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Ask Dr. Natasha Your Own Question
Dr. Natasha
Dr. Natasha, Doctor
Category: Medical
Satisfied Customers: 12910
Experience:  American Board Certified in Emergency Medicine, Ivy League trained
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I have a low TSH (0.03), slightly elevated T4 (1.8) and within

Customer Question

I have a low TSH (0.03), slightly elevated T4 (1.8) and within normal T3 (4.1). I don't really have any symptoms described in medical journals. I have always been slim and have generally pretty low blood pressure. My doctor (not an endocrinologist) associated mild depression i went through with a possibly hyper thyroid but I was depressed because within a short period of time I lost my brother, went through a divorce and then got abandoned all the while living abroad where I inevitably feel quite isolated. I am writing this because I know that depression is often linked with a low THS and so I worry I will be misdiagnosed. I am currently living in Japan... Can you help?
Submitted: 4 years ago.
Category: Medical
Expert:  Dr. Natasha replied 4 years ago.

Doctor Cameron :

hello

Doctor Cameron :

welcome to the chat

Doctor Cameron :

are you still there?

JACUSTOMER-iam9gk76- :

yes

Doctor Cameron :

is your doctor going to treat you for hyperthyroid?

JACUSTOMER-iam9gk76- :

I am not sure how this works but I got an email saying you had an answer for me.... what shall i do?

Doctor Cameron :

No, I have questions for you

Doctor Cameron :

I means were interacting

JACUSTOMER-iam9gk76- :

I see.

Doctor Cameron :

Is your doctor going to refer you to an endocrinologist?

JACUSTOMER-iam9gk76- :

i think so. i am supposed to see someone in a couple of weeks.

Doctor Cameron :

Great

Doctor Cameron :

Well, one of the first things that we check when someone reports a change in mood is to check their thyroid hormones

JACUSTOMER-iam9gk76- :

i was tested by a gynaecologist. my period was late one time and too early the next and because i have been super regular and under A LOT OF stress i went to get checked. this month my period was there on time so.

Doctor Cameron :

Because this can have a profound effect on their mental state of being

Doctor Cameron :

You do NOT have to be losing weight

Doctor Cameron :

You do NOT have to have night sweats

Doctor Cameron :

Thyroid disease can have some or one or many symptoms

Doctor Cameron :

The best thing to do, it so recheck your hormones and see what is going on

JACUSTOMER-iam9gk76- :

nobody checked that here because my depression seemed clearly connected to the trauma i was going through

Doctor Cameron :

You may need treatment

Doctor Cameron :

Right, and you may ALSO have depression

Doctor Cameron :

but you will not be able to successful treat the depression unless you also deal with the thyroid issue

JACUSTOMER-iam9gk76- :

but depression cause by loss ?

JACUSTOMER-iam9gk76- :

i have just had my blooded checked last week so the results are very new. do they sound bad to you, from what i wrote?

Doctor Cameron :

No, they do not

Doctor Cameron :

but they do need to be rechecked in 6 weeks to see what is going on

JACUSTOMER-iam9gk76- :

i see. so i should ask (if not offered) another test when i see the specialist on the 1st of july.

Doctor Cameron :

yeah, I would ask for another one

JACUSTOMER-iam9gk76- :

what do i risk if i leave this untreated? i am very worried about being misdiagnosed. also, if that happens and i am given meds to suppress the hormone production this will change my metabolism and at the very least probably make me prone to weight gain.

Doctor Cameron :

Over time, it can cause toxic effects to your body, particularly your heart, and cause heart failure

JACUSTOMER-iam9gk76- :

even at the rate my results look now?

Doctor Cameron :

Things change over time- which is why you need the labs rechecked

JACUSTOMER-iam9gk76- :

what can affect them? is stress itself possibly responsible for the imbalance in the first place?

Doctor Cameron :

No, stress does not cause this

Doctor Cameron :

it is coincidental

JACUSTOMER-iam9gk76- :

so if i hadn't had the test i would have continued the way i was which is fine and very fit just struggling with a real issue of ....kind of abuse i am experiencing? or do these things just get worse?

Doctor Cameron :

well, we do not know if you have true hyperthyroidism.

