Helped Over 500,000 patients with 98%+ satisfaction.

Connect & Get Personalized 1-to-1 Answers from Expert Doctors

DoctorSpring > Question Home

Opinion about ACHILLES TENDON RUPTURE in MRI.

Resolved Question:

I have my MRI images from today regarding a potential achilles tendon RE-rupture. I have a follow up on Wednesday with my DR but I'd like someone else to look at it before then as well so I have both opinions prior to my appointment.

Category: Endocrinologist

Ask Your Own Question

Category: Diabetologist
 22 Doctors Online

Hello,
Thank you for your query at Doctorspring.com
From your description, you have AutoImmune Thyroid disease (Hashimoto's thyroiditis) which started initially as a subclinical, milder hypothyroidism and over a period has led to almost complete loss of thyroid function, and thats why this high TSH. Your requirement of thyroxine is not met by 50mcg, hence the TSH remains high. Take 100mcg daily, and retest after 2 months. you may have to increase or decrease the dose based on TSH report then. The idea is to keep the TSH in normal range. Thats adequate dose. and this is likely to require lifelong thyroxine supplementation
Feel free to discuss further,
Regards.


Patient replied :

Thank you for the response. I do have 2 follow up questions.
1) Post 2 months of taking 100 mcg if TSH is lower than range and FT3, FT4 are higher than range then I should reduce Thyroxine to 75 mcg? Is that what you mean when you say "adequate dose" else I continue with 100 mcg.
2) What's driving this high TSH? Is it something I can contol beyond the tablet? I mean precautions, food or environmental factors. Also what else should I watch out for? Any other tests that I should get done... In your experience what other things go wrong with patients with similar history? I just want to be prepared and cautious.
Appreciate it.


1) Yes, I mean that only.
2) TSH is in indirect feedback with Free T4 and Free T3. If their levels fall, TSH levels rise, so that thyroid gland is stimulated to produce more T3 and T4. No other thing in diet or otherwise drives the TSH.
You just need to be regular with your medication, not combine with Iron, calcium etc, and test TSH once in 3-6 mths to adjust doses. Once the TSH is stable in normal range, you may check once in a year too.
Nothing else will go wrong, be assured.
Regards.


Dr. J Muthukrishnan
Category: Diabetologist
Experience: 
Fellowships/Training: 
1. 10th Asia-Pacific Pediatric Endocrine Society  Fellows meeting, Seoul, Korea, Oct 2008
2. Eighth ICMR Course on Genetics and Genetic Counseling – Jul 2008 – SGPGI, Lucknow
3. Annual Certificate Course on Endocrinological Laboratory Techniques at National Institute of Nutrition (ICMR) Hyderabad,India, ( Aug-Sep 2006) 
Fellowship: Endocrinology, Diplomate of National Board, National Academy of Medical Sciences, New Delhi, 2008, Medwin Hospital, Hyderabad
Senior Residency: Diplomate of National Board (General Medicine), National Academy of Medical Sciences, New Delhi, 2002
Residency: MD, General Medicine, 1997-2000, Armed Forces Medical College, 2nd position in University
Medical School: MBBS, Armed Forces Medical College, 1992
Dr. J Muthukrishnan and 4 other Medical Specialists are ready to help you

Users who read this, also read:

Make informed and better medical decisions.

Join the 500,000 people who found a smarter, quicker way to get Answers, Recommendations & Expert Opinions.

Expert Doctors at fingertips

Recommendation on next step. Second-opinion.Multi-specialty.

Save Time

Average time for answers: 6 hours.

Save Money

$35 for typical specialist consult vs. $120 for a local appointment.

Free Follow-ups

Clarify, ask further questions for free in private conversation.

100% Satisfaction

Money back guarantee for the 1st reply. MEDNET Quality Board.

Start My Consultation

CHAT NOW

About DoctorSpring.com

Doctor Spring is a novel online Doctor consultation platform where you can get your medical questions answered by leading Doctors. Just Submit your question and rest assured that you will consult a Doctor easily. Once you submit the question, the Doctor from the concerned specialty will reply within hours. You can always ask more questions or add details with follow-up question options and make it an online doctor chat. You may use this service to consult a specialty or for getting medical second opinion. All paid services come with a MEDNET quality assurance and 100% money back guarantee.

DoctorSpring in news