Lethargy, Depression, Diagnosed With Hypothyroidism. Does She Need Hormone Therapy?

Posted on Fri, 2 Dec 2011

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Fri, 2 Dec 2011 Answered on

Mon, 1 Oct 2012 Last reviewed on

Question : My 26 year old daughter is struggling with extreme lethargy and an overall feeling of illness. When she was 17 she was diagnosed as depressed. They gave her an anti-depressant. A month later they diagnosed her as having hypothroidism. I think they jumped the gun on the depression dianosis since hypothyroidism can cause depression. She struggled for years with the depression drugs. When she was in graduate school for her masters in family therapy she took herself off of the anti-depressant. She manage to graduate with honors. She's tough. Sometime before that her thyroid was tested again and was told she didn't need to take the levothyroxine. The doctors always want to put her on anti-pressants. She doesn't respond well on them, get's worse. She has started a new job today that relates to her field. It's a two hour drive both ways and will be working with sex offenders. It's better than working without a break all day with autistic children which has been stressful. She went in for her preliminary job physical two days ago, her BP at rest was 70 over 40. He took it twice to make sure. It went up when he made her do a little exercise. The doctor she talked to yesterday didn't seem to think it was a big deal. She also said that hypothyroidism doesn't cause low BP. I know it can. So now she has no time to see a doctor, at least during her first week at a new job. My next step is to find a good Endocrinologist here in Mpls.that really understands thyroid issues. Doctors now just check for a few markers but don't entertain the thought that she might need an actual hormone therapy that isn't synthetic. Sorry about the long intro. She is strong, but has no energy to fight anymore. She believes she is ill not depressed and yes, depressed too from being so tired and spaced out.
What do you think? What should we do?

Answered by Dr. V. Kumaravel (17 hours later)

Hello

I do understand that your daughter has been suffering from depression and hypothyroidism.

I totally agree that hypothyroidism is associated with depression and vice versa. Many a times both are confused as their features overlap. In order to guide you appropriately, I require some more clarification.

1. Could you please upload your daughters’ thyroid blood report (Along with your lab reference age).

2. Also I would like to know what was the dose and preparation of thyroxine started.

Based on these answers, we can decide whether she requires thyroxine or not.

Regards

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. V. Kumaravel (13 hours later)

Sorry about all the info. The thyroxine dosage she was given was .05mg.
She says she just feels sick all the time, kind of like car sickness.
Last week at her preliminary physical her BP was 70/40.
And she is normally in the 90/60 range.
If this takes too much time I will send some more money.
Thanks, XXXXXXX

Answered by Dr. V. Kumaravel (9 hours later)

Hello XXXXXXX

Her thyroxine dose of .05mg should be adequate, provided her TSH (Thyroid Stimulating Hormone) is normal with this dose. I would prefer to check her TSH levels checked. If that is within normal range then you can continue the current dose of thyroxine. If it high or low, then it requires dose titration.

Her blood pressure of 70/40 is low and is a concern. You can consult your PCP (BP. Low BP per se can make you sick most of the times.

Hope I answered all your questions. Please accept my answer in case you do not have further queries. Wish you Good Health.

Regards

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. V. Kumaravel (3 hours later)

Actually I spent sometime researching and have decided that it is adrenal fatigue.
But thanks anyway. XXXXXXX

Answered by Dr. V. Kumaravel (20 hours later)

Hello and thanks again,

Hypotension can be a feature, where adrenal secretion is affected.

In such case measurement of serum sodium, potassium, cortisol and DHEAS may be useful to confirm the diagnosis. You can get these tests done under the guidance of your primary physician and decide on further treatment if required.

Hope this was useful. Please accept my answer if you do not have any further queries.

Regards

Above answer was peer-reviewed by : Dr. Prasad