For the Love of Science & Medicine Part III

[dinoiii]

For the Love of Science & Medicine Part III – Debut of the Butterfly Gland

Author’s Note: The continued push to offer up free supps and the like in attempts to encourage interaction will become a reality a few issues from now. Stay tuned.

A 29 year old male with no significant past medical history recently had experienced an intentional 20-pound weight loss secondary to going on a crash diet (defined as -1500 calories off BMR in this case) about 3 weeks prior. He became fatigued, depressed, and discouraged. Moreover, despite his continuing efforts and continued decreasing calories, he couldn’t lose any more weight, exacerbating the cycle. He stopped exercising and whatever positive results he had gained from the diet had all come but come to a crashing halt.

Labs:
Sodium: 138 mmol/L [N: 132-142]
Potassium: 4.2 mmol/L [N: 3.6-5.0]
Chloride: 106 mmol/L [N: 101-111]
Carbon Dioxide: 26 mmol/L [N: 21-31]
BUN: 26 mg/dl [N: 8-24]
Creatinine: 0.9 mg/dl [N: 0.9-1.6]
Glucose: 92 mg/dl [N: 60-99]
Tot. Bilirubin: 0.9 mg/dl [N: 0.0-1.2]
Direct Bilirubin: 0.0 mg/dl [N: 0.0-0.2]
Indirect Bilirubin: 0.9 mg/dl [N: 0.0-0.1]
ALT: 13 IU/L [N: 16-49]
AST: 10 IU/L [N: 10-60]
Alk Phosphatase: 68 IU/L [N: 49-142]
Albumin: 3.8 g/dl [N: 3.2-5.5]
Calcium: 9.2 mg/dl [N: 8.4-10.7]
TSH: 1.378 uIU/ml [N: 0.318-5.50]
Free T4: 1.2 ng/dl [N: 0.8-1.8]
Free T3: 233 pg/dl [N: 230-420]

Unphased by his blood work, the man was convinced he had thyroid problems. Per suggestion by a worker at the local health food store, he started taking kelp. Shortly after starting the kelp, his symptoms became much worse. Over the course of the following month, he gained back 15 pounds of the weight he had lost. A repeat thyroid panel was done.

Labs:
TSH: 42.1 uIU/ml
Free T4: 0.6 ng/dl
Free T3: 98 pg/dl

Questions:

1) What would most likely explain the patient’s scenario as seen above?
2) What would the next step of this patient’s treatment likely include (inclusive of additional labs and/or medication you may opt for)?
3) What is the best approach to offering advice on how best to avoid a similar situation from occurring in the future?



D_

[dontknowaboutme]

What happened with this case?