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Re: Update » g_g_g_unit

Posted by SLS on June 27, 2016, at 6:58:08

In reply to Re: Update » linkadge, posted by g_g_g_unit on June 27, 2016, at 0:11:52

Hi.

In what ways did you find thyroid replacement to b
e intolerable?

It can matter which type of thyroid hormone one uses:

T3 (Cytomel) made my depression very much worse. I think I might have been more anxious also, but I don't remember so clearly.

T4 (Synthroid) made my depression mildly better without any adverse effects.

3.3 mIU/L is high for TSH. You might not do well until it is brought down to between 0.5 and 1.5.

What is "replacement" as opposed to "augmentation"? The dosages of thyroid hormone used in depression as augmentation can be higher than those used to treat hypothyroidism. I think T3 was chosen first to be studied in depression, possibly because it is biologically more potent than T4. However, it would be a mistake to consider T3 to be simply a more potent version of T4. Being chosen first, T3 was extensively studied. T4 was mostly neglected, even though it can be very effective.

Combining a TCA (imipramine) with T3 was the treatment chosen to experiment with. SSRIs were not available at the time. Still, noradrenergic agents might be ideal to augment with thyroid. Desipramine can be a better choice than imipramine for producing NE reuptake inhibition, while thyroid makes NE receptors more sensitive. I imagine they would work synergistically. Desipramine is more selective than imipramine for NE and produces milder side effects, particularly those that are anticholinergic.

Another drug first studied for combination with TCA was lithium. If you are heading in the direction of trying a TCA, you can first add thyroid and then add low-dose (300-600 mg/day) lithium to be taken at the same time if you don't respond well enough to the thyroid (assuming that you can tolerate it).


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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