic patient, my blood sugar level was always on the lower side. Latest results are FBS 77mg/dl; PPBS 109mg/dl. I took the above medicines for 4 months. Then I had a problem with my cervical lymph node & found extra pulmonary TB & stopped all the above medicines & was treated with RNTCP - DOT category I for the past 6 months. My weight increased by 15kgs during that time. I got myself tested for thyroid function (RIA method) & the results are T3 44.0 ng/dl, T4 3.98ug/dl, TSH 83.54mIU/ml. Now I can't walk even 100 feet & feel severe pain in my entire body, sleeping disturbances, joint pains, back pain, forgetfulness, irritatability, etc - all symptoms I had earlier. My cholestrol is 167 mg/dl. I don't have any other bad habits. I am a poor eater also. Now my weight is 104.5 kgs. Kindly advise.

A:1. You are suffering from Primary hypothyroidism. You will require life-long thyroxine replacement therapy. The dose adjustment should be precise - neither less nor more; otherwise long-term problems can be there. 2. You may be suffering from Syndrome X. There is no harm in taking metformin. If both hypothyroidism and Syndrome X are managed properly, all your complaints may disappear. In case of any doubt, please consult an endocrinologist.