I do NOT have Clinical Depression, I do have Hypo!!

[albertr]

Sorry if this is a bit of a rant but a couple weeks ago I put all the pieces together and I strongly feel that I am hypo. I went to a Dr who has good word of mouth reccomendations. He did do a good job of asking me questions but at the end of this he said he would test me for TSH and low iron. If those come back "normal" he said that I have clinical depression! I know what clinical depression is as I went thru a bout of it about 10 years ago! Anyway, if the tests come back "normal" I am going to ask him for the results of my clinical depression labs!!!! I know threre are none but hopefully this will open his eyes to the possibility that there are conditions for which labs are NOT reliable or non-existent! Its a good thing I had a preminition of this and ordered glandular suppliments before this appointment!
Thanks!!

[albertr]

I guess I could ask a question... Has anyone else been told its depression but in your gut you know its low thyroid? If you finally got diagnosed as hypo what did you do to get the Dr to believe you? Please dont just say get a 2nd, 3rd, 4th... opionion. I literally cant afford that many appointments as my hubby is going thru treatment of colon cancer and $$$ is tight.

[gimel]

Yes, depression can be associated with being hypo.  If you look at this listing of 26 typical hypo symptoms, do you have other symptoms as well?


http://endocrine-system.emedtv.com/hypothyroidism/hypothyroidism-symptoms-and-signs.html

[goolarra]

We hear from many, many people who have been told "it's depression".  Doctors are much happier to prescrie an anti-depressant than to pursue the underlying cause.

TSH is a pituitary hormone and, at best, a screening test.  Many people suffer hypo symptoms with perfectly "normal" TSH.  A much more accurate thyroid profile is reached by ordering FREE T3 and FREE T4.  These tests show the levels of the actual thyroid hormones available to your body.

You can try to educate your doctor, you can ask for FT3 and FT4, you can beg and demand.  Your doctor might be receptive.  If he isn't, there isn't much choice but to move on, unless you want to take anti-depressants that often make you even more despressed if the underlying cause is hypo.

IF your TSH comes back "normal", do you think your doctor would order more tests?  AACE recommended changing TSH reference range several years ago to 0.3-3.0.  Most doctors and labs are still using an old range that might go as high as 5.5.  Be aware when you get your results that anything above (or even close to) 3.0 should now be considered hypo.

[kevieb]

I've been fighting depression for over 23 years.  I was put on thyroid suppression therapy 14 years ago because I had nodules--they said it would shrink them--I was on a synthetic T4 only medication.  i have now read that on synthetic T4 only it is impossible to not be hypothyroid---regardless of what the tests say.  a TSH is a pituitary test and only tells what the level of thyroid is in your pituitary.  Your pituitary could have a normal level of thyroid hormone in it while the rest of the cells in your body are hypothyroid---that is why people continue to have depression, or headaches, etc.  Before the TSH test existed, dr's used to use a clinical diagnosis, based on symptoms, and treated the patient with natural thyroid hormone until the symptoms were better.

we have really gone backwards in the treatment of thyroid problems and the TSH test probably misses a good majority of the people who are mildly or moderately hypothyroid.

[Barb135]

While it's true that the pituitary can have sufficient hormones, while peripheral tissue does not, TSH does NOT tell the level of thyroid hormones in the pituitary.  TSH is a pituitary hormone that's trying to stimulate the thyroid into producing more hormones, or to stop producing, whichever the case may be.

It's also not true that one on a T4 only medication will ALWAYS be hypo.  There are many people who feel just fine on T4 only medication.

[albertr]

I did order a thyroid panel from Canary Club which is somewhat associated with Dr. Shames. I did this myself because I have asked for a thyroid test since I was 15 and never was granted one (I am 30 now). The tests are free Thyroxine (fT4), free Triiodothryronine (fT3), Thyroid Stimulating Hormone (TSH), Thyroid Peroxidase Antibody (TPO). I showed the questionaire that I filled out to the Dr. and he said that the ft3 ft4 and TPO were not necissary! I beg to differ. Also he said that the lab that is analizing the sample may be fake just because they are in the state of OR. I did find the lab's CLIA cerification and will bring this along with that test's results to my appt on Fri. As of right now I have no test results but when I do get them I will post them (along with the reference ranges). I hope I can elighten him or else I may need to shop around like I have seen others comment on. Thanks everyone!!

[albertr]

Here are my comments on the list of symptoms. I do have most of them and have been experiencing them for a long time if not most of my life!

