### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
My TSH level is 7.7 (checked on Jan.10, 2011). I was diagnosed with higher TSH in July 2010 and have been on thyroxine (50 mg) since then. But the TSH level remains uncontrolled. Now gradually since two months I am experiencing depression, anxiety, palpitations, hair fall, mood swings and difficult PMS. My doctor has prescribed sertraline. What should I do?

### output:

Hi! Thanks for consulting with Chat Doctor The normal range for TSH is 0.4 - 4.0 (mid/L).  Having a high level of TSH is sensitive for primary hypothyroidism; this means your thyroid gland is under-active.  The spectrum of hypothyroidism includes several of the symptoms you are experiencing such as depression and brittle hair.  Please let me know if you are experiencing any other symptoms of hypothyroidism - These include: constipation, weakness, fatigue, weight gain, Chat Doctor.  The anxiety and palpitations you are experiencing could be a side effect of an autoimmune disorder called Hashimoto thyroiditis which initially may present with symptoms of hyperthyroidism (due to follicular rupture) before progressing to hypothyroidism.  Do you have an enlarged thyroid gland?  I would recommend having a full thyroid profile work-up and consulting with an endocrinologist.  Levothyroxine is a commonly used medication to replace the thyroid hormone you are lacking.  The sertraline you are taking is a serotonin-specific reuptake inhibitor which means it will help treat your depression and anxiety, but has no effect on thyroid hormones. I hope this helps and do not hesitate to ask if you have any questions. Take care,