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Should I continue medicines for cholesterol and thyroid?

Monday, 24 January 2011
Answered by: Prof Dinesh Dhanwal
Prof of Medicine and Head of Endocrinology, Maulana Azad Medical College, New Delhi
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Q. I am a 45 years old male suffering from high blood pressure for the last five years. Initially, my doctor had prescribed Aten 50, later he changed it to Nubeta 5. He again changed this to Teleact 40. My blood pressure remains 140/155 - 95/85 mmHg. After taking these medicines, I am having a digital blood pressure machine, which always shows my blood pressure around 120-70 mmHg. But my doctor never believed these readings and suggested to continue with the prescribed medicine. I underwent ultrasonogram of the abdomen, ECG and blood sugar tests. Later I underwent high sensitive ERCP, lipid profile and thyroid function tests. All came normal except total cholesterol level which was more than 200 mg/dl. My T3, T4 are OK but TSH level was around 13. The doctor suggested Eltroxin 50 for thyroid and Rozavel F for lowering cholesterol. I took these medicines for three months. Now, my cholesterol level has reduced to 126 mg/dl but my fasting blood sugar has elevated to 148 md/dl. I stopped taking medicine for cholesterol and thyroid for a month but continued with Teleact 40. Then I again underwent blood sugar test at two different laboratories. One showed my fasting blood sugar level - 90 mg/dl and PP – 72 mg/dl. Another laboratory result showed fasting blood sugar level - 110 mg/dl and PP – 95 mg/dl. Should I continue medicines for cholesterol and thyroid?

A.  There is not much confusion when we put everything together. You have subclinical hypothyroidism as TSH is high and for this you should take Thyroxine 50 ugm every day and get your TSH done after 6 weeks for further adjustment in the doses. There is something called as whitecoat hypertension which means that blood pressure (BP) increases when a person goes to a doctor. You may change the doctor or get your BP readings from another instrument. Also get your retina examined from a eye specialist and if any BP changes this will suggest that you have high BP. Regarding your blood glucose levels; you had high levels at one time which may be due to stress or some infection or one of the medications esp. Aten, but as your levels are normal do not worry but keep a good lifestyle as you are at high risk to develop diabetes later on. This is not uncommon to see lower PP blood glucose levels than fasting and this is something to do with the abnormal insulin response to meals. This also suggests that you are at high risk for diabetes mellitus.

A.  There is not much confusion when we put everything together. You have subclinical hypothyroidism as TSH is high and for this you should take Thyroxine 50 ugm every day and get your TSH done after 6 weeks for further adjustment in the doses. There is something called as whitecoat hypertension which means that blood pressure (BP) increases when a person goes to a doctor. You may change the doctor or get your BP readings from another instrument. Also get your retina examined from a eye specialist and if any BP changes this will suggest that you have high BP. Regarding your blood glucose levels; you had high levels at one time which may be due to stress or some infection or one of the medications esp. Aten, but as your levels are normal do not worry but keep a good lifestyle as you are at high risk to develop diabetes later on. This is not uncommon to see lower PP blood glucose levels than fasting and this is something to do with the abnormal insulin response to meals. This also suggests that you are at high risk for diabetes mellitus.

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