•Feeling tired (fatigue) and sluggishness
•Weight gain (I weigh the same now as I did at 9 mos prego almost 4 years ago!)
•Slow movement and speech
•Constipation (I had gastric bypass 7 years ago and have issues with the opposite problem)
•Increased sensitivity to cold
•Puffy face (I have always had a round full face and in the past 2 years I have developed a puffy 2nd chin)
•Swelling around the eyes (nope but have had dark circles since I was 9 which coincentally is when I started to become overweight)
•Loss of eyebrows (nope but they used to be very thick and now I need to tweeze only twice a year when in years past I needed to at least once a month)
•Joint and muscle pain, aches, and stiffness (yes RLS, twitches, and all of the above)
•Pale, dry, rough, and thick skin (on my feet only)
•Dry, thinning, or coarse hair (maybe, its been so long that I think my current hair condition is normal, who knows if this will change if I am allowed medicine??)
•Brittle nails (my whole life)
•A horse voice (yes)
•An enlarged tongue (yes)
•Decrease in taste (yes)
•Decreased sweating (i still dont know what this means. I sweat so much wilth such littke exertion and I sweat everynight to various degrees)
•Heavy or irregular menstrual periods (heavy, not irregular. but in years past they were very irregular like 2 a year!)
•Infertility (nope 1st pregnancy went to term and I became prego after only 6 months of trying)
•Miscarriage in early pregnancy (nope)
•Depression (I have been on antidepressants for almost 10 years)
•Slowed heart rate (last time I checked it was 78RHR. Is that low?)
•Swollen ankles (not swollen but stiff)
•Decreased hearing (yes and getting worse)
•Mild high blood pressure (appointment on Friday was 129 over 86. I was usually around 120 / 70 even thru pregnancy and even when I was morbidly obese)
•Difficulty catching your breath (severe shortness of breath) when exercising ( i have this at random times during the day and it is not associates with physical activity)
•Decreased ability to exercise (yes! too tired to do housework let alone exercise!)

[gimel]

In a lot of cases, it is worthwhile to try to work with the current doctor by presenting info about the proper testing and treatment, and trying to influence the doctor to treat clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  In view of what your doctor has said about FT3 and FT4, and your many symptoms that the doctor has ignored, I think you should forget that doctor and find a good thyroid doctor.  

You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with from a distance.   The letter is then sent to the PCP of the patient to help guide treatment.  

http://hormonerestoration.com/files/ThyroidPMD.pdf

You definitely need to be tested for Free T3 and Free T4, along with TSH that they always test, so it is good that you have gone ahead with that.  I would also suggest that you should be tested for Vitamin D, B12, ferritin, a full iron test panel, zinc and selenium.  

If you will tell us your location, perhaps a member can recommend a good thyroid doctor for you.

[Brucergoldberg]

Most of your symptoms look almost as though they are the complete list of hypothyroid symptoms as outlined on most thyroid websites.  there are a couple missing from your list, but maybe you just haven't thought of them.  With proper treatment, a lot of those symptoms will disappear.  For the most part i had most of those too.  My eyebrows didnt fall out, but i sort of wish they would since they are so big LOL.

If you need help finding a good doctor as Gimel mentioned above, there are many resources out there for "thyroid smart" doctors.  

[albertr]

I take many suppliments daily due to malabsorption from my gastric bypass. I presented him a list of these and all he had to say was that due to the amounts I am taking that I did not need a B12 or vit D test but he also did not caution me to reduce or stop any of them. We also did talk about other gastric bypass patients he has seen that come in years after surgery but are lacking some sort of traces that cannot be absorbed by the small intestine. I said yes it sounds like you are talking about micronutrients and that is why I eat a lot of veggies and would be a nutritionist if there were $$ in it in my area. So he knows I'm not an idiot and he knows that I am well read but I dont know why he is stuck in thinking that fT3 and fT4 are unnecissary!

[albertr]

The list above is a quick list that I've found. A more in depth questionaire is in Dr. Shames' thyroid power book. I scored 42 on that. He recommends that anyone scoring over 25 should get meds irregardless of what labs say!

[gimel]

You overlooked our question about your location.  There is always a chance for members to recommend a good thyroid doctor for you if we know your area in Minnesota.

[albertr]

I diddnt overlook it. I am in a rural area where, for example, trauma patients need to be flown 120 to 300 miles away. My guess is that any good Dr for thyroid would also be this far away. I am hesitant to take on the expense in seeking treatment far away because of the cost and fear of wasting my time and $$ on another appointment like I described above. But just in case I live in Marshall, MN zip code 56258. Also, I have heard of a Dr in Sioux Falls, SD (120 miles away) that is actively treating someone I know for Hashi's. Thanks!!!

[Barb135]

I know of an excellent endo in Sioux Falls, SD, but can't think of his name right now; can get get it, if you like.  My son goes to him.  

Have you tried the medical clinic in Worthington?  They've always had very good doctors there. I saw an internist there for several years.

[albertr]

I was born in Worthington LOL! Other than that I have not Doctored there. I did get a name of Brandon Allard, MD that practices in Sioux Falls and he is treating someone I work with for Hashi. Was he the guy you were thinking of?

[Barb135]

We lived in NW Iowa, just across the border from Worthington.  No, that's not the doctor.  The one I know of is with the Sanford teaching hospital.  If your co-worker is happy with their treatment, you should be okay.  

There really isn't a treatment for Hashi; it's the resulting hypothyroidism that's treated.  You can save yourself some time and money, by finding out ahead of time if this doctor tests the FT3 and FT4 every time he tests TSH; if he's willing to treat symptoms, not just labs; and if he's willing to prescribe both T4 and T3 medications and/or T4/T3 combo, as in Armour, Nature-throid, ERFA, etc.  You should be able to talk to a nurse or someone who can tell you how thyroid patients are tested/treated.

[albertr]

Good idea about checking on those things ahead of time!! Thanks soooo much!!