Case-01 : Case Study on Hypothyroidism

Introduction to Hypothyroidism

Hypothyroidism is a condition where the thyroid gland doesn't produce enough thyroid hormones. These hormones are crucial for regulating metabolism, energy production, and many body systems.

Specialist : Endocrinologist

Patient Details :

Name :
Age :
Gender :
Occupation :
Height :
Weight :

Present Complaints :

Headache
Cold to intolerance
Dry skin
Weight gain
having Hypothyroidism since 6 years and using the tablets levothyroxine 100mcg

Past Medical History :

History of thyroid disorder in the family

Physical Examination :

Vital Signs : Normal
puffy face
dry skin
No visibility of thyroid gland

Investigations :

Thyoid Stimulating Hormone ( TSH )

Diagnosis :

Hypothyroidism : indicated by high TSH, low T4.

Treatment Plan :

Levothyroxine 137mcg tablet orally once a daily for 60 days

Education :

Stress Management
Regular exercise
Low calorie foods
High fiber diet

Diet advise :

Avoid deep fried foods
Avoid cold and frozen items.
Consume less sugar foods.
Consume zera water to increase BMR rate
Avoid cabbage

Follow up :

Next consultation after 2 monts with TSH report

References :

1. American Association of Thyroid

2. Mayo Clinic

3. Harrisons Principles of Internal Medicine

Pregnancy Workouts

That exercise is vital to a pregnant woman’s health is now a well-recognised fact. Good muscle tone, healthy joints and general fitness help carry the pregnancy, ease labour and maintain good post-natal health.

Your doctor can provide exercise guidelines based on your medical history and level of risk.

Benefits of Exercise

Promotes muscle tone, strength and endurance
Improves posture
Improves emotional health
Helps you sleep better
Prevents backaches
Keeps you active and energised
May prevent gestational diabetes
Helps quick recovery from labour and delivery

EXERCISES YOU CAN DO

SHOULDER ROTATION

Shrug your shoulder upwards, hold for a few seconds and then relax.

Bring your shoulders forward and then rotate them up towards your ears and then back down. This is like making small circles with your shoulder in both clockwise and anti-clockwise directions.

NECK EXERCISE

Gentle relaxing neck movements are important. Sit in a relaxed position.

Now, move your neck up, down and to the left and right.

BREATHING EXERCISES

These help you relax and, in some cases, lower your blood pressure. During pregnancy, deep breathing exercises help your circulatory system work more effectively, which can help your body manage swelling and congestion.

DEEP BREATHING

Sit in a comfortable, supported position. Now, place one hand on your abdomen and inhale deeply through your nose, fully into your abdomen. In case you have nasal congestion, you can breathe in through your mouth. Remember that your abdomen should move outward as you inhale.

If you notice that only your chest is moving, then you aren’t inhaling deeply enough.

Slowly exhale through your mouth as your abdomen returns to its normal position.

PELVIC TILT

Stand straight with your back to the wall and relax your spine.

Breathe in deeply and press your back against the wall. Exhale and repeat. Continue the exercise for about five minutes. Do pelvic tilt exercises many times through the day.

SQUATTING

This is especially useful during the first trimester of pregnancy.

Lean against the wall and stand with your feet spread. Now, lower your body by bending your knees. Pause, then slowly push yourself back to the starting position.

SIT AND CYCLE

Sit on a chair, lift a leg and cycle 20 times. Repeat with the other leg.

In case you have difficulty doing this exercise as your trimester progresses, you can switch to horizontal cycling. Lying down on the mat or bed, you can air cycle with both the legs.

Pregnancy Exercises

WALL PUSH-UPS

Stand facing a wall. Now lean against the wall with your hands. Keep your knees comfortably apart. Place your hands on the wall at the level of your shoulders, slightly greater than shoulder-width apart. Slowly bend your elbows and lower your chest until your chin reaches the wall. Remember to keep your back straight and then return to the starting position.
Wall push-ups engage the triceps and pectoral muscles.

PELVIC BRIDGING

Lie face up on the floor with your knees bent and your feet flat on the floor. Now raise your hips so your body forms a straight line from your shoulders to your knees. Pause for a couple of seconds and lower your body back to the starting position.

BACK PRESS

Lie face up on the floor with legs straight. Roll a small towel and keep it under your lower back.
Now bend your knees and try to press your back against the towel. Hold this position for a few seconds and then relax.

CALF STRETCH

As your pregnancy progresses, your legs may get tired easily. With calf stretches, you can maintain good circulation in your legs.
Sit with your legs stretched out. Hold two ends of a long towel with both your hands and use the towel to pull your feet towards you.
You feel a stretch in your calf muscles. Hold this position for a few seconds and relax.

SIDE RAISES

Lying on your side, lift your leg and bring it down. Repeat on the other side.

KEGEL EXERCISE

Lie down on a flat surface. Bend both knees slightly and place a pillow between your thighs. Imagine you are trying to stop the flow of urine. When you do this, you are contracting the muscles of the pelvic floor.
Try to keep your leg, buttocks and abdominal muscles as stable as possible. You can do the same exercise in a sitting position. Each time you contract the muscles of the pelvic floor, hold for a slow count of five and then relax.
Kegel exercises help strengthen your pelvic floor muscles, which support the uterus, bladder, small intestine and rectum.

Always remember to drink plenty of water to stay hydrated during these exercises. Consult your doctor to discuss your workout plan. A regular workout plan goes a long way to ensure good health during and after pregnancy. Let go of all your worry and stress. Focus on enjoying this season of life. Happy pregnancy!

Reference :

By Dr. Roopa Menon is a Mumbai-based health writer.

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