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Thyroid Problems/Low thyroid and weak adrenals


Dear Dr. Kulkarni,

I live in Northern California and I am 56 years old. I was diagnosed last week with chronic mucus in both nasal passages. There is mucosal thickening and inflammation in left nasal passage. My nasal septum has deviated to the left. I have sinus issues and post nasal drip with chronic green mucus since January 2009. I am currently taking Bactrim, twice daily for three weeks.
ENT specialist has ordered lab work for food allergies, environmental allergies and respiratory allergies. I am highly allergic to oak leaves. There are many trees outside my home and if the leaves puncture my skin while raking I develop severe poison oak and lately all my wounds have been infected. I have a leg wound since 2 months ago and the wound is still trying to heal.

Thank you so much for your prompt response to my low thyroid question. I forgot to mention that in 2010, my TSH levels fluctuated, 5.6, 10.8, and in late 2010 they were 8.4. My Endocrinologist said that 8.4 was in the higher than normal range but due to having no symptoms I did not need medication.
My Nurse Practitioner requested  antibody testing for Hashimoto's disease and free T4. I will have blood test on Saturday. Is it important to have T3 checked?  There is a history of Hypothyroisim in my family, my mother and brother.
Please let me know what tests need to be done?  My weight is 108 lbs and I am 5 ft. 3 1/2 ins.  I weighed 132 lbs. in 2006 prior to Adrenal Insufficiency, my weight dropped to 118 lbs and remained stable until 3 years ago.
I follow a wheat free gluten free diet for blood type O.
My medication is Levothyroxine .025 MG  I pill daily for week 1, 2 pills daily from week 2 to week 7. The NP told me that it takes 6 weeks for Levothyroxine to work. I have an appointment to see her on the 20th September, 2013. Kind regards. Denise

Hi Denise!
Nice to hear from you!
Post-nasal drip is seen in many infections affecting sinuses and in allergies. Also hyper secretion of gastric acid can also cause post nasal drip. Anyway chronic inflammation of the sinuses and abuse of nasal decongestants can result into deviation of nasal septum. I think if its necessary your ENT will suggest you have simple procedure of nerve blocking (ethmodal nerve). This would reduce the hypersensitivity(allergy) permanently.

About your thyroid condition, In 2010 many physicians considered TSH value upto 10 is acceptable. But Later according to guidelines provided by american association of endocrinologists, TSH value above 3 is considered abnormal. So TSH value from 3 - 5 is considered subclinical hypothyroidism and treated only if the symptoms are present or if the patient is positive for antithyroid antibodies. But TSH above definitely needs treatment according to latest guidelines.

I must say testing T3 is very important because, there are many conditions where T4 is within normal range and T3 is abnormal. Your weight is absolutely normal.

Who told you to follow the regimen of 1 pill daily for 1 st week and 2 pills daily from 2-7 week? What after 7th week?

Forgot to mention, continuous use of nasal sprays can result in adrenal insufficiency because of the corticosteroids in the spray.

Thanking you!


Thyroid Problems

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Dr.Shrinidhi Kulkarni


Dont hesitate to ask your health related queries. 24 X 7 ready to provide solutions to your health concerns. All questions are welcome ! Speciallly Endocrinology.


Working as a Doctor in Primary Health care Centre.

KIMS, Bangalore

MBBS, Intership in Internal Medicine

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