I'm worried about hypothyroidism

[pedramasl]

Hi I'm a 28 years old woman diagnosed with hypothyroidism. My TSH level is 10. As my doctor said my thyroid is under performing (sluggish). I only have one question. Does taking thyroid pills would make my thyroid gland more sluggish/lazy? I'm afraid that my body get used to free hormones which gets from pills and do not stimulate my thyroid gland with high TSH. Does this makes my thyroid more sluggish/lazy so my body only depends on hormones from pills and cant produce hormones on its own anymore. You can access my test results from link below.

http://imgur.com/G2l6C8v

Thank you in advance

[Barb135]

Your body must have thyroid hormones in order to function properly.  Your thyroid is already not producing enough of these hormones... the medication will simply replace what your thyroid can not produce on its own.  Thyroid hormones control your metabolism, heart rate, body temperature and other body functions; you can't live indefinitely without them.  

Providing the hormones via medication will not cause your thyroid function to get worse, however, if you have Hashimoto's Thyroiditis, it will get worse on its own.  Hashimoto's is the most common cause of hypothyroidism in the developed world and it's progressive, in that it destroys thyroid tissue until there is none left to destroy and eventually, you will be totally dependent on the medication.  Hashimoto's is diagnosed via antibody tests, which I didn't see on your lab report; if they weren't done, you should ask your doctor to order them, so you'll know the cause of your hypothyroidism.  The tests you need are Thyroid Peroxidase Antibodies (TPOab), sometimes call Microsomal Antibodies; and Thyroglobulin Antibodies (TgAb).  You need them both, as they're both markers for Hashimoto's; some of us have one or the other; others have them both.

All of that said, your TSH is definitely too high and while your Free T4 is still "in range", it's way too low in the range.  It's recommended that Free T4 be, at least, in the middle of its range.  

I did notice that there is no Free T3 on your lab report.  Free T3 is the thyroid hormone that's used by individual cells and correlates best with symptoms.  You should ask your doctor to order it next time you have blood work.

Can you tell us what, if any, symptoms you're having.

[pedramasl]

Hi Barbara, Thank you very much for your quick reply. I've been on ( one meal per day) diet for past couple of weeks. During that time I was feeling feeling slight pain around my throat (thyroid section). I did a blood test last week before reading your reply. it only has FT4 and TSH results. FT4 was still in very left of normal range and TSH dropped to 6 from 10. I was shocked and I was wondering whether my diet has something to do with this results. Do you think if I eat healthy and do lots of sports (and if my case is not hashimatos) I can treat my thyroid problem without any medication ? I used to be on a "not healthy" diet and always avoiding exercises. My heart rate is usually between 80 to 100 while sitting. I'm doing yoga to reduce it. I also noticed a sluggish behavior of my reflexes. I usually do things slowly which bothers me. I feel tired most of the time (sleep a lot) and get bored easily and have low motivation. Due to this my psychiatrist gave me depakine chrono, olanzapin, ketiapin, bupropion HCI. After using these medications I feel more scared and anxious. I have more phobias than before. I'm wondering the cause of all my depression and lack of motivation somehow relates to my thyroid problem. because my psychiatrist didn't check my thyroid condition. I also wonder my high TSH results are because of those medications or not.

[Barb135]

Depression, anxiety and sluggishness are prime symptoms of hypothyroidism, as are slow reflexes... there's a good chance you don't need anti-depressants; you just need thyroid hormones.  

What was the result of your FT4, with reference range?  

You should test thyroid antibodies to confirm/rule out Hashimoto's... Ask for Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb).

[Barb135]

I forgot to mention that TSH can vary as much 75% over the course of a day and many things, other than thyroid hormones can affect it.

[pedramasl]

Thank you Barbara, Here is the link to my latest blood test.

http://imgur.com/ROP08uX

You've been a great help :) I will definitely tell my doctor to include TPOab and TgAb in my next blood test. Unfortunately I might bother you again when I get my new test results :)

[flyingfool]

You are AT the bottom of the FT4 range, and your TSH is elevated (anything above about 3.0 would or should be considered Hypo.  AND you have several classic symptoms of Hypo.

