Understanding High TSH and Enlarged Ovarian Cyst: What to Do Next

Question
SIr
My wife has undergone Ultra sound and found her left ovary enlarged in size & replaced by a well defined hypoechhoic lesion masuring 3.2 X 3.3 and sonological feaure suggestive of corpus luteum cyst- left ovary
also she had undergone lab test of TSh which showed value of 237.87ulU/ml. her Hb is 10.6serum prolactin is 16.77
doctor had advised TAB THYRONORM 50mg

please guide whether any other test is preferred or situation is dangerous
thx
SUMAN

Answer
Hello Suman,

I would recommend that she have another ultrasound done within the first 7 days of her next period.  If it is a CL cyst, then it will be gone.  If it is still present, then she should be placed on birth control pills to try to suppress the cyst for one month, then have the ultrasound repeated again.  If it is still there, then she will probably need a laparoscopy to remove the cyst.

The thyroid is abnormal, and she needs to see an Endocrinologist (Internal medicine - hormone specialist).  They need to find why her thyroid is not functioning correctly and treat it appropriately.  I do not recommend just putting her on medication without a proper evaluation.

Sincerely,

Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com

Monterey, California, U.S.A.