Dr. Joseph

Normal TSH levels for the average adult range from 0.4 ‑ 4.0 mIU/L (milli-international units per lite Normal ranges for adults generally fall between these values Total T4 5.0-12 μg/dL Total T3 80-190 ng/dL Free T4 1.0-3.0 ng/dL Free T3 0.25-0.65 ng/dL.

Mr Sandhu, It is possible that he may be having rheumatoid arthritis. So get his RF(Rheumatoid factor) checked. RF may or may not be positive in Rheumatoid arthritis (RA). If positive and concentration is high then prognosis of the condition is poorer. RA usually affects smaller joints in the beginning. Increased uric acid is usually associated with gouty arthritis. That invariably starts with great toe and very severely painful and red.

You should consult a local doctor in person. Meanwhile I suggest diarex tablet from himalaya, 2 tablet twice daily .with plain water and vomitab from charak 1 tablet twice a day for 2-3 days.

urea temporarily increases if u fluid deficit,and normalise after taking adequate fluid that may be the cause

Dear Lybrate user, The concern may be more suggestive of the situation remaining, Liquid diet eat no more. Do not use soft drinks. Adequate protein diet. Extracted enough sleep, Onion, banana, radish, cucumber, cucumber, fried water, milk, buttermilk, stop this food. 6 almonds, walnuts 5, eat in the morning and evening. Contact back after 15 days, With best wishes, you will succeed.

Your sugar levels are very well controlled. Please make sure you don't get hypoglycemic episodes otherwise dose adjustment has to be done.

Exercise improves insulin sensitivity and also increases glucose use by muscles. So if you skip exercise your sugar level increases.

take 1 day in week nd take fix amount of brink.have something with drink.walk is necessary.take plenty of fluids.

Mr. Lybrate-user, your fasting sugar 139 mg, shows presence of diabetes, but pp 157 mg is in the pre- diabetes state. So it is not clear whether you have diabetes. Please get hba1c% checked. The criteria for diagnosing diabetes are: fasting equal to or above 126 mg / 100 ml, pp equal to or above 200 mg/ 100 ml & hba1c% >6.5. You should avoid sweets, deep fried foods, junk foods, pastries, other bakery items, sweetened aerated drinks, fructose corn syrup containing products and highly processed foods. Exercise regularly so that weight is maintained near normal. Plus avoid alcohol and smoking. Basically it means you have to adapt a modified lifestyle. Thanks.

Mr Mukesh, Hashimoto's thyroiditis is an autoimmune disease, where there are anti bodies formed against thyroxine secreting cells, resulting in deficiency of thyroxine and hypothyroidism. In this condition Iodine has no role. Treatment is to supplement thyroxine from outside as tablets.

IN HYPOTHYROIDISM:--- where there is deficiency of thyroxine hormone leading to sluggishness, tired feeling, weight increase, slow heart beats, intolerance to cold, swelling of legs, feet and face, difficulty in concentrating and at times in speech. Treatment for hypothyroidism is giving thyroxine tablets. And dose are according to level of thyroid for life time. Avoid bad habits . Avoid stress. Some Relax during work. Go for walk, Take plenty of water, high-carbohydrate foods such as potatoes, rice, pasta and bread. Nutrient-rich foods that improve your health may also benefit your thyroid gland, antioxidant-rich fruits and vegetables more plenty of water: Blueberries, tomatoes, bell peppers, and other foods rich in antioxidants can improve overall health and benefit the thyroid gland. Eating foods high in B vitamins, like whole grains, may also help. flax oil, Selenium: Tiny amounts of selenium are needed for enzymes that make thyroid hormones to work properly. Eating selenium-rich foods, such as sunflower seeds or Brazil nuts, can be beneficial. Tyrosine: This amino acid is used by the thyroid gland to produce T3 and T4. Taking a supplement may help, avoid oily foods,junk foods, go for walk. Do Tests every 3 to 6 months. And consult doctor on time.

yes there is medicines for control for thyroid. pl. tell us reports of thyroid. we can advice medicines for it. take iodine -rich meals, banana, intake at least 8 glass of water in day. eat more fiber rich foods, coconut oil, green tea, tyrosine -rich foods, low fat milk, avoid soya - products, go for walk daily, do exercises---yoga.

Hello, Its always better to avoid, but if at all it should not go beyond 2 drinks per week...thats max.. Diabetes is all about metabolic problems and alcohol further slows down metabolism. Which is surely for good for the glucose uptake.

Ask him to check hba1c level in blood which is a marker for three month sugar control in our body and ask your dad to take medication on time and also to do exercise regularly.

