NEWSLETTER
Expert Opinion
Q1: I am 31 years old, and was diagnosed with
hypothyroidism, about 2 months after delivery
of my second child. I have been on thyroxin
since Sept. 2006. I am taking one pill of 50 mg
daily. Recently I have been feeling very weak
and overweight. The doctor has asked me to
double the dose of thyroxin.
I need your opinion, what should I do?
A. H. Faisalabad
A It seems that you developed post partum thyroiditis (inflammation of thyroid gland after delivery). Your recent symptoms can be due to low thyroid hormone levels, for that you need extra replacement. Dose of thyroxin is based on weight of the individual as well as use of concomitant medicines. You should have your TSH test done before a decision to increase the dose is made. TSH can be done in any reputable laboratory, and if it is higher than normal then the dose may be increased.
Q2: My father has been diabetic for over ten
years. He is currently on many tablets for his
diabetes (Glicon, Piozer and Glucophage). Recent
blood test have shown that he has uncontrolled
diabetes. His HbA1C is 9% and his fasting
glucose ranges between 160 and 180. Apparently
he has no complaints, and he walks daily for
30 minutes, and follows a reasonably balanced
diet. The specialist has changed his tablets,
but the glucose levels remain the same.
Please advice for better management.
M. Shaikh. Karachi.
A: After about ten years most diabetics, ~ 80 %, require insulin therapy. The 3 types of tablets which he is currently taking have different mechanisms, but they seem to have lost their effect. Your father should now be started on insulin injections, because changing the brands of these pills will not serve the purpose. Glucophage may be continued with insulin. He should continue with dietary control and regular exercise even when insulin has been started. Target HbA1c should be near 6.5%.