Posted by Noa on April 11, 2000, at 8:44:10
In reply to Regarding thyroids (Noa anyone else), posted by Janice on April 10, 2000, at 20:37:17
Hi, Janice. I am reading this board backwards, from bottom to top, so I already read and responded to your other post, too.
Let's see if I can answer some of your questions about hypothyroid, to the best of my newly acquired knowledge.
> Are the symptoms of a hypothyroid different from depression?They overlap, especially if you have the "atypical" variety of depressive symptoms. For example: low energy, fatigue, low mood, brain fog, etc.
> I am slim, would this exclude me from having thyroid problems?
Apparently not. According to Mary Shomon's book, Living Well with Hypothyroid, thin people can also have hypothyroid.
> I asked my gp for a testing. She opened the book, read something, then said I could have one in 6 months. If I suspect I have thyroid problem, do you think I should wait this long?
I don't know, and my guess would be that it might depend on how badly you feel. It is unlikely that a hypothyroid condition would suddenly become critical (hyperthyroid is another story), and more likely to develop more over the long term. BUT, for a complicated case of rapid cycling mood disorder, I think it is good SOP to do a thyroid screening.
> When I do get one, would it take a specialist to interpret the results?
Possibly. A lot of doctors rely too heavily on the so-called "within normal limits" numbers, and don't investigate further or pay much heed to the symptoms. But this cursory dismissal can be done by a specialist, as well. Still, I imagine the odds are better with an endocrinologist than your average internist, especially in a managed medicine system. That being said, you can have the tests done by your internist but make sure to get copies of the actual lab numbers so that if the doc doesn't take a close enough look, you can take the test results elsewhere. Also, get the "normal" range values for the particular lab you are using. Believe it or not, they can vary from lab to lab, which is part of what makes the reliance on WNL criteria absurd.
Could the test read normal, while I could still have a thyroid problem?
Yes. For example. "normal" for TSH (thyroid stimulating hormone) is considered to be between around .5 and 5.5, and so if yours was 4.9, as mine was, before meds, then the doc will tell you your thyroid is normal. However, newer research is showing that having a TSH level of 2 or higher is highly predictive of later thyroid disease, and may be considered early stages of disease. There is also newer research showing that to be effective, thyroid hormone replacement treatment should aim to get the TSH down to the lowest quartile of the "normal" range, ie, .5-1.75. And, lots of patients say they don't feel well unless they are able to get their tsh down to around 1.
Another way that you can have hyporthyroid disease is that you can have enough T4 and your TSH can be ok, but something is getting in the way of the T4 converting to T3, which is the active form of the hormone that the cells of the body can actually make use of. T4 is the form that it travels around the body in, and it is T4 that the brain monitors in deciding whether to get the pituitary to secrete more TSH to the thyroid. Apparently, sometimes there is a protein missing, but this is something I don't understand yet. In any event, this is also why psychopharmocologists are more helpful with thyroid than many other docs, because they use T3 replacement to augment medications and often it is T3 replacement that is needed, either instead of or in addition to the T4.
Caveat: What I have written is my understanding of all this stuff about thyroid. I might be mistaken, and I will stand corrected if I am wrong.
I recommend this site: www.thyroid-info.com
You can even search geographically for a doctor recommended by other thyroid patients visiting the site.
poster:Noa
thread:29579
URL: http://www.dr-bob.org/babble/20000411/msgs/29620.html