Lifestyle and pharmacological approaches to weight loss

Based on the clinical history provided:

The patient, VG, has been diagnosed with subclinical hypothyroidism. The disorder is distinguished by elevated levels of thyroid stimulating hormone (TSH) over the upper limit of 4.5 mIU/L while free thyroxine levels remain normal (Garber, et al., 2012, p. 1205).

The treatment aims:

To restore TSH levels to their baseline levels without surpassing the upper limit by raising thyroid hormone levels. The usual thyroid hormone replacement regimen is L-thyroxine, also known as levothyroxine. Patients should get about 1.6 milligrams per kilogram of body weight (Garber, et al., 2012, p. 1211).

For subclinical hypothyroidism patients with TSH levels ranging between 8-12 mIU/L:

A start dose of 50 micrograms of L-thyroxine is recommended. (Garber, et al., 2012, p. 1211). The drug should be taken every day. It should not be taken with meals since food hampers its absorption. VG can take the drug either four hours after the last meal in the evening or sixty minutes before breakfast while using adequate water in both cases (Garber, et al., 2012, p. 1211).

The levels of the TSH:

Are expected to decline within a month of initiating treatment, thus dosage adjustments should be made after about eight weeks.

The patient is also advised to adopt several lifestyle modifications:

To help with remission of the disease. Hypothyroidism is usually followed by an increase in weight which, if not checked, may lead to obesity. Dietary changes are recommended for the patient. The patient can adopt diets that have low fat and calories or carbohydrate but with a high content of protein (Bray, 2008). Also, the patient should engage in physical activities such as jogging, riding bicycles, and running to reduce body weight.

References

Bray, G. A. (2008). Lifestyle and pharmacological approaches to weight loss: efficacy and safety. The Journal of Clinical Endocrinology and Metabolism, 93(11). doi:10.1210/jc.2008-1294

Garber, J. R., Corbin, R. H., Gharib, H., Hennessey, J. V., Klein, I., Mechanick, J. I., . . . Woeber, K. A. (2012). Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Thyroid, 22(12), 1200-1235.