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    Old 07-07-2007, 08:12 AM   #1
    lemondrop26
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    Mixed results - lab results in

    My Total T4 was 12.4
    My TSH was 4.44

    Apparently My family doc didn't do Total or Free T3

    He was trying to explain that these were normal but on the HIGHend and they were "screwy" because with higher T4 you would usually see lower TSH. He said that perhaps one was over compensating for the other.

    Because all my symptoms are Hypo But, I guess my results are showing Hyper. Which was the whole reason I didn't get this solved 3 years ago.

    Can anyone give me thoughts and advice? My docotr increased my depression and anxiety meds - said he wanted to see if that made a difference in some of my symptoms before we went to the Endo.

    Last edited by lemondrop26; 07-07-2007 at 08:17 AM.

     
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    Old 07-07-2007, 08:43 AM   #2
    sparkles916
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    Re: Mixed results - lab results in

    Whatever you do, don't raise you psych meds prior to getting treatment for your thyroid imbalance, whatever the cause (likely hypo).

    I myself was put on meds prior to my diagnosis as hypo.

    When I was diagnosed as hypo, I started reading around and read about the connections to mood disorders and psych disturbances and thyroid disease, which really opened my eyes.

    I then looked back at my old medical records, and saw that while I had been given TSH tests and one free t4 test, my condition was overlooked. I was by any definition clinically hypo in 1995 - -which interestingly correlates with the onset of severe panic attacks. I had a TSH of 4. something and free T4 of ,9 (the exact bottom of range).

    There is no doubt in my mind that my anxiety and subequent depression (who wouldn't be after years of anxiety and other stuff?) was caused by my hypo condition.

    No one in my family believed me, and neither did my boyfriend. I have a large body of medical journals I have read and saved demonstrating this link.

    I went on psych meds three years ago - lexapro, seroquel and ativan.

    I was diagnosed as hypo a year and a half ago.

    My dr tested my TSH on a lark. After I saw the results were above range, I did research on the web. My dr said, he would not treat anyone below a 10.0 TSH ( I was 5.8)

    So.....

    I went to another dr who did treat. However, she was satisfied when I reached 2.9 on 50mcg levothyroxine. I have since been working on my treatment with different drs for a year - but that is another story.

    I had to fight to be treated, just like many others here. You need to do the same. The current standard for hypo treatment is TSH above 3.0 - so if your dr or endo is reluctant to treat, go elsewhere.

    You also need the correct tests....free t4 free t4 and the thyroid anti bodies tests anti TPO and TgAB.

    Back to the psych meds. I have since read that SSRI's, esp., interfere with thyroid hormone levels. So, the SSRI s, by lowering your t3 and t4, are in fact making you worse.

    Going up on your psych meds makes no sense in the face of so much evidence that thyorid imbalance can cause mood and psych problems. Going up on your psych meds means you will have a longer time titrating down in order to get off them.

    I am having a hellish time trying to get off my last 10 mg of lexapro

    Pls feel free to ask me for med lit refs or personal experience re your situation. Sorry so long-winded. Hope this helps.

     
    Old 07-07-2007, 09:32 AM   #3
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    Re: Mixed results - lab results in

    Total T4 is a bogus test. Several things can falsely elevate it, making it appear that you have an adequate level when you actually don't. Insist that your doctor run a free T4 test for you, plus the other ones that sparkles mentions... and she's right on about the rest of what she says, too.

    You are definitely hypothyroid according to your TSH alone. You don't need more AD and anxiety meds; you need thyroid hormone.

    Last edited by midwest1; 07-07-2007 at 09:32 AM.

     
    Old 07-07-2007, 12:56 PM   #4
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    Re: Mixed results - lab results in

    I'm going to agree with midwest and sparkles on everything but one point. I was in thyroid storm with a tsh of 7.3 and total t4 of 14.7 (my frees were high too). Some of us are a little "unique". There's also people out there that are actually hypo with labs like that. It's something you need to look further into. If your free t3 and/or free t4 are also high, it's time to look a little further up the chain of command to the pituitary level.

     
    Old 07-07-2007, 04:05 PM   #5
    lemondrop26
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    Re: Mixed results - lab results in

    I need to find a good Endo - (understatement) Maybe it was my imagination but my family doc seemed a little put off that I was asking for the actual test results. The numbers. He just wanted to call and say "normal on high side" etc....

    Plus I think the whole increasing my Prozac dose is wrong. I have had these issues for years and been on a myriad of anxiety/depression pills. I doubt at this point increasing a pill 20mg higher is going to matter. This is about the 10th different pill I have been on since 1999.

    I am going to look for an Endo who has his own practice. I have found that doctors who have their own office and not work for a hospital or large clinic seem to treat you better.

    Thanks for your help.

    I just wonder if this doctor thinks the Prozac increase will raise my body temo from 96, keep me from loosing tons of hair, keep my hands from tingling and make the damn muscle aches in my legs go away.

     
    Old 07-07-2007, 04:24 PM   #6
    lemondrop26
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    Re: Mixed results - lab results in

    [QUOTE=sparkles916;3085181]Whatever you do, don't raise you psych meds prior to getting treatment for your thyroid imbalance, whatever the cause (likely hypo)............
    I am having a hellish time trying to get off my last 10 mg of lexapro
    QUOTE]
    ~~~~~
    Thanks for the help. Even though he increased my dose I held off wanting to see what my results were for my Thyroid testing. So now I have no plans to increase - or wait around. I was on Lexapro for a few years and weening off that med was HELL it turned me into a nightmare. Crying in public, angry, just made me hateful, evil, and rash.

