Are these results indicative of central hypothyroidism?

[encyclopedia]

TSH= 1.7 (0.5-5.0)

Free T4= 0.94 (0.82-1.74)

Free T3= 1.98 (2.3-4.2)

Could this be central hypothyroidism?

Are there degrees of it? Is this a mild case? I had a concussion in 1992, which triggered major depression. Could a concussion cause central hypothyroidism?

What wou,d be an adequate treatment of central hypothyroidism?

(I have taken T3 for 7 weeks now, and this has worked to prevent depression which I have had since 1992)

[jimh111]

Yes, trauma to the head can lead to central hypothyroidism and it seems resonable to assume it will not always be catastrophic, there will be degrees. Central hypothyroidism can also arise from whiplash injuries. Your TSH really should be much higher with both fT3 and fT4 low. Endocrinologists are always telling us how wonderful the TSH is because it goes sky high before fT4 falls and long, long before fT3 falls. So why is it not elevated in your case.

My view as a patient is that treatment of central hypothyroidism may require more T3 than for patients with primary hypothyroidism, since research shows that TSH stimulates T4 to T3 conversion. I would ask for a referral to an endocrinologist so that your other pituitary hormones can also be checked out. Central hypothyroidism is beyond the scope of a GP and guidelines state that patients with suspected central hypothyroidism should be given an urgent referral to an endocrinologist. (I think the urgent referral assumes the cause is unknown, in your case the likely cause is known and there isn't really an urgency).

[encyclopedia in reply to jimh111]

Thanks jimh 111, I did see an endocrinologist, but he said everything is normal and I dont need treatment. My psychiatrist still started me on T3 luckily.

Ihave to see the endocrinologist again in August, I will ask him about central hypothyroidism. I did mention to him my concussion, I will remind him.

I do think my case is mild though, wouldn't TSH T4 T3 be lower if it was more severe?

[jimh111 in reply to encyclopedia]

How much L-T3 are you taking? Were the above results before you started L-T3? Your fT4 is lowish and your fT3 very low. With these results your TSH should be very high, so everything is not normal. Maybe take someone with you to the appointment for support. It's always good to describe your symptoms and how they affect your life, this means more to a doctor than jsut a list of symptoms or blood test numbers.

[encyclopedia in reply to jimh111]

I am taking 15 mcg liothyronine. Thoseresults were before I started it. I plan to recheck my level soon. Thanks for your replies!

[jimh111 in reply to encyclopedia]

Ideally you would off the liothyronine for a few weeks before seeing your endocrinilogist but I would not do this if it resolves your depression. If a doctor prescribed the liothronine you could get them to write a letter confirming it has improved your depression and asking the endocrinilogist to help you (i.e. get off their backside).