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low t4 's
Hello, I am wondering if someone can help me.....my 17 yr old son was diagnosed with major depression in April 2013...we are having a hard time finding the right medications, he always seems to have fatigue and lack of energy and motivation.
His recent free t4 and TSH as of August 23:
t4,free(direct) 0.81 tsh 1.940 and Vit D3 vitamin d, 25-hydroxy 28.9
back on Dec 11, 2012:
t4,free(direct) 0.90 tsh 2.240 vitamin d, 25-hydroxy 17.2
He has been on 800 IU of Vit d3 since Dec, so it hasn't improved much.
Is the 'normal' rand different for adolescents? Does anyone know if antidepressents affect t4?
thank you, a concerned mother just wanting her baby boy happy again
His recent free t4 and TSH as of August 23:
t4,free(direct) 0.81 tsh 1.940 and Vit D3 vitamin d, 25-hydroxy 28.9
back on Dec 11, 2012:
t4,free(direct) 0.90 tsh 2.240 vitamin d, 25-hydroxy 17.2
He has been on 800 IU of Vit d3 since Dec, so it hasn't improved much.
Is the 'normal' rand different for adolescents? Does anyone know if antidepressents affect t4?
thank you, a concerned mother just wanting her baby boy happy again
wow, thanks for the great post!
Yeah, I know what you mean about dr's being quick to prescribe meds...side note to this!: He may not even be ADHD, actually he was diagnosed ADD, but when I looked up about depression this spring....guess what, you take out that 'H' and the symptoms are the same for ADD and depression....now I wonder if he really is ADD....that's what I get for just going with the pediatricians word....but what did I know.....he could of really just been in the beginnings of depression.
Anyway...it is his psychiatrist who ordered all the recent labs, and we see him Friday, it will be interesting to see what he says.....and I forwarded on the info to his pediatrician and she is sending him to a end Endocrinologist to look at his thyroid function, and I asked her if we should increase his vit d, but haven't heard back yet.
Any idea what further tests the Endocrinologist might do? If I know correctly, the most telling test for thryoid is a saliva test, which insurances won't pay for....which is stupid as it would save them time and money over blood test and extra appts.
Yeah, I know what you mean about dr's being quick to prescribe meds...side note to this!: He may not even be ADHD, actually he was diagnosed ADD, but when I looked up about depression this spring....guess what, you take out that 'H' and the symptoms are the same for ADD and depression....now I wonder if he really is ADD....that's what I get for just going with the pediatricians word....but what did I know.....he could of really just been in the beginnings of depression.
Anyway...it is his psychiatrist who ordered all the recent labs, and we see him Friday, it will be interesting to see what he says.....and I forwarded on the info to his pediatrician and she is sending him to a end Endocrinologist to look at his thyroid function, and I asked her if we should increase his vit d, but haven't heard back yet.
Any idea what further tests the Endocrinologist might do? If I know correctly, the most telling test for thryoid is a saliva test, which insurances won't pay for....which is stupid as it would save them time and money over blood test and extra appts.
Not sure of interaction or side effect of antidepressants.
I recently read article about chronic Lyme's. That is need to treat well beyond the 2 or 4 week antibiotics. Also read that the Lyme does NOT use the iron based enzymes or whatever to exist which most infections use. So the body normally uses iron to help the immune system fight the infection. But if the infection does not utilize the iron pathway, then it won't or has limited ability to fight the infection. I wonder if the body knows there is an infection and the normal thing would be possibly to starve the infection of iron. So that would result in iron depletion as the body's effort to kill the infection. The problem is that Lyme's doesn't apparently use the iron pathway so the body is inadvertatly using the wrong pathway to try and heal itself.
I may be able to link you to the story but it was on another website by Dr Mercola. Just in the last few days it was the featured article in his newsletter.
Not saying any of this is true or proven science. But just reporting what I read and letting you know.
A lot of people have been taken off ADHD and anti-depressant medications once their thyroid levels are in balance. Particularly low thyroid. Or at least minimized the amount of those medications needed. This is because low thyroid makes a person have brain fog and inability to concentrate, tend to have anxiety and are moody and short tempered etc. They are tired and fatigued and therefore glum. Their metabilism is slow so they seem slow and depressed.
Unfortunately Dr's are VERY quick to hand out and prescribe anti-depressants and ADHD medicines, but loath to the possible idea that low thyroid could be a root cause and even prescribe a clinical trial dose of thyroid medication.
I do not want to imply that all depression etc is thyroid related or that anti-depressants are not sometimes needed. your son may indeed have other issues at work. However I just want you to also consider and make sure you fully evaluate possibility of low thyroid and low Iron and Vit D etc to at least see if those things could help the situation.
