dear Ian
most likely is non compliance
then malabsorption eg iron, calcium, soya
suggest thyroxine be taken on an empty stomach with no food for an hour ie water only
jeff
Dr Jeffrey Barron
Consultant Chemical Pathologist
Director Newborn Screening
Chair, London Regional Commitee, Royal College Pathologists
St Helier Hospital
Carshalton
Surrey SM5 1AA
UK
Tel UK 20 8296 2660
Fax UK 20 8641 2633
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>>> Ian Barlow <[log in to unmask]> 02/09/07 2:55 pm >>>
Dear colleagues,
we have a post thyroidectomy patient who is now taking 225ug of thyroxine daily but her Free T4 remains <5.2pmol/L and her TSH is 75U/L. (Abbott architect methods). Her Free T3 is also low at 2.3pmol/L (2.6-5.7).
She is clinically hypothyroid, which makes heterophilic ab interference unlikely, and we are confident that she is complying with treatment and has no GI pathology that could cause absorption problems.
Prior to thyroidectomy for Grave's disease ( in Oct 2006), she was rendered euthyroid with carbimazole, steroids, lithium and iodine.
Her current medication, besides thyroxine, is predisolone (5mg/day), risedronate, folic acid and calcichew-D3.
Could anyone suggest why she is not responding to the thyroxine?
Best wishes
Ian Barlow
Scunthorpe
UK
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BEGIN:VCARD
VERSION:2.1
X-GWTYPE:USER
FN:Barron, Jeffrey
TEL;WORK:020 8296 2660
ORG:;Chemical Pathology
EMAIL;WORK;PREF;NGW:[log in to unmask]
N:Barron;Jeffrey
TITLE:Consultant
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