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Old 11-24-2012, 05:50 AM   #1
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Can severely low TSH cause psychosis?

My 17-year old has a TSH level of less than .01 but normal free t-3 and t-4 levels. He began treatment for depression and psychosis 3 months ago. His psychologist thought we should rule out a medical explanation before treating for psychosis and recommended getting his TSH checked. Amazingly, his TSH level was virtually undetectable. Took him to an endocrinologist. The Endo says that he can not treat him with medication because his other levels are normal and that his mental problems have nothing to do with his TSH level. His psychologist disagrees. The Endo suggests checking his TSH level in another 4 months to see if he develops hyper- or hypo-thyroidism.

Until 4 months ago, our son was a completely normal teenager and he now has paranoia, anxiety, hears voices, feels feminine, and says that he feels like his brain is constantly on rapid-fire. All of this is causing severe depression. We would be grateful for any suggestions. Thank you.

 
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Old 11-24-2012, 07:55 AM   #2
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Re: Can severely low TSH cause psychosis?

Since I "talked" with you last night, I did a little research into your situation. The short answer is definitely yes. The suppressed TSH might be caused by a pituitary adenoma, which is a benign tumor that suppresses the TSH.
I easily found an article written by the American College of Physicians that describes a case of an 'otherwise healthy' 30-year old with unexplained psychosis who was found to have such an adenoma which was suppressing the TSH. They go on to say that pituitary adenoma presenting initially as psychosis is extremely rare and unusual.
But clearly, it is not impossible.

An MRI will be needed, and a prolactin level run. The woman described in the above case had one MRI done, which didn't show the adenoma; a second MRI revealed it after it had hemorrhaged and was easier to see.

If I were his mother, I'd grab onto this possibility like a pit bull and not let it go until a professional investigated it seriously. You will meet lots of resistence from endocrinologists who don't like to be told their business. That's their nature. But it's vital you push this issue until you get an answer. And I would surely not wait 4 months, either.

I hope you'll let us know what happens. Good luck to you both.
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Old 11-24-2012, 03:22 PM   #3
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Re: Can severely low TSH cause psychosis?

I agree that an extremely low TSH may explain the psychosis. I would see a different endocrinologist, perhaps a neuro-endocrinologist, and ask to have a pituitary panel run to check all the pituitary hormones. If one is off, others may be high or low as well. If you can get a referral to your university hospital clinic in neuro-endocrinology, that would be great. An MRI should be done, I agree. I think the endo he saw just didn't know what to do, and a second opinion is always warranted when advice conflicts.

 
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Old 11-24-2012, 06:06 PM   #4
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Re: Can severely low TSH cause psychosis?

I sincerely appreciate your time and effort in regard to my son's health issue. Our lives have been turned upside down during the past few months. All help is greatly appreciated. I will certainly post whatever we find to be at the root of the problem. Thank you so much!

 
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