I'm a 28-year-old woman working a desk job, and I've noticed my TSH level is at 8.67, even though my T3 and T4 are normal. I usually keep a pretty healthy lifestyleI'm vegetarian and consume a lot of milk-based products, plus I swim four days a week. Im 5 feet tall and weigh 50kgs. Recently, though, I've been off track with my diet, eating whatever whenever. I've had high TSH before but managed to lower it through lifestyle changes. Do you think adding a multivitamin could help if I focus on fixing my diet and sticking to regular exercise? Would love to hear your thoughts.

_Possible Causes_ 1. _Anal fissures_: Small tears in the anal lining. 2. _Hemorrhoids_: Swollen veins in the anal region. 3. _Skin irritation_: Allergic reactions, eczema, or dermatitis. _Treatment and Relief_ 1. _Warm sitz baths_: Continue using warm water with potassium permanganate (1:10,000 dilution) for 10-15 minutes, 2-3 times a day. 2. _Topical creams_: Apply over-the-counter (OTC) creams or ointments, such as hydrocortisone or lidocaine, to reduce inflammation and pain. 3. _Stool softeners_: Take OTC stool softeners, like docusate, to ease bowel movements and reduce straining. _Precautions_ 1. _Avoid rubbing or scratching_: Gently pat the area dry instead. 2. _Wear breathable clothing_: Loose, cotton underwear can help reduce irritation. 3. _Maintain good hygiene_: Clean the area gently with water and mild soap. _Consult a Doctor If_ 1. _Bleeding or discharge_: Presence of blood or unusual discharge. 2. _Severe pain_: Intense pain or difficulty controlling bowel movements. 3. _No improvement_: Symptoms persist or worsen despite treatment.