Here is My Question:
I just found out my free T4 is low but TSH is mid-low normal. No thyroid antibodies. Can MS affect the hypothalamic-pituitary axis and cause secondary hypothyroidism? Would this still be treated with synthroid or the like? If I’m also on Trileptal and if it is the cause of the issue, do you still treat the low free T4 if the Trileptal is the only thing that has been effective for my pain?
The labs likely reflect early hypothyroidism. This can be seen in association with MS (whether or not you have the TPO antibodies). However, to our knowledge, it is not a cause and effect relationship. Speaking with your internist/PCP to monitor the thyroid and determine if/when to initiate synthroid is appropriate. Trileptal isn’t associated and I would not factor that into the equation.
A. Scott Nielsen MD MMSc
Neurologist and MS Specialist at Kaiser Permanente
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