Internist Questions Hypothyroidism

Thyroid Function Tests

I'm a 35 y/o female with PMH of MDD c/o b/l 4+ pitting edema of the lower extremities. The condition developed over a period of 3-4 months and is only mildly improved with leg elevation. ROS and PE otherwise unremarkable.

I've had a full work up (renal function, cardiac function both normal). The only abnormal finding is a low FT4 (but TSH is normal). TFTs have been repeated twice; same finding.

Is this hypothyroidism or not?

Female | 35 years old
Complaint duration: 3 months
Medications: Abilify, Effexor.
Conditions: MDD

5 Answers

Probable you need to check Ft3 level as well. Some psych meds can affect thyroid function tests
How low is free t4 and did they check the rest of the anterior pituitary hormones? Are your menstrual cycles normal?
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Low FT4 with normal TSH is seen though not frequently. Several things may do this but medication is most common. The Abilify and/or Effexor could be causing. A failing pituitary or thyroid antibodies binding the FT4 could also be the cause. Have your Dr check thyroid antibodies to see if your are developing thyroid antibodies as evidence of developing sub-clinical thyroiditis to which TS has not responded. You didn't say how low the FT4 was so I can go further with diagnosis or recommend treatment without numbers.
It could be hypothyroidism. It is hard to say without looking at the whole picture. The edema may not be related to this. I suggest an evaluation by your doctor.
STOP DRINKING FLUIDS. You need to urinate only 3 to 4 times during the day, one time before going to bed and one time after waking up, never at night.
It will resolve your problem. You are just drinking too much fluids.