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Vakul Aren
Vakul Aren, Doctor
Category: Medical
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Experience:  MBBS,DTM&H,34 years of experience
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Endocrinologist question.During a cervical fusion surgery,

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Endocrinologist question.

During a cervical fusion surgery, the Dr did a biopsy of a nodule he saw on my thyroid. He said he'd never seen anything that looked like that did. The biopsy, thankfully, came back benign.

Since the surgery there have been two thyroid tests done. My TSH level on the first one was 16 & the next was 19.

I've had mild hyploglucemic episodes before, but not for about 10 yrs. I'm getting them often now and much more severe. Twice I tested my glucose level as it happened. First was 3.9 and the other 4.1.

Both of these began after the surgery, which was only 3 months ago. Although shes handling meds, etc., I've asked my doctor if she thought I should see an Endocrinologist. She said it wasn't needed.

Your thoughts?
What does your doctor say about the hypoglycamia?That in itself is a dangerous symptom and needs to be evaluated urgently.Have you been tested for blood sugar levels during a episode?Hypothyroidism symptoms may resemble hypoglycamia symptomatically and will also need evaluation.It would help if you see a Endocrinologist who can examine and investigate you since you appear to be having Hypothyroidism and other symptoms which need management.
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Customer: replied 3 years ago.
I did test the blood sugar level during two of the episodes, as mentioned in the first email. They were 3.9 and 4.1. Also, I've told my dr this but didn't mention it here...there was one that I didn't test during because I was alone at home and didn't think I'd make it to he kitchen for juice or something because I thought was going to pass out. I know that one had to be even lower because even though I had the normal sweating and shaking, I never felt like passing out even at the 3.9. When I took it well after it was over, at least a couple of hours, it came up to 67.My doctor has prescribed medication for the thyroid issue, which I will be starting in the morning. I picked up the medication yesterday. The only thing being done at this time for the hypoglycemia is monitoring what I'm eating and how often. I always make sure I have something with me in case it happens when I'm not home.My pre-surgical labs were all normal. I don't understand why everything changed after that. Because of these issues, my PT is taking longer than anticipated, preventing me from returning to work. My expected return was originally mid November but has been extended until "at least" mid December, per discussion between my surgeon and my short term disability rep. It's all becoming very frustrating.
The kind of hypoglycaemia you are having is exactly what I am afraid of.This can easily lead to severe and irrepairable damage,severe hypoglycemia is a dangerous problem!!.This needs urgent investigation to reach the cause and to eliminate it.
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Customer: replied 3 years ago.
I sent this last question last night but I don't think it went through.I came on this site because, as much as I trust and respect my doctor, I'm not sure I agree with her this time. My last question is, in your opinion, should I follow her advice and just do the follow up labs? Or should I follow my own instinct and make an appointment with an endocrinologist despite my doctor feeling that it isn't necessary?Once again, thanks for your input.
There were quite a few articles on the risks of hypoglycaemia in medical literature.They all were of the opinion that there was a great risk of macrovascular and microvascular complications that could lead to coma,seizures and even death.There is increased cardiac stress and the widened pulse pressure and altered conciousness may lead to many complications within a short space of time.Since most patients are elderly and with atherosclerotic changes and weakened myocardium,as also there is risk of cerebrovascular accidents leading to seizures and coma.As there is evidence of hypoglycaemia in your case,it would be prudent to urgently find out the cause of such hypoglycaemia to eliminate such dangers.Consultations with a endocrinologist may help pinpoint the problem,as he would be aware of the possible causes and dangers of such symptoms,as well as the best methods of management of the problem.
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