Posted by Noa on March 21, 2000, at 17:47:09
In reply to Re: Me? Bipolar III- Noa, posted by Sherry on March 21, 2000, at 13:37:31
At the moment, I am confused, too. It seems mood stabilizers have been found to help with this so-called bipolar depression. That being said, I am not happy with the lithium I am on. But maybe another mood stabilizer will agree with me more.
Also, I am currently very interested in the role of thyroid, particularly hypothyroidism, in this kind of depression. So, I am recommending that everyone with these lethargic depressive symptoms have their thyroid checked, and have the results interpreted by a psychiatrist who knows about thyroid and atypical depression. If the results are read only by your internist, chances are they will say your thyroid levels are normal even if they are hypothyroid from a psychiatric point of view. Specifically, "normal" TSH (thyroid stimulating hormone--this is what the pituitary releases to get the thyroid to release thyroid hormone)levels are between .5 and 5.0. A high TSH level means the pituitary is sending lots and lots of TSH to the thyroid just to get the thyroid to put out sufficient thyroid hormone. So, high TSH, especially above 5.0, suggests hypothyroidism (sluggish thyroid). So, for example, a reading of, say 4.2 TSH, with normal levels of T3 and T4, might be read by a typical internist as "normal". However, these same results might be interpreted by a psychiatrist as an indication of subclinical hypothyroid. My pdoc told me recently that when a patient is treated with thyroid hormone replacement for psychiatric symptoms associated with hypothyroidism, the desired TSH level is 1, ie, at the low end of "normal". I have a friend with a hypothyroid condition known as Hashimoto's thyroiditis, and she tells me she only feels well, physically, emotionally and mentally, when she keeps her TSH at 1, and that even slight increases make her feel worse. I think internists would think this unnecessary and perhaps risky, because there is a possibility of "switching" to hyperthyroid if too much thyroid hormone is taken, and high levels of thyroid hormone increase the risk for osteoporosis (and maybe for other stuff, too, I don't know). According to Michael Gold, MD, (forgive me for forgetting the title of his book), psychiatric symptoms often appear much earlier than other symptoms of hypothyroidism, and doctors often miss the signs. So, a thyroid test might be a good idea. BTW, apparently a TSH level is a fairly inexpensive test.
I am going to look for some of the citations I read recently that referred to "Bipolar III".
poster:Noa
thread:27727
URL: http://www.dr-bob.org/babble/20000321/msgs/27774.html