Subclinical hypothyroidism?

[Mr_Black]

Hi,

I am a 24-year old male living in the United Kingdom. Following several months of depression, anxiety and insomnia I finally went to my doctor's for a blood test. The results of this and one subsequent test one month later showed elevated TSH (6.74 and 7.74 mu/L, reference range 0.35 - 4.5 mu/L) but normal free T4 (19 and 17.2 pmol/L, no reference range given). My first test showed high serum calcium (2.61 mmol/L) but the second was normal (2.57 mmol/L). The tests also show high bilirubin (I've been diagnosed with Gilbert's syndrome, which I understand is basically benign) and also high mean corpuscular volume (96.8 fL) and high large unstained cells (0.3 10*9/L). No idea what these last two mean!

My symptoms now seem to be worsening - I am now alternating between periods of depression and anxiety, suffering from intermittent periods of loss of appetite, nausea, cold intolerance and diarrhea, experiencing chronic fatigue, and also regularly suffering from attacks of irrational and intense anxiety on waking which almost border on night terrors. I do not have a goiter - in fact, my thyroid seems to actually have reduced slightly in size. My body weight is constantly fluctuating between 57 and 60 kilos whereas I always used to be a steady 60 no matter what I ate.

I am shortly due for a third blood test, and this time I have asked for my thyroid antibodies (TPOab and TGab) to be checked to rule out Hashimoto's. My doctor seems to be unsure whether I am subclinically hypothyroid or just clinically depressed, although he did offer a trial of a low dose of thyroxine.

My questions are 1) if my third test is negative for antibodies, would it still be worth taking the trial of thyroxine, and 2) given the high serum calcium, is it worth having PTH checked for hyperparathyroidism? Reference ranges for TPOab and TGab would also be useful so I can interpret my test results.