Q: I am a 27-year-old female, married for 5 years. I haven't conceived as yet. My TSH levels are too high and was therefore prescribed Eltroxin 100 mg per day. I have prolonged periods for the past 6 months. My ultrasound report of the lower abdomen is normal. D&C was done and the reports are normal. But I still have prolonged periods, which last for 14 days. I feel I have slowed down in all activities including walking, cleaning, cooking, etc. I get into depression and above all I drop things very easily, which is causing trouble for me at home. Do I have vitamin deficiency? What vitamins should I take, as I am not sure if I have to take multivitamins, multi minerals or neurobion tablets? I also have elevated ESR with a positive Mantoux test and normal chest x-ray. The doctor thinks that elevated ESR could be due to excessive bleeding, while the positive Mantoux test coincided with my throat infection. Please suggest ways of becoming more active and preventing excessive periods.

A:Your high TSH shows that your thyroid gland is under active. This gland controls metabolism and energy and your lack of energy suggests that your thyroid gland may still be under active. The dosage of eltroxin has to be adjusted to get the TSH level back to normal. Please get your doctor to check your TSH regularly and adjust your eltroxin dosage. You should also get your blood count done to see that your excessive periods are not causing a drop in your haemoglobin level. I do not think vitamins are necessary if your diet is normal. You say your ESR is elevated but you did not mention its level. In women, it tends to be higher than in men. Your positive Mantoux may be because of a past exposure to TB which is not unusual in India. However, it would be worth having a chest x-ray to see if there is an active infection. Also, if the ESR remains elevated, you may need further investigations. Hopefully, with a proper control of your hypothyroidism your periods will become regular. If they remain excessive then you may need attention from a gynaecologist. If your doctor is having trouble in controlling your thyroid status then he might find it useful to refer you to an endocrinologist.