I'm jsut very warry or a Dr who is fast to hand out psycological medications and not even consider the possibility of thyroid or other vitamins as being a contributing factor, all because something like TSH or other tests are "in range". "in range" means very little. as the ranges are established faulty and far too broad. Many people have found they need to be substaintially up into the range in order to feel well. Being anywhere below 50% of the range needs some attention. In facat most people here have found the best target to shoot for is to have BOTH of the following:
1) Free T4 to be in the MIDDLE of the range (50%) if not even a bit higher
and- that means in addition to
2) Free T3 to be in the UPPER 1/3 of the range (66.7%)
Notice that these are well more than simply being "somewhere" within the range.
Every person is different and feels best at slightly different blood levels. However this has been determined to be a good target to work up towards.
I recently read article about chronic Lyme's. That is need to treat well beyond the 2 or 4 week antibiotics. Also read that the Lyme does NOT use the iron based enzymes or whatever to exist which most infections use. So the body normally uses iron to help the immune system fight the infection. But if the infection does not utilize the iron pathway, then it won't or has limited ability to fight the infection. I wonder if the body knows there is an infection and the normal thing would be possibly to starve the infection of iron. So that would result in iron depletion as the body's effort to kill the infection. The problem is that Lyme's doesn't apparently use the iron pathway so the body is inadvertatly using the wrong pathway to try and heal itself.
I may be able to link you to the story but it was on another website by Dr Mercola. Just in the last few days it was the featured article in his newsletter.
Not saying any of this is true or proven science. But just reporting what I read and letting you know.
A lot of people have been taken off ADHD and anti-depressant medications once their thyroid levels are in balance. Particularly low thyroid. Or at least minimized the amount of those medications needed. This is because low thyroid makes a person have brain fog and inability to concentrate, tend to have anxiety and are moody and short tempered etc. They are tired and fatigued and therefore glum. Their metabilism is slow so they seem slow and depressed.
Unfortunately Dr's are VERY quick to hand out and prescribe anti-depressants and ADHD medicines, but loath to the possible idea that low thyroid could be a root cause and even prescribe a clinical trial dose of thyroid medication.
I do not want to imply that all depression etc is thyroid related or that anti-depressants are not sometimes needed. your son may indeed have other issues at work. However I just want you to also consider and make sure you fully evaluate possibility of low thyroid and low Iron and Vit D etc to at least see if those things could help the situation.
I'm jsut very warry or a Dr who is fast to hand out psycological medications and not even consider the possibility of thyroid or other vitamins as being a contributing factor, all because something like TSH or other tests are "in range". "in range" means very little. as the ranges are established faulty and far too broad. Many people have found they need to be substaintially up into the range in order to feel well. Being anywhere below 50% of the range needs some attention. In facat most people here have found the best target to shoot for is to have BOTH of the following:
1) Free T4 to be in the MIDDLE of the range (50%) if not even a bit higher
and- that means in addition to
2) Free T3 to be in the UPPER 1/3 of the range (66.7%)
Notice that these are well more than simply being "somewhere" within the range.
Every person is different and feels best at slightly different blood levels. However this has been determined to be a good target to work up towards.
thank you so much for your response
he just recovered from low iron....we believe he might have had lyme's disease...in May he was tested positive for 3 of the 4 tests, he was treated for Lyme's from that point his iron improved and a month ago his hematologist took him off of iron supplements....he was tested again a month after (the August test) being off the iron and his iron levels were still good.
His B-12 was tested at one point also and it was fine
I know he needs more Vit D, but back in Dec his pediatrician didn't want to go higher than the 800 IU (which was interesting as the np put his sister on 1000 IU, lol)
Do you know if antidepressants can affect the thyroid hormones?
His psychiatrist requested the latest labs and I have not had a chance to talk to him about it.
We are not sure if the fatigue is from the antidepressants, which can cause it also. He had to reduce his Abilify because he just could not get himself up to do anything....now the psych wants to take it back up a bit, but if it makes his tired again my son refuses to take it.
He was taken off of ADHD medication because of problems, and that stimulant helped with the fatigue so we didn't know the fatigue was there so much before.
Not sure why they didn't test the t3 also.
he just recovered from low iron....we believe he might have had lyme's disease...in May he was tested positive for 3 of the 4 tests, he was treated for Lyme's from that point his iron improved and a month ago his hematologist took him off of iron supplements....he was tested again a month after (the August test) being off the iron and his iron levels were still good.
His B-12 was tested at one point also and it was fine
I know he needs more Vit D, but back in Dec his pediatrician didn't want to go higher than the 800 IU (which was interesting as the np put his sister on 1000 IU, lol)
Do you know if antidepressants can affect the thyroid hormones?
His psychiatrist requested the latest labs and I have not had a chance to talk to him about it.
We are not sure if the fatigue is from the antidepressants, which can cause it also. He had to reduce his Abilify because he just could not get himself up to do anything....now the psych wants to take it back up a bit, but if it makes his tired again my son refuses to take it.
He was taken off of ADHD medication because of problems, and that stimulant helped with the fatigue so we didn't know the fatigue was there so much before.
