What help should I seek for my Daughter?

[vincenzo]

My daughter (17) has recently (1 year) become depressed, drug useage, rebellious, flunking school, etc. She was a great student until 1 year ago and a normal, healthy child. After a short stint in the adolescent psychiatric ward due to ongoing strange behavior (bulemia, depression, substance abuse from alcohol/adderall/ecstacy/marijuana), she was sent home and put on Prozac 10 mg for depression. However, she told me that the Clinic had told her she had a thyroid condition, that I was never told about by the doctors that saw her. She is always tired (all day), has a red rash under her tongue, depressed, always cold (sometimes hot), her neck feels stiff and her stomach usually hurts her. I called the clinic and asked for the results to be faxed to her physician. TSH 15.170, Free T4 0.8, Free T3 3.4. The other things in bold on her test were MCHC 30.8 (L), Lymph% 17.9 (L), Mono% 7.1 (H), BUN 22 (H), Protein, Urine Trace!, Clarity Cloudy!. Her regular Physician told us to see an Endocrinologist and put her on IC Levothroxine 25mcg tab myl 1 a day until we can get an appointment, while continuing her Prozac. I am finding it difficult in Cleveland Ohio to get into an Endocrinologist and some are booked out 6 months!!! I am afraid to let her continue the Prozac, and feel a lot of her depression may be from the Hypothyroidism? Should I give her the Levothroxine now, before she is seen by an Endocrinologist?  Help!!!!!

[Super_sally888]

Definitely she should be treated with levothyroxine before she can see an endo.  Her primary can prescribe and adjust this.

25 mcg is a good starting point.  She would then need to be retested after 4 - 6 weeks, and adjusted again.

Target TSH is usually 1 - 2, FT3 and FT4 (please get these done rather than T3, T4) should be in the mid to upper 1/2 of the range.

Poor kid.  No wonder she's been having a hard time.  Prozac is not good.  Agree that better would be to get her thyroid properly treated and wean her off the prozac.

Let her read up on hypothyroid.  At least if she can understand that there is a reason she's been feeling so bad and it is treatable, it will help with her coping too..

An endo isn't necessarily needed, but a good primary who is up-to-date and agressive in treatment, and for you and your daughter to be enducated on this condition and it's management.

[magpieannie]

Can you give us the reference ranges for her TSH and FreeT3 and Freet4 test, with her results listed next to the lab reference ranges please?

[peggy64]

The thing is, that hypothyroidism can cause depression-type symptoms. And if possible it is best to stay off of the anti depressants until the thyroid is brought under control. Then hopefully the depression won't be an issue and she won't have to go through the stress of withdrawal from the antidepressant. That in itself is no small feat, I am here to tell you.

I know you are concerned for you daughter, and as said above, I would get her into her primary doc and recheck the levels and let him start her on treatment. Most of us here can attest that the Endo's aren't all that anyway. Most tend to deal more with diabetics.

I would also recommend you read up on armour thyroid or nature-throid for treatment as opposed to synthroid.

You have my prayers as this is a terrible disease, if not treated properly and in time. But if its your child, well, thats another thing all together.

[torig1229]

Thanks for this post.  It can be challenging dealing with troubled teens. A lot of the problems you mentioned should not be taken lightly. Depression is a serious illness that affects adolescents just like it does adults. I’ve found Silver Hill Hospital’s website to be a useful source of information about treatments for Adolescent depression. They provide hope for people who may not have been getting the right care.

[Totie]

Can her regular doctor get her a quickier referral to an endocrinologist? I would start with getting her an appointment with her regualr doctor to re check the blood work. Those lab results don't look good. Get her into her primary to begin with, he may put her on medication for the thyroid issue right off the bat until she can get into see an endo. And yes, thyroid problems can cause depression, and at her age she may not have known how to deal with it from a clinical point of view. She probably did not know why she felt the way she did.

Hope all goes well. God Bless.