New Here. Help.

[maylowe]

This is all weird and new to me. I’ve never been the type to openly share my problems with people I don’t know, but I figured nothing else has worked so I might as well give it a go. I was diagnosed with depression 8 years ago when I was in high school. I’ve always been the shy awkward heavy set girl that always stayed to herself and my lack of social skills, being overweight, and extremely low self esteem had buried me further into this hole that I’ve been ignoring for a very long time. I didn’t come from a family that liked to talk about their feelings, and whenever I would try, it almost seemed as if I was blamed for whatever problems I was feeling. I eventually went to different therapists, and was put on many different medications but for some reason I could never adhere to them, and the vulnerability aspect of talking to a therapist clammed me up so much that it never got me anywhere. So I would just try my best to ignore it and keep myself busy with school work. I always did pretty well in school, and decided I wanted to further my education and become a pharmacist. I’m currently in my second year of pharmacy school and the amount of stress is astronomical. Add the years upon years of unhandled depression and I’m at a point in my life where I’m a complete zombie. I feel like I cannot function anymore. I wake up, complete whatever school work I need to do, and then try my best to study or stare at the wall in my bed for the rest of the day. My mind feels like it’s detached from reality and is comprehending things 2x slower than anything else. I may not shower, brush my teeth, or eat for days. The only consistent part of my life is going to school because I don’t want to be a disappointment to my family. I’m worried I’m at the point in my life where my depression is getting in the way of my day to day life and it’s very scary. I started going to therapy again once a week but I don’t feel that it’s helping, but I’m scared to tell her because I almost feel like I’m hurting the therapists feelings? Is that weird? I can barely remember the things I have to do for school each day, and by the time I’m done with those tasks, I completely forget to do my therapy homework and fast forward a week has gone by and I haven’t done any of the self-care, affirmations, or journaling she has told me to do and I’m just disappointing her and myself. I’ll even set a reminder on my phone and still won’t do it. What’s wrong with me? It’s like I don’t want to do anything anymore.

[Mary-intussuception]

Hi maylowe and welcome

I wondered, as I read your post, what investigations you have had to look for a physical reason?

For example, have you ever had blood tests for Thyroid Antibodies (TPO & TgAb) and Thyroid function tests (Free T4, FreeT3 and TSH)?

I ask because you have many symptoms of an untreated Underactive Thyroid.

Other conditions should be eliminated too.

But Hashimoto's Autoimmune Thyroiditis is very common and it's the cause of Hypothyroidism in most cases.

[maylowe in reply to Mary-intussuception]

The only hormonal disorder I’ve been diagnosed with is polycystic ovarian syndrome. My mother does have hypothyroidism but I haven’t gotten mine checked myself. Do you know if a pcp can check thyroid levels or would I need a referral to an endocrinologist?

[Hidden in reply to maylowe]

Hi maylowe and welcome! It is my GP who monitors my hypothyroidism and adjust the med. needed accordingly. She orders a blood test every month. My neurologist can apparently also order a blood test of TSH levels since he has in the past.

[maylowe in reply to Hidden]

Hello MinnieMouse and thank you! Before you have gotten your hypothyroidism under control, we’re you experiencing these same symptoms?

[Hidden in reply to maylowe]

With being tired you mean? Definitely!

[Mary-intussuception in reply to maylowe]

Your Mother has Hypothyroidism! So did mine! Hashimoto's is hereditary.

Not sure what pcp is (is it principal care practitioner?).

I'm in the UK, not sure where you are.

Over here you could ask your regular doctor (GP) for the blood tests. Make an appointment and go prepared with a written list of all your symptoms. And ask for the blood tests (below). If refused, you could say something like

" As I have many symptoms of Hypothyroidism, I'd like to eliminate Autoimmune Thyroiditis".

If still refused, then ask for an urgent referral to an Endocrinologist.

You should also have some nutrition levels checked.

Blood tests to ask for;

TPO (Thyroid Peroxidase Antibody)

TgAb (Thyroglobulin Antibody)

TSH (Thyroid Stimulating Hormone)

T4

FreeT3

FreeT4

Plus:

Vitamin D & Calcium

B12 and B9 (folate)

And Ferritin

When did you last have a Full Blood Count ( FBC here , CBC in USA). Ask for that too? Kidney Function, Liver Function, Bone blood tests?

You have to keep pestering your doctor till you get properly tested.

More difficult now with Covid. But you could write a letter to your GP?

You could ask for an Ultrasound Scan of your Thyroid too.

You could also ask for tests to check your Adrenal Function.

If necessary show your doctor this post!

Take a look on the 'Thyroid UK ' website & search on there 'Underactive Thyroid - Symptoms'. There's a list. You don't need to have all the symptoms.

There is also a forum on Health Unlocked you could join.

xx

[Hidden in reply to Mary-intussuception]

I think it's primary care physician.

[maylowe in reply to Mary-intussuception]

PCP is primary care physician (thanks MinnieMouse) and I live in the US. My mother developed hypothyroidism through other means. She had a growth on her thyroid gland and had to get half of it removed and in turn developed hypothyroidism as a result sorry for the confusion! But I will definitely get these labs checked otherwise. I do know I have a vitamin d deficiency and I remember my pcp talking about hypoparathyroidism, but she never did labs for any of my thyroid glands so that’s why I was asking if a gp or pcp can run those tests. I’m a college student on my own and I go to her for pretty much everything so whenever she asks me to go see a specialist I get kind of lost and not really sure where to go from there, mostly because I don’t really know what the right things are to ask. But you two have been a great help and I really appreciate the list of labs to ask for.

