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Am I suffering from tuberculosis?

Prof Dinesh Dhanwal
Prof of Medicine and Head of Endocrinology,
Maulana Azad Medical College,
New Delhi

Q: I am a 35 years old female weighing 94 kg. I am suffering from thyroid from the last five years. My doctor suggested thyroxin (25 mg) and then increased the dosage to 100 mg. For the past four years, I am planning for my second child. My first child is seven years old. My doctor told me that it is difficult to conceive as I am over weight and told me that I am suffering from endometriosis. I was given thyroxin (25 mg) and metformin (500 mg). My doctor also suggested me to undergo tuberculosis test. Tests were done four months back, which showed TB-PCR-1 was negative, ELISA for tuberculosis (IgM) - 0.69 and ELISA for tuberculosis (IgG) – 170. After that doctor gave me AKT-4, Penzole (4 gm), Thyroxin (25 mg), Glycomet (500 mg). These tests were done two years back, follicle stimulating hormone - 6.35, luteinising hormone (LH) - 6.83, estradiol – 94 and testosterone - 0.61. Thyroid profile showed T3 - 2.24, T4 - 1.17 and TSH - 3.016. Serum bilirubin test result showed total as 0.87mg/dl, direct as 0.34mg/dl and indirect 0.53mg/dl. I want to lose 10 kg weight. Please guide.

A:According to description given to have, you have hypothyroidism, endometrial tuberculosis and obesity. Regarding hypothyroidism, if your TSH is normal (which is so) after 25 ug dose for at least 6 weeks then this is right dose for you. Diagnosis of tuberculosis is not 100% confirmed in your case and AKT 4 given to you is not based upon a confirmed diagnosis. Reducing weightwill help you. You have been also given metformin which is given for PCOD and again diagnosis is not complete for this disease. Indication of metformin is also not clear. With treatment you can def get pregnant.