Thyroid labs are normal says dr.

[jhperez81]

For the last 4 years or so I’ve struggled with motivation and energy. The dr I’ve been seeing keeps throwing antidepressants at me and none of them work. I was convinced that my lack of energy was due to thyroid considering my TSH always comes back upper range. My father and his mother both have hypo, not sure if it was caused by Hashimoto since dr’s rarely test for that. I would appreciate some opinions on my thyroid labs if possible. No reverse T3 sorry.

TSH 3.7 (.36 - 5)
Free T4 1.1 (.8 - 1.5)
Free T3 3.2 (2.3 - 4.2)
TPOab 167 (<9)
Total T 386 (250-1100)
Free T 55.6 (35 - 155)
Total T4 8.3 (4.9 - 10.5)
Total T3 101 (76 - 181)

 

[Vince]

Your tpoab looks like it's in the high range. It could be a sign of Hashimoto's.

The presence of TPO antibodies in your blood suggests that the cause of thyroid disease isan autoimmune disorder, such as Hashimoto's disease or Graves' disease. In autoimmune disorders, your immune system makes antibodies that mistakenly attack normal tissue.
Thyroid peroxidase antibody test: What is it? - ...
Mayo Clinic - Mayo Clinic › faq-20058...

 

[jhperez81]

Interesting, my dad and his mom both have rheumatoid arthritis which is also autoimmune disorder. I started taking selenium 200mcg per day to help with auto immune. Would starting on synthroid be a good idea? I’ll have to find another dr since the one I go to wants to wait until my tsh is out of range then she’ll treat it.

 

[Systemlord]

Your testosterone is low as well, by definition you are low, just not low enough for insurance to approve treatment. You can have thyroid dysfunction even when levels are in range, if there are big enough fluctuations within ranges, you can bet on symptoms.

 

[Vince]

Interesting, my dad and his mom both have rheumatoid arthritis which is also autoimmune disorder. I started taking selenium 200mcg per day to help with auto immune. Would starting on synthroid be a good idea? I’ll have to find another dr since the one I go to wants to wait until my tsh is out of range then she’ll treat it.

My recommendation is, but you don't have to follow it of course. Take low-dose iodine and selenium. Have you ever thought about giving up grains?

 

[jhperez81]

I’ve looked into the keto diet. It’s appealing to me but it would be a struggle to follow with 4 kids and constant activities. I’ve almost signed up for one of the prepared meal delivery programs but they are expensive. I still might try it for a month or so and see how I feel. My TSH has been fluctuating in the last year and a half. My last labs were the first time I requested T3, T4, and antibodies.
Sep 2018 TSH =3.78
April 2018 TSH =3.52
Sep 2016 TSH = 3.2

I feel my depression like symptoms are being caused by either my thyroid, testosterone, or mental. I’m not sure where to start but I think it would be better to work on one thing at a time. I went to a psychiatrist for the first time and he said sometimes they use synthroid for depression but he wanted to try effexor xr along with the mirtazapine I am already taking. I’m wondering if it would be good advice to try TRT first before adding antidepressants or the antidepressants first. I just don’t want to on trt, thyroid meds, and antidepressants all at the same time. Too many variables to work with when trying to dial in treatments.

 

[Systemlord]

I’ve looked into the keto diet. It’s appealing to me but it would be a struggle to follow with 4 kids and constant activities. I’ve almost signed up for one of the prepared meal delivery programs but they are expensive. I still might try it for a month or so and see how I feel. My TSH has been fluctuating in the last year and a half. My last labs were the first time I requested T3, T4, and antibodies.
Sep 2018 TSH =3.78
April 2018 TSH =3.52
Sep 2016 TSH = 3.2

I feel my depression like symptoms are being caused by either my thyroid, testosterone, or mental. I’m not sure where to start but I think it would be better to work on one thing at a time. I went to a psychiatrist for the first time and he said sometimes they use synthroid for depression but he wanted to try effexor xr along with the mirtazapine I am already taking. I’m wondering if it would be good advice to try TRT first before adding antidepressants or the antidepressants first. I just don’t want to on trt, thyroid meds, and antidepressants all at the same time. Too many variables to work with when trying to dial in treatments.

