Hypothyroidism Medical Condition Diagnosis

HYPOTHYROIDISM
Medical Condition Diagnosis
The symptoms that the patient in question presents are hair changes, weight gain, and fatigue. On the basis of the symptoms presented, my primary diagnosis in as far as this 34-year-old female patient is concerned would be hypothyroidism. In the words of Athanassiou and Ntalles (2010), “hypothyroidism is the most common disorder arising from hormone deficiency” (83). In this case, certain crucial hormones are not produced by the thyroid gland. It should, however, be noted that during the very early stages, the condition may not necessarily trigger noticeable symptoms. According to Chaker, Bianco, Jonklass, and Peeters (2017), some of the symptoms associated with hypothyroidism are inclusive of fatigue, weight gain, constipation, changes in memory and mood, sore joints and muscles, as well as menstrual changes and hair loss. Other symptoms are goiter (enlarged thyroid gland), slowed heart rate and thinning hair. The symptoms that the female patient presents in this particular case match those highlighted herein.
To ascertain the diagnosis on the basis of the physical examination, it would be prudent to conduct the relevant blood tests. One appropriate test in this case would be the thyroid-stimulating hormone (TSH) test. In basic terms, this particular test seeks to assess the TSH levels. It is important to note that TSH levels are boosted by the pituitary glands in those instances whereby the hormones being produced by the thyroid are not enough. It therefore follows that high levels of TSH indicate hypothyroidism. It should also be noted that low TSH levels indicate hyperthyroidism. Apart from this test, I would also seek to diagnose hypothyroidism using a thyroxine (T4) level test. In this particular case, hypothyroidism would be indicated by T4 levels that are lower-than-normal. In essence, the two tests in this case come in handy in thyroid function evaluation. Thus, in the recounted scenario involving the 34-year-old female patient, a hypothyroidism diagnosis would be ascertained by a high TSH level and a low T4 level.
In as far as differential diagnosis is concerned, Chaker, Bianco, Jonklass, and Peeters (2017) are of the opinion that “owing to the subtle signs and symptoms of hypothyroidism, the list of differential diagnoses is extensive” (1557). The authors suggest that some of the disorders that ought to be taken into consideration as differentials include, but they are not limited to, euthyroid sick syndrome, thyroid lymphoma, subacute thyroiditis, Riedel thyroiditis, anemia, etc.
When it comes to treatment, I would prescribe a daily dose of levothyroxine. This is essentially a synthetic thyroid hormone. The medication prescribed is key in adequate hormone level restoration. Other drugs that could be prescribed in place of levothyroxine are Synthroid and Levo-T. Following the commencement of treatment, the symptoms being experienced by the patient will start to dissipate. The drug prescribed in this case could also come in handy in attempts to reverse weight gain. Going forward, the dosage of this particular medication is likely to be determined by the patient’s TSH levels – which will be assessed after a period of approximately one to two months. Later on, TSH levels can be checked after six months and then yearly. It is important to note that this will most likely be a lifelong treatment.
The relevance of treatment in this case cannot be overstated. This is more so the case given that lack of treatment could result in serious complications including, but not limited to, heart disease and infertility. Other complications of hypothyroidism are obesity and joint pain. Further, it should also be noted that for a woman who is pregnant, thyroid concerns could have a negative effect on the mental development of the unborn baby.
References
Athanassiou, I.K. & Ntalles, K. (2010). Hypothyroidism - New Aspects of an Old Disease. Hippokratia, 14(2), 82-87.
Chaker, L., Bianco, A.C., Jonklass, J. & Peeters, R.P. (2017). Hypothyroidism. Lancet., 390(10101), 1550-1562.