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Hello I Last Received Info From Dr. XXXXXXX On Ma

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Posted on Thu, 13 Jun 2019
Question: hello
I last received info from dr. XXXXXXX on Ma 8.
She asked me to get T4 and ThC and antibody blood tests.
I have the results.
slightly low th4 and free th4
slightly low th3 and free th3.
normal thc and normal antibody.
My original concern was is m anxiety and depression caused by low thyrod. My symptom ....not able to t sleep.
doctor
Answered by Dr. Mirjeta Guni (58 minutes later)
Brief Answer:
About central hypothyroidism;

Detailed Answer:
Hello and thank you for asking!
I have gone carefully through your concern.
Normal TSH with low Ft4 and Ft3 that persists for some months are suggestive for secondary hypothyroidism ( central hypothyroidism).
It means that a pituitary pathology should be excluded as the cause of hypothyroidism as in primary thyroid pathologies TSH is the first that increases than ft4 and ft3 gets low. Furthermore, the antibodies are negative, excluding the most common thyroid disease that causes underactive thyroid.
So i would suggest to discuss with your physician about an MRI of the pituitary gland.
Hope the information will help.
Best wishes,
Dr.mirjeta

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Mirjeta Guni (2 hours later)
Thank you for your prompt reply. Would the venlefaxine that I have taken for 20 years not have some small effect on cortisollevels in the pituitary.?
doctor
Answered by Dr. Mirjeta Guni (14 hours later)
Brief Answer:
About low cortisol levels:

Detailed Answer:
Hi again,
It may have an effect if there is a pituitary adenoma, often they are shrinked under therapy. If you have low cortisol levels too (except of low Ft4 and Ft3) than it is highly suggestive for pituitary pathology.
Try to find a good expert in your area.
Best wishes,
Dr.Mirjeta
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Mirjeta Guni

Endocrinologist

Practicing since :2006

Answered : 2414 Questions

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Hello I Last Received Info From Dr. XXXXXXX On Ma

Brief Answer: About central hypothyroidism; Detailed Answer: Hello and thank you for asking! I have gone carefully through your concern. Normal TSH with low Ft4 and Ft3 that persists for some months are suggestive for secondary hypothyroidism ( central hypothyroidism). It means that a pituitary pathology should be excluded as the cause of hypothyroidism as in primary thyroid pathologies TSH is the first that increases than ft4 and ft3 gets low. Furthermore, the antibodies are negative, excluding the most common thyroid disease that causes underactive thyroid. So i would suggest to discuss with your physician about an MRI of the pituitary gland. Hope the information will help. Best wishes, Dr.mirjeta