How should I manage a 28‑year‑old woman with Hashimoto thyroiditis (elevated thyroid‑stimulating hormone, high anti‑thyroid peroxidase antibodies), new photosensitivity (possible photodermatitis or cutaneous lupus), recent scalp psoriasis, bloating that improves with gluten‑ and dairy‑free diet, constipation, benign breast cysts (BIRADS 2), recent discontinuation of short‑term anxiolytic medication, stable scoliosis managed with exercise, regular menstrual cycles, and a family history of gastric cancer and early coronary artery disease?

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Last updated: February 19, 2026 • View editorial policy

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