Not sure why they didn't test the t3 also.
Really need the reference ranges to go along with the tests. But based upon what ranges that we typically see he is VERY low on Vit D and also would be at or towards the VERY bottom of the Free T4 range.
Being Hypothyroid or low thyroid is common symptom to be depressed also fatigued. Also the D3 test is VERY low. "good" I would suggest is about double his value. 800IU is a VERY low supplement. Many take several thousand IU's of Vit D3 a day. With perscriptions for low Vit D for a short time a Dr might prescribe up to 50,000 IU's a day.
Also fatigue related and common to be low which you may want to check is Vitamin B-12. This should be mid range if not towards the top of the reference range when testing.
I would also recommend testing for Iron and Ferritin. These too can cause fatigue related symptoms.
DOes your son have Hashimoto's? This is the most common cause of low thyroid in the western world. It is an autoimmune condition where the immune system thinks the thyroid gland is foreign and goes about trying to kill it, which then produces less and less thyroid hormone over time. Hashi's can be tested by getting and looking for TWO antibodies. The first is TPOab and the other is TGab. If either one of those is eleveated above the reference range it would be indicative that he has Hashi's.
Treatment for Hashi's is no different than simple hypo or low thyroid. Just that you will know that over time the thyroid gland will continue to be less and less effective and thus more frequent testing will be needed and increased medication dosage to keep pace with the loss of the hormone from the thyroid gland. So nothing really to get scared of.
I would finally also recommend that in addition to the Free T4 (FT4) test that the Free T3 (FT3) hormone also be tested. Many Dr's don't want or think there is a need to test for this but it is important.
T4 is a storage hormone that remains in the blood. It doesn't get used directly. Instead when the body senses the need for thyroid hormone at the cellular level. It converts teh T4 into T3. The body then uses the free T3 hormone at the cellular level. So if you are concerned about Thyroid, since the body ONLY uses the Free T3 hormone at the cellular level, wouldn't it make complete sense how important it is to determine how much of the ACTUAL hormone you have available that the body uses.
TSH is a pituitary hormone that is a signal to turn up or down the output of the thyroid gland. Since it is only a signal it is highly variable and unreliable. It is a screening tool at best. Unfortunately many if not most Dr's are taught in medical school that TSH is the holy grail and the gold standard and the only thing that needs to be used, tested or looked at. They are 100% wrong. TSH is like I said a screening tool at best.
I think this is enough info for now.
But bottom line being low thyroid can contribute both to fatigue and also the depression. You have to be a STRONG advocate to get these additional tests done. If the Dr refuses go find another Dr.
Being Hypothyroid or low thyroid is common symptom to be depressed also fatigued. Also the D3 test is VERY low. "good" I would suggest is about double his value. 800IU is a VERY low supplement. Many take several thousand IU's of Vit D3 a day. With perscriptions for low Vit D for a short time a Dr might prescribe up to 50,000 IU's a day.
Also fatigue related and common to be low which you may want to check is Vitamin B-12. This should be mid range if not towards the top of the reference range when testing.
I would also recommend testing for Iron and Ferritin. These too can cause fatigue related symptoms.
DOes your son have Hashimoto's? This is the most common cause of low thyroid in the western world. It is an autoimmune condition where the immune system thinks the thyroid gland is foreign and goes about trying to kill it, which then produces less and less thyroid hormone over time. Hashi's can be tested by getting and looking for TWO antibodies. The first is TPOab and the other is TGab. If either one of those is eleveated above the reference range it would be indicative that he has Hashi's.
Treatment for Hashi's is no different than simple hypo or low thyroid. Just that you will know that over time the thyroid gland will continue to be less and less effective and thus more frequent testing will be needed and increased medication dosage to keep pace with the loss of the hormone from the thyroid gland. So nothing really to get scared of.
I would finally also recommend that in addition to the Free T4 (FT4) test that the Free T3 (FT3) hormone also be tested. Many Dr's don't want or think there is a need to test for this but it is important.
T4 is a storage hormone that remains in the blood. It doesn't get used directly. Instead when the body senses the need for thyroid hormone at the cellular level. It converts teh T4 into T3. The body then uses the free T3 hormone at the cellular level. So if you are concerned about Thyroid, since the body ONLY uses the Free T3 hormone at the cellular level, wouldn't it make complete sense how important it is to determine how much of the ACTUAL hormone you have available that the body uses.
TSH is a pituitary hormone that is a signal to turn up or down the output of the thyroid gland. Since it is only a signal it is highly variable and unreliable. It is a screening tool at best. Unfortunately many if not most Dr's are taught in medical school that TSH is the holy grail and the gold standard and the only thing that needs to be used, tested or looked at. They are 100% wrong. TSH is like I said a screening tool at best.
I think this is enough info for now.
But bottom line being low thyroid can contribute both to fatigue and also the depression. You have to be a STRONG advocate to get these additional tests done. If the Dr refuses go find another Dr.
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