Given diagnosis of Psychosis about to administer depot Paliperidone 100mg - blood tests below

[nonconventional]

I don’t know if anyone is able to help me understand the tests below.

I have been convinced for years that my Mum has Thyroid disjunction, which over the years has culminated in her become delusional to the point of not accepting any help and not realising anything is wrong with her. She won’t accept help.

Now she has been hospitalised and after months of no meds they are going ahead with depot Paliperidone 100mg

I want my Mum to be well but am not sure chemicals are the way to go, especially when one looks at the side effects which include irreversible tremors & shaking in some patients. It also says not to give to patients with low white blood cell counts - I don’t know if hers is low.

I’m scared - they want to begin to administer this week but my gut instinct is saying this is Thyroid related. She was on Thyroxine but only ever took it intermittently and I’m sure the testing done was not for optimal thyroid function, but rather ‘normal’.

At the same time they suspect she has Lupus. Having been down this road before through my own informal research, it probably is not Lupus. I know through experience Doctors only guess, because they do not know. I feel the Lupus is rather an indication of Thyroid issues & possible her gut.

Will appreciate any thoughts. My Mum is 76yrs.

Recent blood test results.

Taken: 01-NOV-2017 Laboratory No: 0017M295605

* DS DNA ANTIBODIES 37.0 iu/mL [ 0.0 - 17.0 ]

Interpretation:

<17 IU/ml.....Negative

17-20 IU/ml.....Equivocal

20-200 IU/ml.....Positive

>200 IU/ml.......Strong Positive

CRITHIDIA TEST Negative

This suggests that the DNA antibodies detected by ELISA are either low titre, of low affinity or not specific for double stranded DNA.

The latter antibodies may occur in several inflammatory diseases, and are not specific for systemiclupus erythematosus (SLE)

NEGATIVE for anti-Ro (60kDa and 52kDa), La, Sm, RNP, Jo-1, Scl-70.

Apologies, for technical reasons, we cannot identify low level Jo-1 antibodies using this ENA screening assay. If Jo-1 antibodies are required, or myositis suspected, please contact the lab directly on 64956 to ask for an AIM panel to be performed.

ANA TITRE 400

ANA PATTERN homogeneous

ANA interpretation: Weakly positive anti-nuclear antibody. This may be associated with autoimmune diseases, infection and inflammatory conditions. Found also in some healthy individuals.

ANTI-NUCLEAR ANTIBODIES POSITIVE

B12 427 (190-800)

- folate 4.9 (3-17)

- ESR 25mm/1hr (normal range for a 76 year old lady 30-38mm/1hr)

HAEMOGLOBIN 120 g/L [ 115 - 165 ]
WBC 7.90 10 E9/L [ 4.00 - 11.00 ]
PLATELETS 292.00 10 E9/L [ 150.00 - 450.00 ]
RBC 4.49 10 E12/L [ 3.80 - 5.80 ]
HCT 0.405 L/L [ 0.370 - 0.470 ]
MCV 90.00 fl. [ 84.00 - 102.00 ]

ALT 14 U/L [ 0 - 35 ]
TOTAL BILIRUBIN 7 umol/L [ 0 - 21 ]
TOTAL ALK.PHOS. 126 U/L [ 40 - 130 ]
ALBUMIN 38 g/L [ 35 - 52 ]

SODIUM 138 mmol/L [ 134 - 145 ]
POTASSIUM 4.8 mmol/L [ 3.5 - 5.3 ]
UREA 4.7 mmol/L [ 2.9 - 7.5 ]
CREATININE 50 umol/L [ 45 - 84 ]

TOTAL ALK.PHOS. 126 U/L [ 40 - 130 ]
PHOSPHATE 1.19 mmol/L [ 0.80 - 1.45 ]
ALBUMIN 38 g/L [ 35 - 52 ]
ADJUSTED CALCIUM 2.36 mmol/L [ 2.20 - 2.60 ]

25 HYDROXYVITAMIN D 24 nmol/L [ 24 - 167 ]

TSH 0.5 mU/L [ 0.3 - 5.5 ]

HBA1C IFCC-ALIGNED 40.0 mmol/mol [ 20.0 - 48.0 ]

EGFR BY CKD-EPI /1.73M2 > 90 ml/min/1.73m[ 60 - 200

ECG showed normal sinus rhythm.

Obs - 14 RR, HR 100, O2 96, BP 125/70.

[Clutter]

Nonconventional,

Untreated hypothyroidism can masquerade as psychiatric illness but TSH 0.5 is low in range and doesn't indicate undermedication. There is no optimal TSH. TSH alone is not a reliable test of thyroid function. Your mother's FT4 and FT3 should also be tested. healthunlocked.com/thyroidu...

Lupus does seem to be a likely diagnosis google.co.uk/search?q=DS+DN...

B12 427 is unlikely to be deficient but it wouldn't hurt to supplement 1,000mcg methylcobalamin with a B Complex vitamin to boost folate if you can persuade your mother to take them. High B12 can be helpful in preventing dementia.

