Posted by noa on April 11, 2002, at 16:29:57
In reply to Re: Lithium and thyroid disorders, posted by BarbaraCat on April 10, 2002, at 16:57:36
I was on lithium for about 2 months or so. I was struggling with refractory depression and couldn't tolerate high levels of the ADs, and my pdoc hypothesised that I might have a cycling pattern to my depression and could have a depression in the bipolar spectrum, and that lithium might be effective.
After about 1.5 weeks on litium, my depression started to improve. But at about 6 weeks, I started to feel worse and worse--depressed, crying, totally foggy-headed, completely fatigued, etc. And, I developed edema. At that point--when the edema showed up-- I had my TSH checked and it was up to about 3.5, having been about 2.2 or 2.3, I think, prior to the lithium.
I began reading about thyroid problems--this coincided almost exactly with the release of Mary Shomon's book, Living Well with Hypothyroidism. I decided to discontinue the lithium, even though I understood I could stay on it and increase the thyroid hormone doses to adjust, because I felt that it was more likely the thyroid problem that was making my depression so hard to treat than having a bipolar spectrum depression and needing a mood stabilizer. I wanted to test out the thyroid hypothesis first. When I went to Mary Shomon's web site, I saw that there was a doctor recommendation page--rec's from other readers. I went to see one doc in my area and he was great. He confirmed I could have stayed on the lithium, but he also said my hypothyroidism was very undertreated and probably contibuting a lot to the depression. He had me increase my dose of synthroid as long as the increases led to improvement in symptoms, and then stop when the improvement leveled off. He anticipated that I would need a level where my TSH was 1 or less. The improvements leveled off when my TSH was 0.3.
BTW, he also had me split my cytomel dose--telling me it has a shorter half life than the synthroid and would be more effective in split doses.
Finally getting the thyroid properly treated was a major breakthrough in getting my depression under control. I continued to feel better over the course of many months.
I continue to feel pretty good. The only other change I needed to make was to add the light box in the fall and winter this year, which also made a big difference for me.
poster:noa
thread:102374
URL: http://www.dr-bob.org/babble/20020408/msgs/102788.html