Dexamethasone Suppression Test
Prolactin level over 200 is almost always a prolactinoma.
-Do MRI with contrast or CT Scan with coronal cuts.
-presents bone pains, depression, pain, kidney stones, loss of appetite.
TSH goal should be below 3.0
Increase levothyroxine dose by 25-50 percent.
-Graves disease: Use PTU in first trimester, then methimazole.
-It presents with nervousness, palpitations, tremor, heat intolerance, weight loss, mental changes, fatigue, insomnia, increased appetite,
-Diagnosis: TSH, Free T4,T3, Radioactive Uptake Scan, CBC, ESR, Ultrasound, Thyroid antibodies.
-Graves Disease: Most common cause of hyperthyroidism.
-Other causes: Hashimoto’s, amiodarone, iodine, postpartum thyroiditis, metastatic thyroid cancer.
-Graves Disease Treatment: Radioactive Iodine, PTU or methimazole, beta blockers.
-Methimazole safer than PTU.
-With PTU, there is risk of serious liver injury.
-In pregnancy, use PTU.
First Test to diagnose hypothyroidism is TSH.