To treat or not to treat?

[arkies]

46 yo female.  

Multiple Sclerosis -- peripheral neuropathy and fatigue are the worse symptoms
HTN
High Cholesterol
Depression
Mild Reactive Airway Ds.
Insomnia/sleep issues
Symptoms of Carpal Tunnel - right wrist

LAB:
Free T4  0.75  (LOW)
T3 Free, S   2.8
Thyroperoxiod AB  13.4  (HIGH)
TSH3  2.276 and 1.793 (two different times)
All other pituitary hormones have been normal according to endocrinologist.

I was initially told that my thyroid should be treated and was placed on Cytomel.  I became hyperthyroid very quickly and the dose was lowered.  My heart rate continued to be elevated, so the endocrinologist took me off the Cytomel completely and now says that I don't need treatment and we will "just watch it".

My question - Should I be on thyroid treatment?  Possibly a low dose of Synthroid?  The carpal tunnel symptoms have begun since the endocrinologist stopped the Cytomel.  I have so many symptoms - but it is hard sometimes to differentiate from the M.S.  I have fatigue, peripheral aches and pains, dry skin, brittle hair, increased hair loss, depression, carpal tunnel, etc. . .  

Current meds -
Copaxone, Advair 100/50, Diovan HCT, Toprol XL, Cymbalta, Metanx, Zanaflex, Zetia, ASA, Marinol, multivitamin, AmbienCR.

Thank you.  

Nancy

[Mark Lupo, M.D.]

The vitamin D check is reasonable.

The thyroid tests are borderline -- there is not a definite indication for treatment and the standard answer would be observation.  A trial of low dose synthroid could be considered to see if there is any benefit, but in many cases like this there is not a clear benefit.

[mommy9]

Have you had your vitamin D level checked?  A LOT of your symptoms sound the same as mine, and mine was extremely low.  Since I started on 50,000 units a week (prescription by doctor only for 4 weeks), my symptoms are less.  The endocrinologist recommends 1200 units a day of Vitamin D.