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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Low TSH Levels Due To Chronic Back Pain

I have been on 580mgs of morphine!!!! a day for 4 years for back pain. I have been taken off and now suffer from chronic pain Found out pain causes a rise in the D2 enzyme, which causes an increase in brain thyroid conversion and a decrease in D1 enzyme, which is for body thyroid conversion. Because of this my TSH has gone to .045 where dr s (not knowing about D1,D2,D3) think I have hyperthyroidism and want to give me a thyroid lowering drug which, for me, will make things WORST. I cannot find anything on high brain thyroid. Question: 1) what will high brain thyroid do? 2) other then back surgery to lower pain how can I correct this thyroid problem?
Tue, 20 Feb 2018
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Endocrinologist 's  Response
Hello and thank you for asking!
Your concern is right, but to make a diagnosis oh hyperthyroidism or central (brain) hypothyroidism, FT4 and Ft3 level should be known.
An ultrasound and scintican of the thyroid gland would be also of help to differentiate between two pathologies.
If a pathology causing overactive thyroid in ultrasound and scintiscan is confirmed, together with a high FT3 and FT4 than starting treatment for hyperthyroidism is correct.
If Ft4 and Ft3 are low and there is no pathology in thyroid ultrasound, than central hypothyroidism is confirmed.
So, you need further examination to make a correct diagnosis and than decide for the treatment.
Kind regards,
Dr.Mirjeta

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Suggest Treatment For Low TSH Levels Due To Chronic Back Pain

Hello and thank you for asking! Your concern is right, but to make a diagnosis oh hyperthyroidism or central (brain) hypothyroidism, FT4 and Ft3 level should be known. An ultrasound and scintican of the thyroid gland would be also of help to differentiate between two pathologies. If a pathology causing overactive thyroid in ultrasound and scintiscan is confirmed, together with a high FT3 and FT4 than starting treatment for hyperthyroidism is correct. If Ft4 and Ft3 are low and there is no pathology in thyroid ultrasound, than central hypothyroidism is confirmed. So, you need further examination to make a correct diagnosis and than decide for the treatment. Kind regards, Dr.Mirjeta