health professional needing HELP

[loripop]

I have suffered from panic disorder and later moderate depressive episodes (x3) for about 13 years. It was well controlled on meds (most recently zoloft/wellbutrin low dose combo for about 8 years). I have recently had severe depressive episode, multiple infections (MRSA) and my TSH was 4.8 and T3 0.8. My PCP dismissde the numbers, saying they were normal and could be rechecked in 6 months. My psychiatrist has suggested considering Cytomel but i have not yet started it. I have been tired, depressed, tearful, had infections, unidentified back pain x 5 months. I am a nurse parctitioner in psychiatry and still don't understand all the thyroid controversy. It was suggested i have thyroid antibodies checked for autoimmune issues- especially since i have had panic disorder since early 20's.
Any suggestions?

[loripop]

yes, it has been frustrating. The endocrine society (AACE) put out new guidelines over 7 tears ago that anything over 3.0 for TSH indicates hypothyroid especially if symptomatic. my psychiatrist did consider putting me on Cytome, my PCP thought my numbers were fine. I more recently have been getting rashes, my first ever cold sore and generally my body just freaking out. A couple alternative providers i have seen suggestive a detox type diet to calm any inflammatory responses. i may start there...i have experienced a huge amount of stress lately so i definitely think my body has pooped out!

[SLadylani]

oh my goodness, I am a RN going to NP school and cannot get answers myself. Usually I am dismissed as I have a history of psychiatric illness. I have a lot of personal medical backgroud in autoimmune disease however (I'm fearing cancer right now... or MS). So weird, I have reocurrent MRSA infections-what they say is MRSA in my sebacceous gland above the eye and low back pain. I would suggest first simply requesting for an ANA titer to suggest for any autoimmune disease before going that route, if it's negative it will rull that out. Does anyone in your family have a history of autoimmune disease or thyroid problems? Have you seen an endocrinologist? TSH can have a wide range although levels can fluctuate during pregnancy... Your TSH is within normal range-occuring to my lab records, on the high side with the high being 4.8/5.0. And your T3 is varriable, depending on the practitioner... I've gottent different responses. So I would ask to be referred to an endocrinologist if possible, and if he thinks its in the autoimmune reaglm and rheumatology should be consulted, I would go from there. The depression would suggest hyppothyroid, but panic would be more suggestive of hyper, which is why I think endo would be a good way to go.