Curofy
Dr. Ajeet Singh (General Practice) needs a second opinion on this medical case.
A 35 year old female presented to OPD for routine follow-up for Hypothyroidism and T2DM
*Chief Complaints*
No fresh complaints as of now, she only complaints of pain left knee and gastric discomfort, which I attribute to metformin 2gm/day that she was on
*Investigations*
RBS - 193
BP - 148/90
PR - 90
Weight - 70kgs
Her last TSH was 23.6 in September 2020 and she was on 150mcg L-thyroxine
Her recent report of TSH is 18.21 on 16.12.2020
*Management*
Previous medications - glimipiride 2mg bd+ Metformin 1gm bd + Linagliptin 2.5mg BD
She is started now on -
Tab. Gliclazide 60mg XR + Metformin 500mg BD
Tab Dapagliflozin 10mg OD
Increased the dose of L-Thyroxine from 150 to 175mcg E/S
Tab. Telmisartan 40mg OD
Tab. Tramadol + PCM SOS for pain
I was also willing to advise her a gluten free diet, but she is already taking only 2 chapatis in BD dose,
Secondly, I thought of advising her to get herself tested for TTG IgA but I didnt do
Please give me your opinion on gluten free diet advises that you give and whether u get someone of this picture tested for TTG IgA??