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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by bipolarspectrum on September 27, 2006, at 13:25:48
I just got a prescription, wish me luck! I hope this doesnt only pertain to women...
bps
Posted by Phillipa on September 27, 2006, at 15:18:25
In reply to Check this out bipolars!!, posted by bipolarspectrum on September 27, 2006, at 13:25:48
I don't think I'm bipolar but my last labs indicated my T4 was a bit low. I take synthroid for hasimostos thyroiditis should I be concerned? Love Phillipa
Posted by bipolarspectrum on September 27, 2006, at 16:08:25
In reply to Re: Check this out bipolars!! » bipolarspectrum, posted by Phillipa on September 27, 2006, at 15:18:25
Hi P,
No need to be concerned... I think there using doses at super high levels in this study.. I'm sure ur nowhere this level... If anything, the t4 may be giving ur mood a little boost! btw, what dose do u take?
bps
> I don't think I'm bipolar but my last labs indicated my T4 was a bit low. I take synthroid for hasimostos thyroiditis should I be concerned? Love Phillipa
Posted by Jimmyboy on September 27, 2006, at 18:53:06
In reply to Re: Check this out bipolars!!, posted by bipolarspectrum on September 27, 2006, at 16:08:25
What dosage are you going to take? Let us know how it goes.. good luck!
JB
Posted by Squiggles on September 27, 2006, at 20:18:19
In reply to Check this out bipolars!!, posted by bipolarspectrum on September 27, 2006, at 13:25:48
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=15724143&query_hl=1&itool=pubmed_docsum
>
> I just got a prescription, wish me luck! I hope this doesnt only pertain to women...
> bps
In cases of hypothyroidism, it has been known
for some time that major depression can be
a side effect. And perhaps in Grave's disease
(i think that's hypo) and other related
endocrionological problems, a thyroid supplement is just the thing.But, in cases where the patient is euthyroid,
that can't be the case, and adding thyroxine
could only make him/her hyperthyroidic, with
all the serious problems that would present.Squiggles
Posted by Phillipa on September 27, 2006, at 21:51:16
In reply to Re: Check this out bipolars!!, posted by bipolarspectrum on September 27, 2006, at 16:08:25
I take .125mcg of synthroid. TSH between l-3 last time checked. Love Phillipa
Posted by Phillipa on September 27, 2006, at 21:54:05
In reply to Re: Check this out bipolars!! » bipolarspectrum, posted by Squiggles on September 27, 2006, at 20:18:19
Squiggles Graves is hyper thyroid. But are you all taking extra t4? How does it differ from synthroid? Thanks Love Phillipa
Posted by SLS on September 27, 2006, at 23:50:57
In reply to Re: Check this out bipolars!! » bipolarspectrum, posted by Squiggles on September 27, 2006, at 20:18:19
> But, in cases where the patient is euthyroid,
> that can't be the case, and adding thyroxine
> could only make him/her hyperthyroidic, with
> all the serious problems that would present.
Supraphysiological dosages of T4 have been used to treat resistent case of bipolar disorder, particularly rapid-cycling presentations, in the past. I don't know how popular the treatment is, though. What are the more serious sequalae that you anticipate occurring from such treatment?I would think T4 safer than using T3, actually. It is less bioactive. I could be wrong, though. It might depend on how the feedback loops are set up. Cytomel has been used for decades as an augmentor of antidepressants, regardless of thyroid state. I should probably push the issue with my doctor at some point. My TSH was over 5.0. I would go the T4 route.
I would also like to know the dosage chosen by BPS for his treatment and how he arrived at it.
- Scott
Posted by Squiggles on September 28, 2006, at 7:04:28
In reply to Re: Check this out bipolars!! » Squiggles, posted by Phillipa on September 27, 2006, at 21:54:05
I don't know if it's T4, though
i am checked for that;
Posted by Squiggles on September 28, 2006, at 7:07:54
In reply to Re: Check this out bipolars!! » Squiggles, posted by SLS on September 27, 2006, at 23:50:57
OK, i found my values in one of my old
notebooks:
October 1999TSH 2.54
Lithium 0.8
January 2002TSH 5.960
FT4 10.07
Lithium 1.52 (this was not the usual reading;
usually i am between 0.8 - 0.1-----------------
I have not had any tests since;
Squiggles
Posted by Squiggles on September 28, 2006, at 7:58:36
In reply to Re: Check this out bipolars!! » Squiggles, posted by SLS on September 27, 2006, at 23:50:57
BTW,
I just found this excerpt from a recent article
by Dr. Charles Bowden on Lithium (he recommends
Quetiapine or other drugs, all preferable to
lithium. I have never agreed
with Bowden on almost anything he says. He
has always bashed Lithium."Lithium may well have the least potential to improve function due to the large number of adverse effects, particularly cognitive, many of which worsen with age and duration of treatment. There is evidence that patients with
bipolar disorder have significant cognitive deficits, even when asymptomatic (Atre-Vaidya et al 1998; van Gorp et al 1998), which are closely related to psychosocial and functional impairments. Moreover, lithium may lead to
induction of depressive symptomatology which may further impair functionality (Bowden, Collins, et al 2005).
