A 30 year female patient with C/O Rapid weight gain, Amenorrhoea from last 6 months and constipation came to me. According to her she was operated for thyroid in 2012 ( details she don't know nor she is having any file record of the operation) post operatively. She was put on levothyroxine (100 ucg) which she is taking continuously from the last 3-4 years without follow-up to her doc. She is having hirsutism, mild buffalo hump, mild facial puffiness and no pedal oedema. Done Following investigations.
T3 is 109(60-200), T4 is 12.4(4.5-12), TSH is 0.77(0.30-5.5) , 8AM cortisol is 0.22(6.2-19.4) n 4 PM Cort is 0.23 (2.3- 11.9), Triglycerides R 194 n Cholesterol is 263 LDL /HDL ratio is 4.86, FBS is 95 n PPBS is 123. USG (ABD+Pel) is s/o Grade 1 fatty infiltration of Liver. Do I need any more investigations? What would be the line of treatment? Can I reduce the dose of levothyroxine and…
