instruction: hello doctor my sister is going through psychiatric treatment for depression she had a miscarriage 10 years back and childless after that since the last six years she is in depression and unable to mingle with society doctor asked for routine blood tests and her ash level are above normal she advised her to visit an endocrinologist she is lacking energy in her day to day work and always complains of body aches like in waist area and in back she is very silent and only responds to any query after knocking her two to three times she cannot walk for more than 500 meters at a stretch and feels tired always she also complains about constipation and less sleep she is 41 years old and her weight is keg with a height of 161 am blood pressure is normal 10 80 mhg I have uploaded her reports and her medications are tablet arpizol 15 my nextto my neuro do 60k and optineuron please advise for her ash levels and vitamin levels it is low iron and calcium levels are low as well I would request you to upload a prescription if possible so that I can buy the medicines from local shops or online
output: hello I just read your query and the detailed reports about your sister well the ash thyearoid stimulating hormone is not that high as to require a treatment currently usually it so happens when the patient is already under some physical ailment and this is often temporary I suggest no treatment for her subclinical hypothyearoidism at this stage although I would advise to repeat just her ash to and to after three months and then regularly at six months twice and then once yearly to rule out any future thyearoid disorder regarding her vitamin levels I saw the prescription which said it does contain 60 iu of vitamin so no need for anything from that aspect from me as well although it is better to give her sun exposure regularly early in the morning daily for 30 minutes both for vitamin deficiency and her depression as it helps for both conditions rest all her symptoms are due to her psychological disorder and not due to thyearoid as of now I hope this helps thyearoid function test after three months