A lot of the time men and women being diagnosed with depression and anxiety actually are in the beginning stages of experiencing low thyroid hormones and or low testosterone. The problem is doctors never look for a cause because it's cheaper and easier to prescribe an SSRI to deal with the problem when the underlying problem is never addressed.

Over the years as the hormones get lower the medication can no longer mask the symptoms of low hormone levels. Antidepressants worsen all your hormones, you might as well be ingesting poison.

These SSRIs will not correct your thyroid problem and low testosterone. The fact that your doctor hasn't shown concern for elevated TSH doesn't look good.

Thyroid Symptoms in Men + How Low Thyroid Causes Low Testosterone

 

[jhperez81]

That’s what I wad thinking. I’ve been on and off antidepressants for about 7 years and they never seem to work. I’m 37 and I feel like I’m an old man! Maybe testosterone will get me feeling like my age or younger.

 

[Systemlord]

That’s what I wad thinking. I’ve been on and off antidepressants for about 7 years and they never seem to work. I’m 37 and I feel like I’m an old man! Maybe testosterone will get me feeling like my age or younger.

When we see elevated TSH above 2.0, it's telling us the thyroid is struggling which is why TSH is elevated in the first place. TSH increases when your pituitary gland senses low thyroid hormones (low Free T3 or high Reverse T3), I don't have a thyroid problem and my TSH is .9 which is closer to 1.0 which is optimal.

Few doctors even know how to diagnose and properly treat low testosterone, I had to go private since known of my endo's had no idea what they were doing. A lot of thyroid doctors are found wanting and don't fully understand thyroid problems and never do enough testing, we see this a lot.

 

[OMI100]

Your FT4 is at 43% of range.
Your FT3 is at 47% of range.
Both no where near optimal.
As noted above RT3 is another piece of the puzzle that is needed.
Most DRs are taught to treat to ranges and NOT symptoms...
I will add some other links to the one Systemlord provided that have great sound information to consider. Dr. Childs does an amazing job of distilling each blog post to a level that us non-DRs can understand:
The Connection Between Hypothyroidism and Depression (+Treatment)
How T3 Thyroid Hormone Helps Treat Depression (+ Other Treatments)
High TSH Symptoms, Causes & What it Means
4 Conditions that make TSH Levels Inaccurate + "Optimal" Ranges & More
Also another great site with great info.
Barbara has a book out that covers all thing thyroid and is easy to read.
Get it.
While not a DR., she has spent many, many, many years researching thyroid physiology.
This book is at a Doctoral theses level..... All points are backed up with legitimate medical studies and research... ALL chapters are source footnoted with many pages of references at the end of each chapter.
http://www.tiredthyroid.com/index.html
http://www.tiredthyroid.com/what-labs.html
http://www.tiredthyroid.com/optimal-labs.html
Now after all that you might see if you can find a DR. that treats to "symptoms" and is not tied down to "ranges".
As Systemlord noted above, finding a GOOD DR. that truly understands the thyroid is no simple task
BTW both sites have a wealth of additional information on the thyroid, so look around both.
One last point is that Dr. Child's blog post points are also hyperlinked to the underlying study / research, so if you come across something that rings true you might want to print out the underlying study / research paper to take to your DR. Some DRs. may get offended... If so you don't need that DR., but others are open minded and will read the information and consider it. THAT is the type of DR you need....

 

[jhperez81]

Thanks Orrin. I’ve been doing alot of research lately and I’ll check out your links. I’ve read some good things about Cytomel being used for both Hashimoto and depression. I have a consult with Defy soon so maybe they can help.