VitD 24 nmol/L is severely deficient. Your mother's physicians should prescribe loading doses of D3 followed by 800iu maintenance dose once vitD is replete >75. Probably easiest to give her a vitD3 loading injection. Otherwise her GP/physicians should refer to local guidelines or the NICE CKS recommendations for treating vitamin D deficient adults cks.nice.org.uk/vitamin-d-d... Vitamin D should be taken 4 hours away from Levothyroxine.

EGFR indicates excellent kidney function and HbA1c 40 doesn't indicate diabetes.

[nonconventional in reply to Clutter]

Clutter thank you so much, I’m in awe of your knowledge regarding these tests and I will certainly take cognisance of what you’ve said. I so appreciate you for taking the time 💕

[shaws Administrator in reply to nonconventional]

This is from TUK:

thyroiduk.org.uk/tuk/testin...

[Jazzw]

Heart rate of 100 - actually, maybe this is hyperthyroidism rather than hypothyroidism. Hashimoto’s flare perhaps? But agree with the others that it seems wrong not to test FT4 and FT3 ahead of treatment that has irreversible side effects. Definitely worth asking them to do it.

[nonconventional in reply to Jazzw]

Thank you for your contribution it means a lot to me 🙏🏼

[shaws Administrator in reply to nonconventional]

thyroiduk.org.uk/tuk/testin...

I was undiagnosed for a long time despite clinical symptoms which they know none these days. preferring to only look at a TSH result (if bloods are tested at all).

[nonconventional in reply to shaws]

Shaws still so much work ahead - I remain so optimistic seeing the advocacy on this site - it’s heart warming and encouraging 🙏🏼

[nonconventional in reply to Jazzw]

Thank you Jazzw I would never have picked this up

[nonconventional]

Thank you I really needed to hear this. I will do this immediately 🙏🏼

[Hidden]

Her vitamin D is very low.

[nonconventional]

So I’ve asked for them to do test for T3, T4, free T3, free T4 & will await the result. They also told me today my Mum is taking Levothyroxine, which they administer, which means she is actively taking it, though I don’t know dosage or how this will affect the results from the above tests.

Serendipity played a part today when I found this Talk from Dr Kelly Brogan, (psychiatrist from USA who no longer prescribes - her book ‘A Mind of your own’ is excellent) of someone cured of Lupus after 18yrs. youtu.be/clCUwyGne1g(Not working as expected?)

I think back, even as a child, to a Mother who suffered with malais/tiredness

[nonconventional]

I’m praying these tests I’ve requested will halt the urgency of them wanting to give my Mum antipsychotic drugs, enough for a miracle so she never has to take them.

I read the side effects of Zolof today and they are as bad as the symptoms they are supposed to treat. 🤷‍♀️

[nonconventional]

Unfortunately we are at their mercy but I will try

[nonconventional]

I have to say reading the symptoms of autoimmune cerebal hypothyroid certainly resonate - my Mum has so many of the same

[nonconventional]

This research brought up lots that resonated, thank you

[nonconventional]

Please keep my Mum in your prayers 🙏🏼

Thx to all of you I have come across so many things.

I have been able to make a connection to her Thyroid & psychiatric symptoms through hashimotos-encephalopathy which seems a very likely diagnosis, especially as it very often is misdiagnosed, sometimes as schizophrenia, as in my Mum’s case.

verywell.com/hashimotos-enc...

A video links vit D deficiency directly to this and my Mum’s Vit D is very low as you pointed out.

youtu.be/82CSlDFjTiw(Not working as expected?)

Then the itchy rash she has is also linked which I found through this article:

hypothyroidmom.com/chronic-...

She is to go into a tribunal Mon where a panel will decide on administering Psychiatric drugs. I only hope her Doctor is reading and listening to everything I have submitted

Looking for a miracle

[Marz in reply to nonconventional]

Don't forget to make a noise if the anti-bodies have not been tested - TPO and Tg. There should be an ombudsman type scenario where you can have help and support with this Tribunal. Wishing you all the very best outcome ....

[nonconventional in reply to Marz]

THank you Marz

[nonconventional]

How did he get better? There’s a lot of research I’ve found that says to ignore the fact that results may be normal and rather look at symptoms and vit D being low.

[nonconventional]

You have helped me so much by pointing to Hashimoto's encephalopathy because so much of what is said here is clicking into place including low VitD, symptoms including an explanation for the rash on her body (also linked to her diverticulosis), psychosis, malais and the biggest fact that this disease often goes misdiagnosed. I have a story of someone with Hashimoto's encephalopathy who was treated with psychotic drugs & remained the same, and was cured by being treated neuropsychiatric. One of the issues I’ve realised is that if you go to a dentist he’ll pull a tooth, a psychiatrist will medicate with psychiatric drugs, a psychologist with talk therapy, a neuropsychiatrist by looking at psychiatric symptoms through how the nervous system (autoimmune) is affecting the brain.