Hypothyroidism

Patient is here for a recheck. We last saw her on 04/07/2015. At that time, she was doing very well and today she continues to do very well. She has been on allergy immunotherapy for little over three years and has found great relief of her seasonal allergy. She states that this year has been the best year yet. She has significant allergies to weeds that it is the season we are currently in and she has not had any complaints. She currently has about two more shots left of her last vial and she would like to try stopping her allergy immunotherapy and see if she has sustained relief for her allergies. She denies any history of sinus infections, upper respiratory infections, or other complaints since last time we saw her in April.

ASSESSMENT:
1. Seasonal allergic rhinitis.
2. Allergic conjunctivitis.
3. Hypothyroidism.

PLAN:
1. At this time, we will try discontinuing her off the allergy immunotherapy and see if she has achieved sustained immunity to her allergen.
2. I encouraged her to use Zyrtec or other over-the-counter antihistamines as needed if she has any mild breakthrough symptoms. If she has significant symptoms after being off the allergy immunotherapy, I encouraged her to let us know so we can potentially restart allergy immunotherapy for another year or two to again attempt to get the sustained immunity for long term.
3. We will follow up in next year to see how she continues on without the allergy immunotherapy or sooner if she has any questions or concerns.

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