In other words everything points to low (Hypo) thyroid and it would make sense for you to strongly fight for a starter dose of thyroid.

In addition to the Two antibody tests.  I would strongly encourage you to test for the following items. Any or all of them if deficcient can cause fatigue and other symptoms similar to Hypo.  And it is very common to be low in one or more of them.

Vitamin D3
Vitamin B-12 (You will want to be WELL up towards the top of the range)
Iron
Ferritin

ALSO Maybe most importantly. Make sure you get tested for FREE T3.

TSH because as Barb stated the significant variability of the test makes it a screening tool at best and not worth much beyond that.  Certrainly NOT good enough to make dosage adjustment decision.  Relying only on TSH is almost a sure bet to keep  you from ever getting well.

I don't know how long you have been taking the anti-depressants and anti anxiety medication. But my personal thought would be to try to come off of them ASAP.  And get your thyroid levels balanced first.

Many people have reported once they have gotten their thyroid levels optimized, they were able to eliminate or at least minimize any antidepressant medication.  You will have to work that out with your Dr.

Understand some if not most of the anti-depressants you cannot stop cold turkey as they can be addicting and you can or can or will have withdrawls.

It never ceases to amaze me how Dr's are so quick to hand out addictive anti-depressants by the handfulls like candy.  and yet so reluctant to even try a small clinical dose of thyroid medication!

[pedramasl]

Thank you Mr. flyingfool, according to one of my latest test results [ http://imgur.com/G2l6C8v ] my B-12 is way upper the range and Ferritin is in range. In my next blood test I will definitely include the things you've mentioned. Unfortunately some of Drs prescribe medications like candy :)

[flyingfool]

Ferritin needs to be about 70 and not merely "in range" to best help metabolize thyroid.  So anything under 70 would be an idication where supplementing should be considered.

[flyingfool]

Oops. I saw the link and your Ferritin is 90. So no need to supplment.

Your FT4 is below range.

[pedramasl]

Yes you are right and I really need to put it in range. After my doctor approval on stopping anti-depressant medications, I started to decrease the dosage of medications. I hope for minimum withdrawal. I'm also on a diet and doing sport. I also want to see how healthy diet will affect my thyroid hormone levels and  will go to a doctor for my thyroid test ASAP :) Thank you

[Barb135]

You should NOT stop anti-depressants or anti-anxiety medication without the blessing of your doctor and you should not stop them ASAP, as most anti-depressants must be tapered not stopped cold turkey...

Aside from that, many of us need one or the other, even with optimal thyroid hormones... I was on anti-anxiety medication for nearly 3 years due to circumstances beyond my control, in spite of being on thyroid medication and having good levels.  

While depression and anxiety are prime symptoms of hypothyroidism, anti-depressants and anti-anxiety medications must be handled very carefully.

[pedramasl]

I've talked to my psychiatrist and I've told him that these medications were not effective and still I feel the same even some of my phobias and anxieties have became worsen. The only thing that medication helped was 12 hours uninterrupted sleep :) and I also mentioned that I have thyroid problem and he agreed upon stopping anti-depressant medications.( thanks to you guys :) ). Right now I'm tapering off my anti-depressant medications and I hope the only reason behind all of these sufferings was my thyroid hormones imbalance :)

[Barb135]

Please be sure to keep us posted on your progress...

[pedramasl]

Thank you Barbara I'll do. I really appreciate your kindness :)

[pedramasl]

Hello Mrs. Barbara and Mr. flyingfool :)

Last time I have talked with my psychiatrist he ordered to stop my medication by reducing dosage by half each 10 days. now I'm using 1/16 of first dosage. I think its almost over. 3 days ago I did a blood test with all things you mentioned. Test results are in following link.
http://imgur.com/a/aH5jA
My TSH is within range I guess. My Anti-TG and TPO  antibodies are still high. Would love to hear your idea on this new results.

Thank you :)