[Mary-intussuception in reply to maylowe]

Haven't you had an Ultrasound Scan of your Thyroid and Parathyroids? In the UK this can be ordered by a GP.

Following the mention of Hypoparathyroidism, what further tests or referrals did your pcp actually arrange ?

It's an Endocrinologist you need to see. Not sure why your pcp leaves you lost - wouldn't she direct/refer you to the right Specialist?

When did you last have a blood test to check your Calcium levels, Phosphorus, Magnesium and PTH? These are what you need testing to confirm /eliminate Hypoparathyroidism. Did you have a Urine test?

What treatment were you prescribed for the Vitamin D deficiency? Was it a) Severe Deficiency; b) Deficiency; or c) Insufficiency?

This is important because the treatment is different. With severe deficiency you should have been prescribed a Loading dose to be taken over 4 to 6 weeks, then left on a daily maintenance dose which may be around 800 to 1000 iu, in some cases more. You should be monitored with repeat tests then annually as far as I am aware. With a result revealing Vit D Insufficiency, you would probably be prescribed 800 iu daily here in the UK.

Do you know if your Mother ever had any Antibodies tests? Is she under an Endocrinologist? Could you see her Consultant?

It's one Thyroid gland and four Parathyroids which are not related to the Thyroid, it's just geography.

I have a 2mm growth on one of my Parathyroids which is assumed benign. My phosphorus and calcium levels are ok. If I wasn't producing enough Parathyroid hormone (PTH) then my Calcium level would be low. and my phosphorus high.

Hope you are able to get fully investigated soon and the right medication (if needed) to correct any imbalance.

I understand that Hypoparathyroidism is rare, but I'd still be wanting to eliminate it with the U/S scan and bloods.

[maylowe in reply to Mary-intussuception]

I have not gotten an ultrasound scan of my thyroid or parathyroids.

I was seeing an endocrinologist regularly when I was under 18 for my PCOS. Labs were done and my vit d was around 12. He put me on 50,000 iu of vitamin d a week plus calcium citrate everyday 1000mg. I eventually I went to college for a few years and it was difficult to have our schedules sync up, plus I wasn’t a child anymore. I eventually got an adult doctor around my 2-3 year of college. She ran labs again and my vitamin d went up to 18. This is when my pcp thought maybe I had a parathyroid issue because she thought with the vitamin d and the calcium it should’ve worked itself out we started the vitamin d 50,000 again but twice a week. Along with the calcium. That was back in 2018. Since then I have been in pharmacy school and it has been extremely difficult to schedule any appointments. She’s booked months in advanced (say I try to schedule an appointment in June when I’m out of school, she won’t have an open slot til September when school has started back up again and I have no clue what my schedule is going to be so I cannot make the appointment, and the cycle just continues)

Currently I’m taking 1000 mg calcium citrate and 5000 iu vitamin d daily til I can see her again in December and get some more tests run.

[Mary-intussuception in reply to maylowe]

I would want blood tests now.

What were your most recent results? Could you post them on here?

Always get copies of your results ask for print outs. In the UK we can get these free of charge now.

When giving results on here (or in Thyroid forum) always give full info;

Date of test, result, ranges in brackets, any comments on form from lab or doctor.

[maylowe in reply to Mary-intussuception]

I have given you my most recent results that I am comfortable sharing in an online forum.

[Mary-intussuception in reply to maylowe]

Haven't seen any

No range given with Vit D "result'.

If results are true they look very low, but no range given. Plus - years out of date.

[Mary-intussuception in reply to maylowe]

So you have been under an Endocrinologist and are being treated for Hypoparathyroidism?

When did you last see your Endocrinologist?

[maylowe in reply to Mary-intussuception]

I’ve never been diagnosed with hypoparathyroidism. I thought I was being treated for the vitamin d deficiency.

[Mary-intussuception in reply to maylowe]

You were prescribed Calcium too?

If this were me then I think I would be asking for up to date blood tests.

If it's difficult to see a doctor, how about a telephone consultation or write a letter. You may he able to arrange blood tests without needing to see your doctor first.

And may be able to get results over the phone or by letter too.

If writing I think I'd try to keep it simple. Say how you are feeling, and that you're not coping. List the meds & supplements & doses you're taking and ask for blood tests as it's two years since you had any.

Hope you manage to get some blood tests soon, especially Vitamin D and Calcium, then your doctor will know if you need any adjustments to your doses.

It's really your doctor's advice that you need.

xx

[maylowe in reply to Mary-intussuception]

Also, I found some labs from 2-3 years ago and my thyroid panel was on there and it was all within normal levels. I know a lot can change in a few years, so I will get them checked out again. Thanks

[Mary-intussuception in reply to maylowe]

With Hashimoto's, the regular tfts (Thyroid function tests) can fluctuate and fall within the normal ranges so are not reliable on their own. Also the Therapeutic level of TSH is much lower than the lowest level of the normal range.

Many doctors test only TSH which is not conclusive on its own. For example, someone with Central Hypothyroidism would have a normal range TSH result and a Low T4 because the Pituitary gland isn't functioning as it should.