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More Thyroid tales, Effexor questions re hypomania » Noa

Posted by AnneL on November 14, 2001, at 0:02:53

In reply to Re: Noa, Mitch and Wendy - Interesting twist, posted by Noa on November 13, 2001, at 16:43:05

Hi Noa,
Thanks for your thoughtful response. I researched
a website at www.thyroidmanager.org This is an excellent site which includes an entire textbook
on thyroid disease and management.

"Lid lag" is seen in Grave's disease and I would surmise that this is caused by the inflammatory process of the ocular muscles which result in the actual "eyeball" being pushed out which in early stages can cause "lid lag". Although I have Hashimoto's disease which can cause an initial hyperthyroid state as the thyroid is being attacked by the body's own antibodies, it ultimately ends up with the thyroid gland being replaced by lymphocytes and other diseased tissue
which causes gland failure. I have been hypothyroid for 17 years now and have been followed closely either by a GP or most recently
(last 3 years) by a competent endocrinologist.

She (my endo) laughed at the lid-lag diagnosis and said that can occur with Grave's disease patients and also can be a normal finding in persons who are euthyroid. So essentially his observation of "lid-lag" is pretty meaningless and
reducing my dose of Synthroid would not be something she suggests.

As I mentioned my TSH is within range at 1.57 From some of the web sites that you suggested, I have read that many hypothyroid or sub-clinical hypothyroid patient's "feel better" when the TSH
does not exceed 2. As a matter of fact your suggestions to do some research on thyroid disease
also led me to a New England Journal of Medicine abstract which indicates that many hypothyroid patients actually do better on a combination of T3 (Cytomel) and T4 (Synthroid, Unithroid, levothyroxine). I gave my endo the article and she agreed to drop my Synthroid to 0.125 mg and add 12.5 mcg of Cytomel to try out the combination approach.

All I can say is that within 2 days of getting rid of the hormone levonorgestrel, a potent synthetic hormone with high androgenic properties
from my system, I feel great! I am not moody whatsoever and did not have any "weekender's syndrome" at all last weekend. Progesterone is just to depresogenic for me.

I have reduced my dose of Effexor from 225 to 150(with Pdocs blessings) and I am hypothesizing that since I am not under the depressive effects of the progestin, I am starting to feel a little wound up, or hyper. I started an exercise program again and I do notice that I am getting "gung ho" again. This bears careful watching or I fear I will start overdoing it again.

I did not have the hyper feeling when I was first taking Effexor when I became acutely depressed last February. If in fact, I am prone to mood lability such as Bipolar II (I have no idea what the difference between I and II is) wouldn't Effexor have caused me to shift rapidly to a hypomanic phase due to not being on a concurrent mood stabilizer?

Ever since the first Pdoc mentioned that he wanted me to see a psychopharmacologist because he felt that maybe I was "not on the right meds"
and maybe needed the addition of a mood stabilizer, I have been overly concerned, call it
obsessed if you will. And now with the new Pdoc
calling my thyroid meds into question, I just feel really insecure about the whole thing. Maybe
someone can help break this into bite size pieces for me. Thanks for listening, I know I am obsessing over this. :) Anne


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