পর্যাপ্ত Thyroxine Therapy সত্ত্বেও ক্রমাগতভাবে TSH মাত্রা বৃদ্ধির Cause___
Pt Compliance ( Most common cause)
ড্রাগ Interaction _যেমন
• Rifampicin EX TAB:-Rifcin 150mg (AS A Rifampicin AS A Anti-Tubercular Antibiotics)
• Calcium সাপ্লিমেন্ট (e.g. calcium carbonate)
• Iron সাপ্লিমেন্ট ( iron Containing মাল্টিভিটামিন Also*)
• Amiodarone EX TAB Pacet 200mg (AS A Amiodarone Hydrochloride Potassium channel blockers)
• Ferrous sulphate (Ex Capsule Ferol-TR 150MG (AS A Ferrous sulphate+Folic Acid+Zinc Sulfate)AS a Iron, Vitamin & Mineral Combined preparation)
• PPI(Omeprazole**)
• Antacids
• Sucralfate(EX TAB Protecto 1000mg (AS A Sucralfate AS A Chelating complex)
• HRT
• Glucocorticoids
• Milk or Dairy products
• Orlistat(EX Capsule Olistat 120mg (AS A Orlistat AS A Appetite suppressant drugs/Anti-obesity drugs)
• Ciprofloxacin
• Vonoprazan
Coeliac Disease
Nephrotic syndrome
Thyroxine_খেতে_হবে সকালে খালি পেটে খাবার খাওয়ার ১ঘন্টা আগে বা লাস্ট Meal এর ৪ ঘন্টা পর। সাথে (৪-৬)ঘন্টার মধ্যে উপরের Medicine গুলো না নেওয়াই ভালো।
Clue**(মনিটরিং থাইরয়েড Status )
নরমাল TSH সাজেস্ট________Adequate Thyroxine পাচ্ছে & Euthyroidism
↑↑ (TSH) & নরমাল (T4) সাজেস্ট_______Poor Compliance
↓↓ (TSH) & নরমাল-High (T4) সাজেস্ট _______Over-replacement
Raiyyan Tahsan. Date:-21-01-2025 Tuesday Time:8-49-45 PM
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