What should I do with thyroid stimulating hormone 72.94

TSH levels of TSH72.94mIU/L were significantly higher than normal, indicating hypothyroidism and requiring intervention through drug replacement therapy, etiological investigation, regular monitoring, lifestyle adjustments, and prevention of complications. Hypothyroidism is usually caused by Hashimoto's thyroiditis, iodine deficiency, thyroid surgery or radiation therapy, pituitary lesions, and medication effects.

1. Drug replacement therapy:

Levothyroxine sodium is the preferred treatment for hypothyroidism, and the dosage should be adjusted according to TSH levels. The initial treatment usually starts with a small dose and gradually increases until TSH returns to normal. During medication, avoid taking calcium or iron supplements together, with an interval of at least 4 hours. Some patients may require the use of thyroid tablets or drugs such as iodine selegiline as adjuvant therapy.

2. Etiological investigation:

Thyroid ultrasound, thyroid antibody TPOAb, and TgAb testing need to be completed to determine whether it is Hashimoto's thyroiditis. Iodine intake assessment can determine whether it is caused by iodine deficiency. Pituitary MRI examination can rule out central hypothyroidism. Collecting drug history helps identify hypothyroidism induced by drugs such as thiourea and lithium.

3. Regular monitoring:

TSH and FT4 should be rechecked every 4-6 weeks during the initial stage of treatment, and monitored every 6-12 months after stabilization. Patients with hypothyroidism during pregnancy need to have their thyroid function tested monthly. Elderly patients and those with concomitant heart disease need to closely monitor changes in indicators such as heart rate and blood lipids.

4. Lifestyle adjustment:

Ensuring sufficient intake of selenium, zinc, and vitamin D can help restore thyroid function. Avoid consuming large amounts of cruciferous vegetables. Regular aerobic exercise can improve metabolic rate, but excessive fatigue should be avoided. Pay attention to keeping warm in winter to prevent the occurrence of hypothermia.

5. Prevention of complications:

Long term uncontrolled hypothyroidism may lead to mucoedema, coma, cardiovascular disease, infertility, etc. Regular screening of blood lipids, bone density, and cardiac function is required. Women of childbearing age should control TSH below 2.5mIU/L before pregnancy and maintain TSH within a specific range during pregnancy. Patients with hypothyroidism should maintain a balanced diet and increase their intake of iodine rich foods such as seaweed and seaweed in moderation. However, patients with Hashimoto's thyroiditis should avoid excessive iodine intake. Engage in 3-5 moderate intensity exercises such as brisk walking and swimming per week for 30 minutes each time. Ensure 7-8 hours of sleep and avoid staying up late. Pay attention to keeping hands and feet warm in winter, and wear a scarf to protect the thyroid area when going out. Check thyroid ultrasound every six months and assess cardiovascular risk annually. When symptoms such as increased drowsiness, sudden weight gain, and lower limb edema occur, timely follow-up visits should be made to adjust medication.