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Re: Reminder - Check that thyroid

Posted by noa on February 13, 2004, at 8:45:56

In reply to Re: Reminder - Check that thyroid, posted by cupcake on February 12, 2004, at 23:38:16

Yes, me too. Max, thanks for the reminder to all.

I first was treated for "subclinical" hypothyroidism by my former pdoc. The primary care doc would not have picked up on the thyroid problem at all based on the test results. But the pdoc was up on his lit about subclinical hypothyroidism and atypical depression, etc. He put me on cytomel at first, and then later added syntrhoid when my thyroid and depression got worse.

A couple of years passed and although the thyroid meds helped, I was still struggling with worsening episodes of recurrent major depression. It took a crisis--rapidly worsening depression simultaneous with worsening thyroid due to lithium for me to suddenly put two and two together. Because I kept having depressive recurrences, my pdoc started to hypothesize that I might have an illness in the bipolar family and because there was support for the idea that lithium could help boost the AD effects of my other meds, I tried lithium. I had 6 weeks of significant improvement followed by a sudden worsening of depressive symptoms. Pdoc had my thyroid checked again and it had gotten worse. That is when I decided to stop the lithium and go after the thyroid issue becuase it just seemed to be a clear connection to me.

I looked for info, and as it happened, this was a few weeks before Mary Shomon's book "Living Well With Hypothyroidism" came out. I found the reference to its upcoming release on the web and then started looking up more info. When the book came out, I read that cover to cover in a day and felt very validated. I found an amazing endocrinologist via Mary Shomon's web site

The endo diagnosed primry hypothryoidism and explained that some patients with hypothyroidism and depression need to have it treated more aggressively than was the generally accepted approach. He went by symptoms, not just numbers. He had me gradually increase my synthroid dose until I did not notice any more symptom improvement and stop there. When I got to this point, my TSH was 0.3. He then wrote a long letter to my primary doctor to explain the approach, including to say that contrary to the conventional wisdom, having a low TSH in itself does not put the patient at risk for osteoporosis--it is hyperthyroid symptoms that do. That as long as I monitor my symptoms, and get my levels checked periodically, I'd be fine.

This made a huge difference in my recovery from depression. Finally, I started seeing improvemenet and better response to my medicatoins. The other hypothyroid symptoms also started improving---aside from the depression, cloudy headedness, fatigue, etc....there was extreme weakness, muscle pain, edema, etc.

So cupcake's comment about undertreatment is a good one--it was true for me and apparently happens a lot.




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