Description
Peer Responses:Length: A minimum of 180 words per post, not including referencesCitations: At least two high-level scholarly reference in APA per post from within the last 5 yearsRelate to another journalThe patient is a 27-year-old male who is a high school football coach. He came into the office for a follow-up after he went to the ER last week due to malaise and fatigue. In the ER, his T4 is low, and his TSH is high, so the ER provider prescribed him 25 mg of levothyroxine daily for hypothyroidism. The plan for that day was to recheck his level of T4 and TSH first to confirm the diagnosis and evaluate the medication’s effectiveness. When I reviewed his chart, I noticed his hemoglobin was 11.8, which I remembered from the Iron Deficiency Anemia guideline was low for his age and gender (Sonoda, 2021). My preceptor asked me what I thought about the case; I asked her if it was appropriate to order the iron profile serum test, which she said it was. During the assessment, the patient reported feeling better since the ER visit and denied any other signs and symptoms, such as palpation. His vital signs are within normal limits, and there is no sign of hemorrhage, such as pale skin, black tarry stool, ecchymosis, or spontaneous gum bleeding. I also paid attention when examining his oral cavity to see any sign of glossitis, but I didn’t notice anything. We discussed his low hemoglobin levels with him and recommended that he take an iron supplement. We also asked him to check his iron level, to which he agreed. So, my preceptor prescribed 150 mg of Ferrous Sulfate orally daily for iron deficiency anemia and serum iron profile. We received the test in the afternoon, and his ferritin and serum iron levels were low, which confirmed his diagnosis (Sonoda, 2021). I did some more research afterward, and some studies link hypothyroidism and iron deficiency anemia, and combination therapy of iron and levothyroxine resulted in a more favorable outcome compared with treatment with monotherapy of iron or levothyroxine alone (Ravanbod et al., 2013). References Ravanbod, M., Asadipooya, K., Kalantarhormozi, M., Nabipour, I., & Omrani, G. R. (2013). Treatment of iron-deficiency anemia in patients with subclinical hypothyroidism. The American Journal of Medicine, 126(5), 420–424. https://doi.org/10.1016/j.amjmed.2012.12.009 Sonoda K. (2021). Iron Deficiency Anemia: Guidelines from the American Gastroenterological Association. American family physician, 104(2), 211–212.
