ConfusingThyroid Tests

[mosesgt]

As a general psychiatrist I test a lot of people for thyroid disorders. I usually test TSH & Free T4 (FT4), since I frequently see clinically relevant hypothyroid sx (that also happen to be sx of depression) in people with TSH >3. In those people, I like to see the FT4.
I recently had a 35 yo, white female, not on hormones of any sort, including OCP. She complained of breast milk after taking 25mg of Seroquel, which has almost no proclivity to do that. 2 weeks after stopping the Seroquel, there was no change in the galactorrhea. She also said she was hypoglycemic & had a remote hx of significant head injury. Her labs were as follows:
TSH- 0.336 (0.4- 4)
FT4- 1.15 (0.8-1.9)
FT3- 2.3 (2.4-4.2)
Prolactin 112 (1.9-25)
Fasting Insulin 4 (3-19)
T.Chol 202, LDL 104, VLDL 12 & HDL 86
She was in the leuteal phase of her cycle, according to the LH, FSH & estradiole E2.

I am really curious about what appears to be conflicting thyroid tests, but threw in the others since I know everything affects everything in this wonderful creation of the human body. I am planning on testing the reverse T3 (rT3), but I saw a negative article from one of you on the usefulness of that test. I thought the rT3 could inhibit the conversion of T4- T3 & still provide negative feed back to the pituitary, thereby causing a low TSH. Is that accurate? I will obviously refer to an endocrinologist, but should I do the rT3 or maybe an TRH? I recognize that the anterior pituitary affects both the TSH & the prolactin. Maybe we should scan her brain before sending to endo? Any guidance will be greatly appreciated.

[utahmomma]

My daughter and sister were both diagnosed as bipolar.  Neither had clinical signs of thyroid problems (antibodies weren't tested prior to surgery).  Both had thyroid nodules with a very significant family history of thyroid cancer.  Both had their thyroids removed.  Sister had papillary carcinoma, my daughter had atypical (precancerous) thyroid cells.  Both were placed on thyroid replacement hormones after surgery.

Both showed 80 - 90% reduction in bipolar symptoms.  (It was found they both had Hashimoto's too based on pathology).  Daughter went off thyroid replacement over a year ago and all of her bipolar symptoms have returned.

perhaps a thyroid ultrasound would be a good screening tool too?

[Christy1950]

my husband as all five mental illness's and he found that taking Vitiamin B complex groups has greatly reduced his mental problems along with his one tablet he takes a day for scitzo. He was also allergic to the sun (coming out in rash all over ofter sun exposure - runs in the family) but his D has been improved and now he can tolerate son So I guess what I am saying is that all the vitiamins should be checked as well. bestest

[sherryjustine]

I dont know that I can be any help to you, but I had conflicting tests, and they followed up with a COMPLETE thyroid panel.  They now placed me on t3 and t4 treatments.  One other thing they found was a serious vitamin d deficiency which was discovered in the full panels.  I am no doctor by any means, just sharing my experience in hopes that it helps.

[AR-10]

http://www.medhelp.org/forums/show/120

Don't know if it will help, but here is where you need to try.
Good luck. :)

They only take so many questions per day. You may have to try a few times. I don't know if the "overflow" gets kicked over here automatically, but a lot of of people post a thread here that starts "Dear Dr. Lupo," so it's not just you. :^)

[mosesgt]

Sorry folks I did it again. I tried to post to Dr. Lupo but I did not get in in time today & accidentally posted to general forum again. SORRY!