Hypothyroidism presenting with psychosis

[SJS1106]

My mother (age 63) started suffering from paranoid delusions, forgetfulness, hair loss, sudden cold intolerance, loosely connecting people etc. Her initial ER blood work showed her TSH levels at 12.  Nobody mentioned hypothyroidism at the initial appointment (5/8/14) and then when the delusions increased we went back to the ER on 5/11/14 & her TSH was at 9.9.  It was at this time that a doctor mentioned hypothyroidism casually.  She also did show new white matter on her MRI (she does have MS as well - but the MS specialists have already ruled this out as the cause)

Through my own research I learned this hypothyroidism could be the cause.  The doctors are not available to talk to us.  We must talk to them through the nurse who unfortunately I have lost confidence in her when she told me my mother had high TSH therefor was hyperthyroidism :(  They have not offered any insight into the cause or added any new drugs or changed levels of her regular medication.

I am hopeful that correcting her thyroid levels will fix her psychosis but I am wondering how long of being on the synthyroid 75mcg until we will see a resolution of symptoms. It has only been 2 days so far.  She has been treated for hypothyroidism for years and we are not sure if she had stopped taking her medicine or if her thyroid function had become that low.  Any insight you can give me would be appreciated

[ahmee]

Synthroid will take 4-6 weeks to build up in the bloodstream. It is not a fast-acting medication, so some patience will be required. However, to give any further advice it would be useful to know if she was tested for anything other than TSH (Free T3, Free T4 are the most useful tests).

The hypothyroidism should indeed be treated, although I wonder about the MS connection as well. I know an MS patient who over the course of many years went through periods of delusions and cognitive decline into full-on dementia. In that case it seemed very much connected to the MS. I suppose if the MS specialists said the symptoms were not connected to your mother's MS they would know more than I, but it is curious. Usually hypothyroidism does not present with such severe symptoms right off the bat, but then again if your mother was being treated with meds and suddenly stopped taking them, it could result in a "whiplash" type effect with my severe symptoms. Just thinking aloud here.

[Barb135]

What are her actual thyroid hormone levels?  Along with TSH, they should be testing Free T3 and Free T4.  If you have (or can get those), please post them, so we can better assess the testing treatment your mother is getting.  Be sure to include reference ranges with any labs posted, since ranges vary lab to lab and have to come from her own report.

Most of the symptoms you listed can apply to hypothyroidism, however, I'm not familiar with paranoid delusions as being a thyroid symptom.  That's not to say it can't be; just that I'm not familiar with that as a thyroid issue.

It takes 4-6 weeks for the medication to reach full potential in the blood, then it may take longer for the body to readjust to having hormones again.

Do you know if your mother has Hashimoto's?  If your mother has Hashimoto's, it could be that her thyroid function has simply declined to the point that she'll need periodic adjustments, until her thyroid can no longer produce any hormones (if it isn't already at that point), then she will be dependent on the medication.