Sodium bicarbonate is a base when its concentration in blood increases the pH also increases and becomes more basic. When its concentration in the blood decreases pH decreases too and becomes more acidic.
Sodium bicarbonate must not be over-replaced, it may cause cerebral edema or in some cases, severe metabolic alkalosis.
The general rule to replace bicarbonate is;
Hyperthyroidism secondary to toxic multinodular goiter can be treated by any of the following means:
Usually done when the goiter is large and causes significant cosmetic disfigurement. Patient is made euthyroid with the help of antithyroid drug, Carbimazole or Methimazole and surgery is planned when patient becomes euthyroid.
Letrozole which is an aromatase inhibitor, which blocks the conversion of testosterone to estrogen and thus blocks the negative feedback effect of estrogen on FSH. Therefore, the level of FSH increases and the chance of follicle maturity increases.
Clomiphene also works by increasing the level of FSH and LH. but clomphene acts directly on hypothalamus.
Studies have shown Metformin has a number of benefits, some say it is a miraculous drug. Metformin has shown following properties;
- Its antiging
- It reduces the risk of cancer
- Decreases the risk of stroke, cardiovascular diseases,
- Decreases progression of atherosclerosis
- Reduces the risk of developing open angle glaucoma
- Helps to induce ovulation in polycystic cystic ovarian syndrome.