Q: I am 47 years old. Last year I had irregular periods and profuse bleeding during periods. I took medicines prescribed by my doctor. I underwent a thyroid test, which turned out to be positive and my TSH showed 9.61. Then I took Eltroxin tablet, one tablet per day. After three months my TSH came down to 0.42 and then I stopped the medicine. Now since the last 10 days, I have a severe feeling of cold from inside, whereas there are no outside symptoms of cold. I have a swollen eye and there is considerable swelling in my hands and legs, too. My blood test shows Eosinophils 4% and Lymphocytes 46% and urine is quite normal. Now I have started taking Eltroxin again along with other medicines for cold like Nise and Sinarest. What is the problem with me? The place where I live is quite remote and there are no big hospitals. Am I in immediate need of advanced medical treatment?

A:The thyroid gland produces hormones called T4 and T3 when stimulated by a hormone called thyroid stimulating hormone (TSH) secreted by the pituitary gland. The secretion of TSH, in turn, is regulated by the hypothalamus gland, which secretes TSH releasing hormone (TSRH). Thyroid function tests usually involve several tests, which help to diagnose different thyroid diseases. When the thyroid gland is underactive, or is not producing enough thyroid hormone, a person is said to be hypothyroid. The normal range of TSH in blood used to be 0.5 to 5.0, but according to the American Association of Clinical Endocrinologists, treatment should be considered for patients whose test values lie outside 0.3 to 3.0. You should not stop treatment on your own and should consult your doctor every 6 to 8 weeks after the treatment has started. For best absorption of the thyroid hormone, you should take it first thing in the morning, on an empty stomach, one hour before eating, and after six to eight weeks, you should have another TSH test to ensure you are taking the proper amount of thyroid hormone.