Brief Answer:
Auto immune thyroiditis

Detailed Answer:
Hello,
Thank you for your query.
I'm Dr. Shuba Hariprasad and will be answering your query today

Based on your reports, you have hypothyroidism - auto immune in origin (hashimotos or granulomatous thyroiditis)

I would :
-get a detailed medical, family, personal history. (any family history of thyroid hormone imbalances or auto immune diseases
-do a clinical exam to look for signs of thyroid enlargement.an ultrasound or an MRI may be required
-if necessary, do a fine needle biopsy to check the tissue pathology of the thyroid

I suggest treatment with 100 mcg of levothyroxine (thyroid hormone replacement) for 4 weeks and to recheck your TSH levels after which dose adjustment will be made based on response.
I would also check other organ systems to look for autoimmune related problems

An autoimmune disease is when your own immunity is unable to differentiate between your body tissue and foreign tissue. This leads is an immune attack again your thyroid gland.

You will probably need life long treatment and regular monitoring to check for adequacy or treatment.
Please see your physician as soon as possible.
Hope this helps.
Please let me know if there is anything else I can help you with.

Wish you good health.
Regards,
Dr. Shuba Hariprasad

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Brief Answer:
Please check TSH after a month of treatment with Eltroxin

Detailed Answer:
Hello,
Thank you for the follow up.

To address your concerns,
1)doctors choose to treat differently. Treating with 50 mcg is not wrong. I would, however, start at 100mcg. Your doctor knows you better and I recommend that you follow his advice.
Your TSH would need to be monitored after a month of treatment and dose of eltroxin adjusted accordingly.
I would also repeat your thyroid antibodies after 6 months.
Did your doctor say if you had any thyroid gland enlargement?

2)auto immune diseases are not curable but are treatable. Your thyroid hormone needs to be replaced adequately and regular follow ups over the years will ensure that it remains normal.
It's severity is based on the reports and yours seems to be mild /subclinical.

3) an endocrinologist opinion may be sought if you prefer to do so. Treatment would be supplementing levothyroxine.

4)checking for other organ system involvement would depend on symptoms,if present
Joint pains, bowel movement abnormalities, blood in urine,unusual fatigue, frequent infections, hair loss (in patches), white discoloration (in patches).

I recommend the following tests
- a complete blood count
- serum creatinine
-Erythrocyte sedimentation rate
-urine analysis.
-chest x-ray.

You mentioned frequent colds with dry cough.
How frequent? What are your symptoms? How long do they last? Does it get better without treatment?
Do you have asthma, or allergies.
Are you on any medications other than eltroxin?

Hope I've answered your queries. Please let me know if there is anything else I can help you with.

Wish you good health
Regards,
Dr. Shuba Hariprasad

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