Since these itchy, acne-like patches on your forehead haven't responded to adapalene or Clearz Plus, and given your PCOD, this might not be typical acne. The itchiness strongly suggests a condition called fungal folliculitis (an overgrowth of natural yeast), which mimics acne but requires antifungals rather than standard acne topicals. Hormonal fluctuations can also contribute. I gently recommend consulting a dermatologist to confirm this. They may suggest a topical antifungal like ketoconazole, which is safe to use alongside your metformin and levothyroxine.

To make your upcoming consultation more helpful, getting a few basic tests beforehand is a great idea. I recommend a Liver Function Test (LFT) to evaluate her enlarged liver, a Thyroid Profile (TSH) to monitor her levothyroxine (Thyronorm) dosage, and a routine Urine Analysis alongside a Kidney Function Test to check her kidney health. These simple tests will give her doctor a clear picture.

Your low TSH of 0.05 suggests your Thyronorm (levothyroxine) dose may be too high, putting you in a temporary hyperactive thyroid state, which commonly causes hair loss and fatigue. Additionally, taking both Nexito (escitalopram) and sertraline together is unusual and needs a doctor's review. Please consult your physician soon. They will likely reduce your thyroid medication dose and evaluate your anxiety treatments. Once your hormone levels balance, your energy should return and your hair will start to recover.

When you stopped your Thyronorm (levothyroxine), your body suddenly lacked thyroid hormone, prompting your pituitary gland to produce a massive amount of TSH to try to kickstart it. After restarting your 100 mcg dose, it is completely normal for TSH to remain high at 10 to 12 days. Levothyroxine builds up very slowly in the body, and it typically takes 4 to 6 weeks of consistent daily use for your hormone levels to stabilize and for your TSH to safely come back down. Please continue taking your medication exactly as prescribed, and your doctor will likely recheck your levels soon.

It is very likely that stopping your Zonisep (zonisamide) after six years is causing these symptoms. Suddenly halting this medication can disrupt your nervous system, leading to blood pressure fluctuations, body cramps, and that strange sensation in your head. While your daily Thyronorm (levothyroxine) is important for your thyroid, abruptly stopping zonisamide is the most probable trigger here. but it is very important that you contact your doctor immediately. They can help you safely manage this transition or adjust your dose to keep you safe and comfortable.

Since your thyroid levels are slightly high, it is very important that you continue taking your Thyronorm (levothyroxine) exactly as prescribed for now and do not change your dose on your own. A 'slightly high' result, along with your symptoms, suggests your thyroid hormone levels may need a precise adjustment, which your doctor should guide. I recommend sharing these recent blood test results with your physician soon so they can safely tailor your dose and help you start feeling much better.