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How can hypothyroidism be managed?

Q: I am a 23 years old housewife diagnosed with hypothyroidism (TSH: 16.67) a week ago. My doctor suggested blood tests which showed ESR – 24 mm/hr, T4 is normal and antimicrosomal antibody is 157 IU/ml (very high). Sonography revealed enlarged size of ovaries with small follicles situated peripherally (right ovary - 4.2 x 2.5 x 3.0 cm and left ovary - 3.9 x 2.6 x 2.9 cm). I am planning for a baby. Is it curable? What causes hypothyroidism?

A:Your thyroid profile is suggestive of subclinical hypothyroidism which is due to autoimmune process as your anti-TPO is positive. With a TSH of 16, you need thyroid hormone replacement with thyroxine 50 ug every day in early morning fasting state. This disease can be controlled with medications which most patients need lifelong. But treatment is very simple and there are no long standing complications unlike patients with diabetes mellitus. There is no problem during pregnancy if you continue treatment. You should plan pregnancy only when TSH is normal which takes around 6 weeks of treatment. Once TSH is normal, even then you should continue to take treatment. Baby should be tested for hypothyroidism after birth. Bottom-line is that please do not worry or get panicky; continue medical advice and treatment suggested to you.

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