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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How To Treat Hypothyroidism While Treating High BP In The Elderly?

My mother is 87 and has refused to treat her hypothyroid condition ( has had it since she was in her early 30 s) or treating her very extremely high BP for the past 15-20 years (non compliant patient). She has recently started seeing a new Dr. who has referred her to an endocrinologist because of nodes on thyroid. Bless him, he also has convinced her to take BP medication. Here is the problem, she refuses to let family members accompany her to her appointments (secretive) and tells us whatever... She has started stirring stories up about any and everything. She has told me the endocrinologist said she doesn t need surgery (did not have a biopsy) but they want her to start infusions for her thyroid. Does this sound plausible? What should be treatment if any, and should they do a biopsy? She told me it is not cancerous, how would they know? Do labs confirm the presence of cancer of the thyroid?
Thu, 2 Jan 2020
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General & Family Physician,  's  Response
Hi,

Thanks for sharing your concerns with us. We will try to help you in best way possible. First of all it's sad to know what your mother had been going through lately.

Based on the history you have shared, the symptoms favour hyperthyroidism more than hypothyroidism. Ideally if such nodules are felt it's better to get thyroid scan if she hasn't had it already to look for any possibility of cold nodules and if so biopsy will be inevitable to rule out any possibility of malignancy. It's better to get the ultrasound of thryoid as well.

Meanwhile if thyroid levels are uncontrolled the medication may be needed to limmit the related complications.

If any infusion or injectable therapy is planned, may be any inflammation or infection like in thyroiditis requiring fluids or antibiotics may be needed but it's difficult to predict more based on this knowledge unless all the reports are seen. Wishing her a speedy recovery. Regards
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How To Treat Hypothyroidism While Treating High BP In The Elderly?

Hi, Thanks for sharing your concerns with us. We will try to help you in best way possible. First of all it s sad to know what your mother had been going through lately. Based on the history you have shared, the symptoms favour hyperthyroidism more than hypothyroidism. Ideally if such nodules are felt it s better to get thyroid scan if she hasn t had it already to look for any possibility of cold nodules and if so biopsy will be inevitable to rule out any possibility of malignancy. It s better to get the ultrasound of thryoid as well. Meanwhile if thyroid levels are uncontrolled the medication may be needed to limmit the related complications. If any infusion or injectable therapy is planned, may be any inflammation or infection like in thyroiditis requiring fluids or antibiotics may be needed but it s difficult to predict more based on this knowledge unless all the reports are seen. Wishing her a speedy recovery. Regards