Mr. lybrate-user, If you have hypothyroidism and taking thyroxine, then ideally TSH should be maintained betweei 3 to4 mU/L, to remain free from all the symptoms related to it. So if TSH level goes up, then there is a need for increasing the dose of thyroxine. Thanks.

Since your father has diabetes, it is advisable that you take care. Excessive sweets will make you put on weight and that is a well known risk factor for the development of diabetes.

Yes worm infestation is a common problem in children. I would suggest the following: 1. Repeat deworming dose every 2-3 weeks for 4-6 courses 2. Personal hygiene measures eg. Daily bathing, clean & soft towel, clean & loose clothes, clean socks (even if shoes are not worn), clean toys as the child has a tendency to put toys in the mouth, brushing of teeth, hand washing / sanitizer use & so on 3. Good nutritious food 4. In view of the itching, massage of the skin in general & area around the anus in particular, with oil / cream of your choice will be helpful 5. Periodic check by your paediatrician for this as well as immunizations and preventive & promotive health is a good idea.

Mr. Lybrate-user, feeling hungry and thirsty could be symptoms of diabetes. So it is better for you to get a blood check up done of both fasting and pp sugar levels, that can clarify your doubt. If fasting is >126 mg and pp >200 mg then diabetes is confirmed. If fasting is between 101 to 125 mg it is impaired fasting glucose and pp above 141 to 199 is impaired glucose tolerance (igt). Both these conditions are also referred as prediabetic state. At that stage t2 dm is still preventable.

Dear, Yes your sugar levels are not well controlled and you are on a number of medications. But do not worry you still do not need to be insulin as we can still increase the doses of your medications. Glimepiride 1 mg can be increased so can met for min and pioglitazone. However januvia or sisal up tin is at the highest dose possible.

Dietary management for diabetics:

CHEW MORE, EAT LESS : Studies show that the longer time you spend chewing, the lesser calories you consume. Chewing for longer prevents over-eating, by giving the brain more time to receive signals from the stomach that it is full. It is not only great for digesting, but it also helps in limiting your portion size. Try chewing your food 35 to 50 times per mouthful.

DON'T SKIP BREAKFAST : No matter how late you are running to work, avoid missing breakfast. There is a reason why it is called the most important meal of the day. Your body (rather your brain) expects to be refueled a few times each day, so when you skip breakfast, you feel so hungry that when lunch time comes, you overeat or maybe choose foods items that are not the healthiest choices. Missing breakfast slows down your metabolism. More importantly, always eat your breakfast, within an hour of waking up, as your body has gone without food the entire night.

CONCENTRATE ON YOUR FOOD : How many times has your mother reprimanded you to not talk, read or watch TV while eating food? Not without a reason. When you are multitasking during meal times, your brain isn't focussing on the amount of food that you are consuming and you are more prone to piling on pounds. This doesn't mean that you cannot enjoy a meal with your friends. You can do so, but just pay attention to what you are putting in your mouth!

DON'T OVERCOOK YOUR MEALS : Overcooking food kills or reduces the number of nutrients your meal contains, and when you don't get enough nutrients, you don't feel satisfied and soon start to get junk food cravings. To combat this, try eating more raw foods like sushi and salads. Steam, bake, blanch or grill vegetables and grill or bake meat and fish. Avoid microwaving.

FRUITS BEFORE MEALS : It is advisable to eat fruits at least 30 minutes before any heavy meal. This way, the fruits will digest quickly. Eating fruits on an empty stomach detoxifies your system and supplies you with a great deal of energy for losing weight.

HAVE SMALLER MEALS, MORE OFTEN : Ideally, you should eat five to six times per day, with a two to three hour break between each meal or snack. Eating more frequently gets your metabolism going and keeps it working at an elevated level continuously throughout the day. But don't use this rule as an excuse to overeat.

AVOID EATING AFTER 8 PM : It's good to eat your last meal before eight in the evening. This way you don't land up binging on a snack before dinner time. If you find it hard to resist, have some herbal tea or brush your teeth after dinner immediately to switch your mind off from the idea of eating. THINK AND DRINK : While everyone knows it's necessary to drink at least eight to 10 glasses of water, very few know when one should consume it. When you drink is as important as what you drink. If you drink water in-between meals, the liquid slows down digestion, diluting the acid in your stomach and so the nutrients from the food that you eat are not well absorbed. To avoid this try to drink water 15 minutes before or after a meal, and if you really need to drink while you eat, limit yourself to small sips only.

Dr surbhi agrawal
consultant physician and diabetologist