Thyroid Problems/thyroid


My daughter had a blood test showing a tsh score of 5.7, vit d deficiency of 5!, and total cholesterol of 268. She is 30 years old.  They want to do another blood test. She went to the internist for constipation she's had for 15 years.  Sometimes it's worse than other times.  Meanwhile, I have been googling.  Seems to me she may have hypothyroidism.  However, it also seems like the vit d deficiency can cause the tsh score and the high cholesterol, and the constipation can cause all these things too.  It seems like she could be put on incorrect medications.  Can you shed any light on all this?  Thank you

ANSWER: Lauren,
Yes you are right. All lab reports suggestive of hypothyroidism. Need to test complete thyroid profile and antithyroid antibodies. In my opinion low vit D doesnt cause those symptoms on its own. But low vit D levels make the hypothyroidism worse. So there is definite relation between them. Need to put her on high dose vit D supplements. Also need to improve storage form of vit D. Please check her iron profile. I am sure that will be low too. Tell her to get good sun exposure. What medicines she has been put on now?

Thanking you!

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QUESTION: I'm not sure what you mean by "improve storage form"?  Her iron was fine.  She is on no meds or any vitamins.  She is a vegetarian, and eats no foods with vit d, it seems.  Could getting her vit d in the normal range be an option for now - and then retest including a complete throid profile in a few months?  Could the vit d in the normal range correct things?

Thanks so much!

ANSWER: Lauren
To improve the vit D levels completely she need to take cholecalciferol or vit D3 which is the functional form of vit D. Vit D is stored in body as precursor molecules like calcitriol and alfacalcidol. So if she takes all 3 forms togetger in combination it will raise her vit D reserves so that it wouldnt get low repeatedly. When you say her iron was fine i believe you have also checked her ferritin levels. Vit d is not available in any food sources. Its prepared in our body with the help of sun light.My suggestion is check at least antithyroid antibodies for now. Only improving vit D levels will not resolve thyroid problems. If her thyroid antibodies are positive she should start immediately on low dose thyroxine. Later we can retest thyroid profile once in 3 months. Simultaneously we can improve vit D levels also.

Thanking you!

---------- FOLLOW-UP ----------

QUESTION: This is great info!  Can I just ask you - what if her antithyroid antibodies are normal?  Also, if she goes on thyroxine, is that for life?
Thank you so much!

If antithyroid antibodies are normal then we will only monitor TSH once in 6 months
Yes thyroxine therapy is to be taken throughout life and she can lead normal life withoutany side effects after adjusting appropriate dose
Its just like eating food daily you take one tablet daily morning

Thanking you

Thyroid Problems

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Dr.Shrinidhi Kulkarni


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KIMS, Bangalore

MBBS, Intership in Internal Medicine

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