Q: I am a 30 years old man who has been getting small white patches on the skin. My TSH level is 8.88 and fasting blood sugar level is 89 mg/dl, what should I do? Please advise.

A:Your TSH is high, I would suggest testing it again along with free T4 and thyroid peroxidase and thyroglobulin antibodies and if the test shows evidence of hypothyroidism, then treat with thyroid hormone replacement therapy. You blood glucose is normal. I would suggest you to see a dermatologist for the white patches on the skin, as it may be a separate problem. One of the possibilities is vitiligo. This is an autoimmune disease of skin and sometimes vitiligo and thyroid problem due to an autoimmune etiology can coexist.