![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Pandora on February 25, 2001, at 20:42:31
Noa, I know you suggest thyroid testing for a lot of people and it sounds like you're somewhat of an "expert" about the benefits of taking thyroid hormones to treat depression. If you've answered this question before, please just direct me to the proper post.
I just began taking Synthroid as a supplement to Effexor for my depression. My TSH was at the high end of "normal" at 5.5. I realize my doc and I will have to monitor this and probably tweek the dosage a bit. My question (yes, I finally got around to the question!) is, how long does it usually take before any real effect from Synthroid is felt? Thanks in advance for any info : )
Posted by Noa on February 26, 2001, at 7:31:29
In reply to Thyroid Question for Noa (and anyone else), posted by Pandora on February 25, 2001, at 20:42:31
Offhand, I don't really remember how long it took for me to see any result when I first started on thyroid hormones, but I *think* it was noticeable pretty early on, like within a few weeks.
But for a few years, that level of treatment was insufficient. Finally, when my thyroid meds were raised last spring, I noticed improvement within a month, but the improvement continued for many months after that. I would say that I didn't feel well until my TSH was less than 1. Once it was down that low, I started to feel better, and in the months that followed, kept on noticing improvement.Acc. to my endocrinologist, some people benefit from raising the dose slightly, waiting about 6 weeks to see if there is any improvement in symptoms, and if not, raising it slightly again, until no further benefit is noticed, and then dropping back to the last dose at which benefit was added. This works, if you have a doctor who will tolerate the possibility that your TSH will go very low.
BTW, if your TSH test shows improvement with the synthroid, but your mood doesn't improve at all, ask your doc about cytomel (T3). For some people, the conversion from T4 to T3 is deficient, and also, there is discussion of T3 as an augmentor to ADs on Psychopharmocology Tips. One thing my pdoc didn't know about Cytomel, tho, was that it needs to be taken in a split dose, because it has a short action.
I will try to see if I can come up with old posts that might say more about how long it takes to start working.
Good luck.
Posted by Greg A. on February 26, 2001, at 11:08:52
In reply to Thyroid Question for Noa (and anyone else), posted by Pandora on February 25, 2001, at 20:42:31
Thyroid – I have some questions about thyroid replacement therapy and depression. Years ago I was treated for hyperthyroidism and very shortly thereafter was diagnosed as hypothyroid. I have been on 0.15 mgs of synthroid aver since. I have also been depressed off and on (mostly ‘on’) since the onset of hypothyroidism. I had read about Wilson’s Syndrome and last winter decided to see a naturopath about treatment. I phased out my AD’s and supplemented my synthroid with the natural thyroid hormone the naturopath supplied. In four months I was so depressed I was almost non-functional. I resumed my AD’s and have stabilized somewhat.
I have always thought that the onset of my depression was at the time I was hypothyroid and for a long time I was sure I was not being treated correctly with replacement hormone. I have tried cytomel (briefly) with little beneficial effect and have pretty well given up on this course. Any other thoughts on treating depression when you are on thyroid replacement? My pdoc assures me that all my thyroid tests are normal and there is no way that there is a problem there.
Thanks.Greg A.
Posted by Pandora on February 26, 2001, at 15:15:43
In reply to Re: Thyroid Question for Noa (and anyone else) » Pandora, posted by Noa on February 26, 2001, at 7:31:29
Thanks for the response. I've read a few books about the connection between thyroid and depression (the best IMO was Ridah Arem's book) and have already talked to my doc about the possibility of doing more specific T4 and T3 tests as well as taking Cytomel (sp?). I feel good about this doctor - he seems to appreciate a well-informed patient and doesn't take offense when I suggest different treatments. For now, since it's so early, we're going to wait and see how the Synthroid does on its own. Anyway, thanks again for the info! : )
Posted by Noa on February 27, 2001, at 5:59:57
In reply to Re: Thyroid Question for Noa (and anyone else) » Noa, posted by Pandora on February 26, 2001, at 15:15:43
Yeah, and I just went back and read a bit in Arem's book last night, and he does say that when starting thyroid hormone replacement, you need to test app. every 6 weeks, get the TSH down to between .5 and 2, and be stably at that level for a while before seeing real results. If when you test again, your TSH is still high, then you will know you need a bit more.
I was trying to remember some more of what it was like when I first started---I think I did notice *some* improvement in weeks, but it didn't level off right away. And, as I mentioned before, I was UNDERtreated for a few years, so my depression would creep back in and get worse every once in a while.
Keep in mind that stress also has a role. Ironically, it was partly extreme stress that got me to reevaluate the thyroid problem, because my depression got much worse after a very stressful period of time. It was also lithium that helped prompt the reevaluation, because when I was on lithium for a short time, my thyroid really plummetted and, despite initial improvement on lithium, my depression got worse and I developed more physical symptoms of hypothyroid. BTW, I could have stayed on the lithium and just adjusted the thyroid dose--they aren't incompatible. I just chose not to, because my hunch (correct, I think) was that for me, the thyroid problem was more salient.
When I did get evaluated, and the endo raised my doses of synthroid and cytomel, I started to notice results within weeks, but continued (perhaps continue to see even now) to see improvement for many months.
Good luck.
Posted by Noa on February 27, 2001, at 6:03:43
In reply to Re: Thyroid Question for Noa (and anyone else), posted by Greg A. on February 26, 2001, at 11:08:52
Greg, is it possible that your hypothyroid is still undertreated? I don't know what your doctor means when he says it is normal. For me, having a TSH in the normal range wasn't normal for me. I didn't start to really feel better until my TSH was really low. Dr. Ridha Arem ("The Thyroid Solution") says the target TSH is between .5 and 2. I recommend his book, as well as Mary Shomon's "Living Well with Hypothyroid", and her web site. To get there, go to the Thyroid and Depression folder link at the top of the Psychobabble page.
Good luck.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.