QUESTION:

Dear Dr. Heller,

My 20yr old son is being treated for schizophrenia (Seroquel, Klonapin and Paxil). His TSH and FT4 have always been low but within normal range. No regular doctor would do any further testing given those results. I had an environmental doctor order some thyroid antibody tests. On the thyroid microsomal peroxidase antibody test, his titer was 29.4 (normal is <2.0), the antithyroglobulin test was <2.0. What further testing would be required to diagnose Hashimoto's thyroiditis? Can thyroid dysfunction explain the symptoms of schizophrenia; disorganized thinking, depression, audio and visual hallucinations? Why does his regular physician, who now thinks he has Hashimoto's not give him thyroid medication? Even if his TSH and FT4 are within normal range, he still has severe symptoms. I am sure thyroid medication would be better for him than the major tranquilizers he is on and causing elevated liver enzymes, and as well, be treating the cause and not just alleviating some of the symptoms. My son has lost the past five years of life, if indeed he has been misdiagnosed.

Grieving mom.

ANSWER:

Unfortunately it’s highly unlikely that low thyroid is causing his problems. The treatment however is inexpensive, and the risks of a short term treatment with thyroid supplementation to keep the T7 or FTI level in the high normal are very low. The possibility of "non-primary hypothyroidism" does exist. The Newsletter that I use for my patients on this topic can be seen at http://www.biologicalunhappiness.com/LowThyrd.htm. Schizophrenia is a very disabling illness, and the cause is yet to be determined. I have encountered a number of patients with the diagnosis of schizophrenia who had other diagnoses instead. The reason for the schizophrenia diagnoses was the persistent or intermittent psychosis, particularly when paranoia was present. The most common diagnosis was the borderline personality disorder with chronic dysphoria (anxiety, rage, depression and despair) along with many other diagnoses together. I would highly recommend you review the screening test at the top left of the home page. I’m not telling you the diagnosis of schizophrenia is wrong, just that you’d hate to miss alternate diagnoses that are much more treatable, and miss your son’s chance at a better life.