    Last edited by lemondrop26; 07-07-2007 at 04:24 PM.

     
    Old 07-07-2007, 04:25 PM   #7
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    Re: Mixed results - lab results in

    Quote:
    Originally Posted by accessn12 View Post
    I'm going to agree with midwest and sparkles on everything but one point. I was in thyroid storm with a tsh of 7.3 and total t4 of 14.7 (my frees were high too). Some of us are a little "unique". There's also people out there that are actually hypo with labs like that. It's something you need to look further into. If your free t3 and/or free t4 are also high, it's time to look a little further up the chain of command to the pituitary level.
    ~~~~
    Thankyou so much for adding that. A "thyroid storm".

     
    Old 07-07-2007, 04:27 PM   #8
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    Re: Mixed results - lab results in

    Can anyone direct me to a thread on "finding a doctor" questions to ask and signs you should run. For example someone mentioned they knew a doctor who wouildn't treat for anything under TSH 10. What types of questiosn should I ask to make sure I have a good chance of the doctor treating me and taking it seriously.

     
    Old 07-07-2007, 06:02 PM   #9
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    Re: Mixed results - lab results in

    I'm new here and I'm certainly learning a lot from reading. I just started meds (Levoxyl) today to treat hypo (TSH 5.2, but lots of symptoms). I, too, have been on many meds over the years to treat anxiety. Currently, I'm on 150 mg of Zoloft, but would LOVE to be free of SSRI's at some point in my life. I went from Prozac, to Zoloft, to pack-it-on Paxil, to Lexapro, to Effexor and back to Zoloft. Is it possible that, once my hypo is properly addressed, that I will no longer need the anxiety meds? Thanks!

     
    Old 07-07-2007, 07:17 PM   #10
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    Re: Mixed results - lab results in

    Quote:
    Originally Posted by Luv2Travel View Post
    Is it possible that, once my hypo is properly addressed, that I will no longer need the anxiety meds? Thanks!
    Yes, it certainly is once you receive treatment for hypo and obtain your proper levels of Ft3 and Ft4 (that is a problem for some people, but you will find out if you are a good responding patient during treatment or need more help..fingers crossed)

    There is tons of stuff on the internet regarding depression, mood and affect disorders, and other psych manifestaitons connected with both hypo and hyperthyroidism. Most psychiatrists perform a routine thyroid test on patients presenting with depression, since it is well known to coexist with hypo. Problem is that they often rely on outdated ranges just as GP's do, etc, etc, and it may be overlooked. Or, it may be overlooked because of poor practice in not screening for a thyroid disorder to begin with. Of course, there are the difficult to diagnose cases which are overlooked too.

    I recently found a good general article which you can obtain (have to register - can get it for free) entitled:

    Identifying hypothyroidism’s psychiatric presentations, Current Psychiatry
    Thomas D. Geracioti Jr, MD 11/1/2006

    (Search web for this...not trying to be obtuse, but just abiding by the posting rules )

    On SSRIs and their effects on lowering thyroid hormone levels, see

    J Psychiatry Neurosci. 2004 September; 29(5): 383–386.
    Peripheral thyroid hormones and response to selective serotonin reuptake inhibitors

    [url]http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=518867[/url]

    SSRIs actually in this study, and others related, have been shown to reduce the t4 and t3 levels, thereby (my conclusion) underming thyroid hormone treatment. The t3 is particularly important in the role of depression (low t3), so, if like me, you are taking t4 (levoxyl) and not achieveing the proper conversion levels of t3 because of the SSRIs, and therefore your free T3 is still below optimum level, your mood disorders may not resolve, because you have less t3 than your body requires. You can only go up to a certain t4 therapy level before it become too high for your body to tolerate and still not achieve enough t3. There are a number of reasons for poor T4 to t3 conversion, which some people experience, which I have not addressed. But, this is definately one in your situation. And one to deal with.

    I am now taking Armour, since I was not doing well enough on the Levo alone.

    Even so, I had a great reduction in anxiety when I started treatment with the thyroid hormone, and could cut down on my seroquel. I am just sort of stuck on the remainder of it along with the Lexapro since I was waiting to have optimal improvement by getting my Free t4 and free t3 levels sorted out. But, in the meantime, someone here on this board pointed out that my antidepressants were likely significantly interfereing with my treatment. So, I started my research and here were are. I am down to about 7mg from 10 over the past month Slowly but surely....

    Ok. I am lost in my response, but pls feel free to ask any follow ups Qs

    Let me just say, wait a bit into treatment till you see some improvement. Then it may be time to deal with the psych meds. But, by no means would I recommend any radical change at this point. It was only when I started to feel the brain fog lift and other mental improvements, that I started to consider that maybe the psych meds were not really supporting me anymore - there was no mistaking the giant leap I made with the thyroid hormone. When you feel this way, I would revisit the psych med problem.

     
    Old 07-08-2007, 07:03 PM   #11
    Luv2Travel
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    Re: Mixed results - lab results in

    Thanks for all of the great information, Sparkles. My diagnosis was made within the past week, so I'm trying to read and learn as much as possible. Input from members like you is so helpful and greatly appreciated!

     
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