![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by AnneL on October 26, 2001, at 0:09:50
Hi,
Diagnosed with major depression of a situational nature last March. Saw a Pdoc for a few times and he wanted me to see a psychopharmacologist for a med review to see if Effexor was the right med or not or if I needed to add a mood stabilizer.
Went to the new Pdoc today and he is the first one to ask me whether I have any medical conditions and I told him I was diagnosed with Hypothyroidism after the birth of my first child approximately 17 years ago. I have been on Synthroid all this time and my dose has
been consistant at 0.15 mg. Most if not all of my TSH levels have been within the normal range. If any were elevated slightly, it was due to taking a Calcium supplement, an iron supplement or from estrogen in a birth control pill and my TSH would normalize after discontination of one of these.My new Pdoc would like to review my thyroid panel results for the last year or two. He is following up on a hunch that even though my TSH may have been "within normal limits" that perhaps I am taking too much Synthroid. He is basing this on an experience that I had about 1 year ago where I became obsessed with dieting and constant exercising. He wants to explore the possibility with my endocrinologist of lowering my Synthroid dose in order to lower my Effexor XR dose which is currently at 225 mg. I believe he wants to explore any possible reduction in thyroid med and possible reduction in Effexor XR prior to the addition of a mood stabilizer.
I have three questions: 1. Why mess with my Synthroid dose? (I don't have any symptoms of hyperthyroidism and my tests are within normal limits). His point: You treat the person not the numbers.
and 2. What behaviors or symptoms make one believe that a mood stabilizer is recommended? and 3. Why lower my Effexor dose? (My only side effect is one of sexual disinterest, but no loss of capability - not a big deal to me).
Thanks for your input, Anne :)
Posted by SLS on October 26, 2001, at 10:13:14
In reply to Need Info on Thyroid meds and their effects!, posted by AnneL on October 26, 2001, at 0:09:50
Hi.
This looks like a good place to start:
Good luck.
- Scott
Posted by susan C on October 26, 2001, at 12:58:10
In reply to Need Info on Thyroid meds and their effects!, posted by AnneL on October 26, 2001, at 0:09:50
Hi, this is an area of possible consideration for me, so I keep trying to learn more by reading related posts. If you havent checked the archives by doing a search and also the tips section, you may find even more information there. I would definately print out your post and take it with you to your doctor(s) and ask them the same questions.
Susan C
(often referred to as mouse)
Posted by Noa on October 26, 2001, at 18:58:11
In reply to Re: Need Info on Thyroid meds and their effects!, posted by susan C on October 26, 2001, at 12:58:10
AARGH. I had a post all ready to go and then encountered the new registration thing, and lost the post.
I guess what I wrote was that I had a few questions, such as whether the exercise/dieting thing was an episode, or a chronic thing, and whether the doc thinks that is related more to poss. hyperthyroid or to mood cycling. And, what other signs were making him think you could be hyperthyroid.
Also, I do think that more comprehensive thyroid testing is a better idea than just the TSH.
Also, there is a lot of good info at the Tips page (link at top of babble page) under the thyroid and depression folder.
Posted by AnneL on October 26, 2001, at 21:58:35
In reply to Re: Need Info on Thyroid meds and their effects!, posted by Noa on October 26, 2001, at 18:58:11
> Also, I do think that more comprehensive thyroid testing is a better idea than just the TSH.
> >
Hi Noa,
I was hoping you would respond to my inquiry. You seem very interested and up-to-date in the field of endocrinology. When you indicate "more comprehensive" thyroid testing do you mean T4(Thyroxine), T3 Uptake, etc? Because everytime I get a TSH, I also get a "thyroid panel" as well.
