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Re: Advice for a Psychiatrist in Training

Posted by Nuala on August 3, 2008, at 13:18:03

In reply to Advice for a Psychiatrist in Training, posted by psychpsych on August 1, 2008, at 21:52:42

Before you go on any sort of psych meds, I would first have a thorough examination of your endocrine function, especially, thyroid and adrenal function. There is a clear connection between endocrine dysfuntion and "mental illnees", really the psychiatric manifestations of endocrine illness/dysfunction.

I regret that I did not have this opportunity.

there is a ton of medical literautre on the subject,and I have read as much as I could on pubmed. the fields of nueroendocrinology and psychopharmachology are populated with lots of these studies. Very interesting stuff.

Some background

I have been treated for a variety of conditions for a number of years - including major depression with psychotic features, depersonalization, extreme anxiety and some unspecified personality disorders (which I really see now are adaptive behaviors and a consequence of my mood shifts)

In the midst of treatment, after being put on Seroquel and Lexapro, with ativan as needed, I was diagnosed with hypothyroidism.

I subsequently discovered that I was already hypo ten years prior, after ordering all my old medical records, but it had been overlooked.

I was then treated with thyroxine and felt IMMENSELY better. I tapered down on my meds and was totally stable. I also felt like I was "waking" up as I reduced the psych meds.

I have spent the past year and a half researching the connection between endocrine dysfuntion and psychiatric manifestations thereof.

My psych "disorders" are really expressions of my endocrine problems. I also have seconday adrenal insufficiency.

Currently, I am not able to tolerate my thyorid meds becasue of the untreated adrenal situation (but, that is a long and complicated story).

What i know now, from being on and off thyroid meds, and on and off hyodrocritsone, is that I exerienced a preety good remission of my psych problems when on thyroid meds, and re-experienced them as well when I was off my thyroid/adrneal medications,

Now, I while my research was always focused on my own situation, I did see quite frequently, studies concerned with endocrine dysfunction and bipolar, as well as schizophenia.

Believe me, even though I hve suffered while "re-experiencing" my "illness" during the course of trying to remedy my endocrine problems, I know with such certainty that it is not "me" or some impersonal biochemical mystery which makes me feel the way I do, it is simply a hormonally-based phenomenon, which in many instances is treatable without having to resort to psych meds.

At least give yourself this option before you go on bipolar meds, or lose faith in your own abilities.

I still have a way to go, but I am much further along than I was when I was "zombied out" on 300mg Seroquel, and slept so much of the day away and lived so much of the day in a stupor.

Finally, the reason I started on this research journey is that someone on a thyroid board pointed out that psych meds themselves have a great effect on the endocrine system. For example, SSRIs are now understood to reduce circulating thyroid hormones, esp. T4, while Seroquel significantly reduces ACTH and cortisol (downregulating the HPA axis).

I thought it was counterintutitve for me to be taking thyroxine and at the same time taking the psych meds which worked against it.

Good luck :)


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poster:Nuala thread:843594
URL: http://www.dr-bob.org/babble/20080727/msgs/843896.html