This case study was written by Y. Pritham Raj, MD Medical Director, Internal Medicine Practice, Departments of Internal Medicine and Psychiatry, Oregon health and sciences University. In it she discusses the many symptoms associated with hypothyroidism, and her interactions with a women patient only known in the case study as Mrs A. The patient under her care complained of weight gain and feeling lethargic also felt very depressed. According to the patient she “generally felt like an 80 year old women”.
The doctor decided to screen for adrenal disorders because most doctors do not routinely screen for these disorders. One of the main reasons why is because the symptoms are so closely linked to other disorders or sicknesses. They do however specifically screen for thyroid disease, because depression is so closely linked to it. (Raj, 2013) Initially Dr. Raj considered the patient was of menstruating age. So she checked hemoglobin/hematocrit levels to test for anemia. Alongside this she checked renal function by monitoring electrolytes. Lastly she had the patient take a fasting blood sample, A1C test, in order to check for diabetes. The purpose was to rule out other reasons for depressive symptoms. The rest of the symptoms in the patient included facial swelling and abdominal cramps. …show more content…
This is all consistent with hypothyroidism. Dr. Raj put the patient on a full levothyroxine (synthetic hormone) replacement dose. The patient had no cardiac issues so the dosage of the treatment could be based on weight, versus starting small and building up. This method is more cost effective, safe, and convenient. (Raj, 2013) The patient responded quickly and when she came back in at six weeks (which is the recommended time frame for further thyroid lab tests) she was fine. Thyroid levels were normal, depression still