Conversely, mostly open studies compared with normative data suggest that lithium may reduce suicidal behavior even when not effective as a mood stabilizer (Tondo et al 2001)."from:
BIPOLAR DISORDERS: TREATMENT OPTIONS AND PATIENT SATISFACTION
Charles Bowden
Vivek Singh
Department of Psychiatry, The
University of Texas Health Science
Center at San Antonio, San Antonio,
TX, USAAbstract: Functional recovery, the goal of treatment, has long been overlooked in the
assessment of effectiveness of pharmacological treatments. However, with the recent shift in
paradigm, from syndromal symptomatic recovery to functional recovery, there appears to be
a new interest in the definition and evaluation of functional recovery. Since functional recovery
lags symptomatic recovery, sometimes by months or years, the attainment of functional
recovery will be determined by both efficacy and long-term compliance. Quetiapine, due to
its efficacy in both mania and depression, and effect on cognition may lead to improved
functioning in patients with bipolar disorder.
Keywords: bipolar disorders, syndromal recovery, functional recovery, efficacy, effectiveness/
in*Neuropsychiatric Disease and Treatment 2006:2(2) page 151.*
Squiggles
Posted by bipolarspectrum on September 28, 2006, at 14:00:43
In reply to Re: Check this out bipolars!! ?SLS, posted by Squiggles on September 28, 2006, at 7:58:36
I'm happy to see this has arisen a rise!
I'm currently taking 300 mcg... its early but i feel a mood boost, but i also feel very activated... im taking it with lithium, which also activates me.. im gonna talk to my pdoc about switchin from lithium to tegretol.. the research seems to indicate that t4 alone is useless, but combined with lithium and/or a mood stabilizer, it can be effective... ill keep everyone updated!
bps
Posted by Squiggles on September 28, 2006, at 14:25:40
In reply to Re: Check this out bipolars!!, posted by bipolarspectrum on September 28, 2006, at 14:00:43
ok good luck - you're brave :-)
Squiggles
Posted by Phillipa on September 28, 2006, at 17:52:55
In reply to Re: Check this out bipolars!! » SLS, posted by Squiggles on September 28, 2006, at 7:07:54
Squiggles you need yearly tests. Love Phillipa ps don't know your age but the older you get the more important labs are.
Posted by Squiggles on September 28, 2006, at 18:00:16
In reply to Re: Check this out bipolars!! » Squiggles, posted by Phillipa on September 28, 2006, at 17:52:55
> Squiggles you need yearly tests. Love Phillipa ps don't know your age but the older you get the more important labs are.
That's not true. At first I got yearly tests,
but as i got older, my body stabilized to lithium
and they can be less frequent; this you can
see on many GUIDES TO LITHIUM TREATMENT.Squiggles
Posted by Phillipa on September 28, 2006, at 21:22:09
In reply to Re: Check this out bipolars!! » Phillipa, posted by Squiggles on September 28, 2006, at 18:00:16
Squiggles sorry I was referring to thyroid and electrolytes, metabolic panel. Love Phillipa
Posted by Squiggles on September 28, 2006, at 21:42:04
In reply to Re: Check this out bipolars!! » Squiggles, posted by Phillipa on September 28, 2006, at 21:22:09
> Squiggles sorry I was referring to thyroid and electrolytes, metabolic panel. Love Phillipa
Maybe; I don't know about the rationale of
the right sequence of monitoring these things;
perhaps, a change is clinically significant
when other symptoms or signs appear.I seem to be ok, despite not getting tests
every year, but every two years or so.Electrolytes, can change from week to week
after all, depending on sodium and potassium
intake, sweating, flu, etc.Squiggles
Posted by Phillipa on September 28, 2006, at 22:13:01
In reply to Re: Check this out bipolars!! » Phillipa, posted by Squiggles on September 28, 2006, at 21:42:04
True but I think liver enzymes should be checked mine have been elevated I had diverticulitis it messed up all my labs scared me to death. Hope they are okay now. Love Phillipa
Posted by Squiggles on September 29, 2006, at 8:00:10
In reply to Re: Check this out bipolars!! » Squiggles, posted by Phillipa on September 28, 2006, at 22:13:01
Liver enzymes..hmm; thanks for the
advice. My check-up is coming soon
and i think i will probably get the
blood tests this time.Squiggles
Posted by Squiggles on September 29, 2006, at 14:10:08
In reply to Re: Check this out bipolars!! » Phillipa, posted by Squiggles on September 29, 2006, at 8:00:10
I just received a lengthy article
http://www.nature.com/mp/journal/v11/n3/full/4001793a.html
from M. Gitlin of the Geffen School
of Medicine at UCLA, Los Angeles, CA
on "treatment-resistant" bipolar disorder
and the advance of psychopharmacology and
other means of addressing the problem.It's a very scholarly article ( a tad too
scientific for my understanding ), but
obviously trying to cover all the bases
of this problem.I do have a question about this neologism
in Medicine "treatment-resistant" -- there
is magic in them words. Is it really resistance
to treatment that the patient is showing, which
in my understanding would be adverse reaction or
unpleasant, or lack of efficacy -- or is it
simply the wrong diagnosis? You gotta wonder
why antibiotics should work on some infections
for example, and not others; why some antidepressants should work on catatonic depression and not others, why lithium should work on some manic-depressives and not others.Squiggles
This is the end of the thread.
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