One other question, If I had problems associated with "mood cycling", wouldn't Effexor or another SSRI tend to promote mood cycling without the addition of a mood stabilizer? Just questions, I don't feel driven like I was before I started Effexor, actually I feel unmotivated and "blah", but not weepy, teary, etc. Thanks for your input! It is very helpful. :) Anne
Posted by AnneL on October 26, 2001, at 22:00:55
In reply to Re: Need Info on Thyroid meds and their effects!, posted by susan C on October 26, 2001, at 12:58:10
> Hi Susan,
Thank you for your suggestions. I will definitely do a search. Do you take thyroid replacement as well? Anne:)
Posted by AnneL on October 26, 2001, at 22:03:15
In reply to Re: Need Info on Thyroid meds and their effects!, posted by SLS on October 26, 2001, at 10:13:14
Posted by JohnX2 on October 27, 2001, at 10:42:32
In reply to Re: Need Info on Thyroid meds and their effects!, posted by SLS on October 26, 2001, at 10:13:14
Scott,Thanks for the link. I haven't had as much
time to look into the HPA axis. As far as you
know have all your testing in this area turned
out normal or in line with text book major
depression? I recall you said you were a DST
non-supressor, which I believe correct me if
i am wrong that you have higher than normal
circulating levels of coriticosteroids and/or
downregulated glucocorticoid receptors?-john
> Hi.
>
> This looks like a good place to start:
>
> http://www.endocrineweb.com/
>
> Good luck.
>
>
> - Scott
Posted by susan C on October 27, 2001, at 12:19:50
In reply to Re: Need Info on Thyroid meds and their effects! » susan C, posted by AnneL on October 26, 2001, at 22:00:55
> > Hi Susan,
> Thank you for your suggestions. I will definitely do a search. Do you take thyroid replacement as well? Anne:)Hi,
No, I am not, it has been considered, even tho i am in normal range...that is why I keep my eye open for posts like yours and the responses...a poster named afatchick was recently diagnosed with it, but havent seen an update lately...
good luck with your huntmouse with an eyepatch
susan C
Posted by JGalt on October 29, 2001, at 10:55:22
In reply to Re: Need Info on Thyroid meds and their effects!, posted by Noa on October 26, 2001, at 18:58:11
I did some reading on this in the past. Just reading TSH is kinda like looking at IBM when you want to know how the stock market is doing. It doesn't always help. T4 levels, I do not believe, are that important. The reason being that your body converts T4 to T3, which is primarily what your body uses for metabolic and other reactions. Thus I would say the tests involving T3 are most important. If you have your results and T4 and T3 were both low, then you probably should take synthroid, if only T3 is low, take cytomel. There's a subgroup of people with hypothyroidism who have what is known as Wilson's Syndrome. In Wilson's syndrome, the body shows normal T4 levels, and normal T3 levels, but you still are hypothyroid. The reason being that your body is sabotaging the conversion to T3, and the hormone is spinning in the wrong direction. Thus a reverse T3 test is also good to have. If you have it you take cytomel, nothing else is going to do much. The last test I can think of that'd I go with for thyroid is to test for hashimoto's autoimmune thyroiditis (sp?). Here your body continously sends out T3 antibodies, but your T3 production remains the same. I can't remember the name of the test for this, I believe its acronym is FAMA. Its still a fairly rare diagnosis, but if you're looking to prove yourself thyroid sound, it might be appropriate. Well that's the only tests I can think of that I'd bother with. I wrote that off the top of head so if anyone finds any inaccuracies, don't shoot me.
JGalt
Posted by Noa on October 29, 2001, at 17:57:42
In reply to Re: Need Info on Thyroid meds and their effects! » Noa, posted by AnneL on October 26, 2001, at 21:58:35
Sorry, when I mentioned the thyroid and depression folder, I gave the wrong directions to get there. The address is:
http://groups.yahoo.com/group/psycho-babble-tips/links//Noa_s_thyroid_links_000963272558/
Here are some useful sites listed there:
HELP! My TSH Is "Normal" But I Think I'm Hypothyroid
http://thyroid.about.com/library/weekly/aa111097.htm?once=true&Key Thyroid Function Tests
http://thyroid.about.com/library/weekly/bltest-values.htm?once=true&
Posted by Noa on October 29, 2001, at 17:58:53
In reply to Re: Need Info on Thyroid meds and their effects! » SLS, posted by JohnX2 on October 27, 2001, at 10:42:32
Have you read this?
Neurobiology of Depression
Scientific American article by Charles Nemeroff, MD
http://www.sciam.com/1998/0698issue/0698nemeroff.html
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.