SAQ. A 75 year-old woman presented with increased fatigability for 4 months. She also has a H/O anterior MI 2 years back and treated accordingly. On examination- BP 140/100 mmHg, pulse 58/min, BMI 32 kg/m², no thyromegaly. Hb 12 gm/dl, RBS 6.1 mmol/L, electrolyte normal, FT4-15 pmol/L, FT3 4 pmol/L, TSH-8 mIU/L.
- What is your most likely diagnosis?
- Subclinical hypothyroidism with IHD.
- Mention 1 important investigation you want to do next.
- Anti TPO ab
- How will you treat her?
- Treatment: levothyroxine 25 microgram/day very cautiously as there is an increased risk of developing heart failure from IHD
- What are the indications of treatment in this condition of thyroid disorder?
Indication of treatment
- Symptomatic patient
- Features of cardiovascular disease/ heart failure
- TSH > 10 mIU/L
- Anti TPO ab