Questions about Hypothyroidism

[Husker26]

Recently returned from my doctor and he thinks I could have hypothyroidism. It runs in my family (mother and brother). I gave blood last week and expect the results this week. My specific question is related to aniexty/depression as it relates to thyroid issues.  I have had trouble sleeping, anxiety, weight gain, always cold, and most importantly have had trouble getting out of bed and engaging with my family. I just want to today to be tomorrow. Has anybody else had this issue with thyroid problems? Can I expect medicine to help alleviate these problems if I do have hypothyroidism? Frustrated and just want to cry for no reason at all. I just want things to go back to normal. Thanks for the help.

[gimel]

You have many symptoms that relate to being hypothyroid, and symptoms are the most important indicator, along with levels of the biologically active thyroid hormones, Free T4 and Free T3.  Hopefully you were tested for both of those, along with TSH that is usually tested, and perhaps TPO ab and TG ab, to see if Hashimoto's Thyroiditis is the underlying cause.  

Yes, all of us with hypothyroidism have had symptoms like you describe.  You can expect symptom relief if properly treated.  We can help make sure of that.  If you will please post your thyroid related test results and reference ranges when available, we will be glad to help interpret and advise further.  

[Husker26]

Thank you gimel. I really appreciate this board.  Everybody seems so knowledgeable. I will post my test results this week.  Again, many thanks for your response and encouraging words. Sorry to jump the gun a little bit before I have my test results, I just feel terrible.  

[gimel]

Following is info you just posted on another thread.  I have pasted it here so that all your info is in one place.  


"I had a follow-up question regarding my test results. Here are the results:

TSH: 1.39
T4, Free: 1.4
T3, Free: 3.5
T3 Reverse: 24
T Peroxidase Antibodies: 13H

The TPA was above normal levels but everything else seems in the normal range. Do I need to see an endocrinologist regarding the TPA? My GP said it's my choice but I should keep an eye on it. I have all of the symptoms of a thyroid problem. Any opinions would be appreciated. Many thanks."

Test results and associated reference ranges can vary from lab to lab.  So in order to compare your results to ranges, please post the reference ranges for those tests as shown on the lab report.

[Husker26]

Thanks gimel. I should also point out that my Testosterone level was on the low end of the range at 298 and my Vitamin D was below acceptable levels.

[Husker26]

Here are the ranges:

THS: 0.40-4.50 mIu/L
T4 Free: 0.8-1.8 ng/dL
T3 Free: 2.3-4.2 pg/mL
T3 Reverse: 8-25 ng/dL
TPA: <9 IU/mL

The GP prescribed me Vitamin D and Lexapro. I am reluctant to take the Lexapro until I talk get an appointment with an endocrinologist given the elevated TPA, lower testosterone level, and low Vitamin D. Thoughts? Thanks again.

[gimel]

I agree about your reluctance to take Lexapro.  Looking at your list of symptoms I can't see an antidepressant helping with all of those.  I think your symptoms are more indicative of being hypothyroid.  I am a bit surprised by your relatively low TSH, in view of the TPO Ab test being above range, but it doesn't really affect the actions to be taken for you.  

Your Free T4 is above mid-range, which is adequate.  Your Free T3 is at 63% of its range, which by itself is not bad; however, along with your Reverse T3 level of 24 it gives a ratio of Free T3 to Reverse T3 of 1.46, which is lower than recommended.  Sources say the ratio is best if at 1.8 or higher.  

Excess RT3 blocks some of the effect of Free T3, and can cause hypothyroid symptoms.  Causes of excess RT3 are discussed in Recommendation 9,on page 12 of this link.  You will note that some of the postulated causes for RT3 dominance include low ferritin (iron), low selenium, Vitamin D, B12 and others.  I highly recommend reading at least the first two pages of the link and delve further if you want to get into the discussion and scientific evidence supporting all the recommendations.

http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf

So before considering thyroid med of any kind I think you should test for all of the above.  (Not sure what your D was but it should be at least 50).  I also suggest testing for cortisol.  The best test for cortisol is the diurnal saliva cortisol panel of 4 tests taken at different times of day.  Most doctors will not order that and instead order a morning serum cortisol test.  It is not as revealing, but might be a start anyway.  Do you think you can get those tests done?

Personally I would not rush to see an Endocrinologist.  Instead you need a good thyroid doctor.  Since you are in Dallas, I have names of a few doctors considered good thyroid doctors.  I will send you a PM with names.  To access, just click on your name and then from your personal page click on messages.  

[Husker26]

Sorry, I meant to post this as a comment and not a question.  See below, Thanks again.

[Husker26]

Thanks gimel. I will read the link.  Also, I did have a Cortisol test but not a saliva test.  The results were:

Range: 4.6-20.6 mcg/dL, my Results: 14.6 mcg/dL

My endocrinologist specializes in Thyroid specifically.  My mom and brother both go to him for thyroid problems.
I just feel like all of these red flags are Throid related and will probably delay the Lexapro until I have additional answers. My Vitamin D level was 22L and the range was 30-100 ng/mL. Any additional thoughts are greatly appreciated.  Thanks again.

[gimel]

What time of day was the cortisol test done?  Was the listed range specifically for that time of day?

I think you need to be supplementing for Vitamin D, at about 3000-4000 IU of D3 daily.  If possible I would go ahead and try to get tested for ferritin, selenium and B12 and then supplement as needed.  Ferritin should be at least 70, and some say 100.  B12 should be in the very upper end of its range.  Selenium should be mid-range.

The serum cortisol test was within range, but borderline I think.  I say that because cortisol sufficiency is very hard to diagnose.   A  diurnal saliva cortisol (free cortisol) panel would be much better, but I would hold off on that until finding out about the ferritin, selenium and B12, and supplementing as needed to optimize.  

[Husker26]

Thanks gimel.  Posted additional info below.

[Husker26]

The cortisol test was done at 8:00 a.m. Range for that time was 4.6-20.6 mcg/dL.  I was at 14.6.

I was also tested for B12 but I don't see ferritin or selenium.  The B12 results were as follows:

Vitamin B12: 550, Range 200-1100 pg/mL
Folate, Serum: 11.5, Normal: >5.4

I was prescribed Vitamin D supplements yesterday and I'm already taking those.

Working on getting an appointment with a thyroid specialist today.  Will talk to him about ferretin, selenium and saliva cortisol test.