Doctor Cameron :

You need to get your labs rechecked

JACUSTOMER-iam9gk76- :

what else could it be?

Doctor Cameron :

depression. anxiety

JACUSTOMER-iam9gk76- :

so depression can cause the hormones to be on overdrive?

Doctor Cameron :

no, they are unrelated

JACUSTOMER-iam9gk76- :

or basically out of balance

Doctor Cameron :

they are unrelated

Doctor Cameron :

you have an imbalance of your hormones

Doctor Cameron :

this can CAUSE depression/anxiety OR you may have BOTH

JACUSTOMER-iam9gk76- :

so when you wrote depression and anxiety what did you mean? sorry.....

Doctor Cameron :

that is what I meant

Doctor Cameron :

Either you have hyperthyroidism AND a psychiatric issue or you have just the psychiatric issue

Doctor Cameron :

the hyperthyroidism has not been proven yet

Doctor Cameron :

you need another set of labs

Doctor Cameron :

you are borderline

Doctor Cameron :

Did I provide you with excellent service?

JACUSTOMER-iam9gk76- :

so i have hyperthyroidism AND depression or just one impacting the other (depression caused by hormone imbalance). another thing i am concerned about it the actual definition of depression. my world has in real terms fallen apart and it seemed only natural that i was depressed. i was never really bad though. even in the worst of times i continued working and being very active. mainly to avoid dealing with the abusive relationship. i mean what i am saying is that i might not really have a depression (my japanese doctor doesn't think i have a classic depression but rather my anxiety is a result of a very complex abusive plus unresolved personal issue on top of the strain living alone abroad can bring.

Doctor Cameron :

You can have anxiety and depression

Doctor Cameron :

Mental illness is complicated

Doctor Cameron :

But I think that you understand what I am saying

Doctor Cameron :

you need to see the endocrinologist and a psychiatrist

JACUSTOMER-iam9gk76- :

it all sounds very depressing. anyway, so i am borderline according to the UK standards, right? they might be a bit different here (the doctor was worried about that)

JACUSTOMER-iam9gk76- :

i am seeing a psychiatrist but he thinks i need to get out of the abusive relationship and does not think i am clinically depressed.

Doctor Cameron :

Take care of the endocrine issue

JACUSTOMER-iam9gk76- :

yeah i will. thanks

Doctor Cameron :

and if you are in an abusive relationship you MUST address that

Doctor Cameron :

quickly and soon

JACUSTOMER-iam9gk76- :

i know. this is the hard part. relates to stuff from childhood (doesn't all?).

Doctor Cameron :

I hope that I was able to provide you with excellent service?

Doctor Cameron :

yeah.

JACUSTOMER-iam9gk76- :

thanks. it is hard to get the answers one wants. i.e one would want to be told one is ok but.... one is not ;). anyway, thanks.

JACUSTOMER-iam9gk76- :

could you just tell me what are the UK standards for TSH?

Doctor Cameron : They use a different standard to the US
JACUSTOMER-iam9gk76- :

who? the UK?

JACUSTOMER-iam9gk76- :

i thought i was talking to a brit. sorry.

Doctor Cameron : The uk- that is what you asked, right?
JACUSTOMER-iam9gk76- :

yeah but only because i thought you were british. i just want to know the generally used standards and see if they are the same as the ones i was given here.

Doctor Cameron : 0.15- 3.5.
Doctor Cameron : i am American
JACUSTOMER-iam9gk76- :

here it's like this: TSH 0.5-5. T4 0.9-1.7 and T3 2.3-4.6

Doctor Cameron : The more important deal is the trend- is it stable or changing?
JACUSTOMER-iam9gk76- :

i see. so i am below then.

Doctor Cameron : Yes, we use a tighter definition because of more causes of thyroid. Yes, you are borderline hyperthyroid
JACUSTOMER-iam9gk76- :

ok. thanks.

Doctor Cameron : You are welcome.
Doctor Cameron : Keep me posted
Doctor Cameron : i hope that I was able to provide you with excellent service? :-)?
Expert:  Dr. Natasha replied 4 years ago.
Hi Katherine
It appears that our chat did not close properly.

Did you have another question about this or did I provide you with excellent service?