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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Ilene on March 23, 2004, at 20:53:30
I started lithium (300 mg) about 2 weeks ago, while hospitalized. At about the same time they found a possible, borderline low thyroid problem. Since getting out of the hospital I have been experiencing more and more symptoms that point to hypothyroidism: rapid weight gain (about 10 lb), constantly feeling cold, fatigue, and most recently swollen feet and ankles.
My question is whether lithium can trigger thyroid problems this extreme, this quickly. Anyone else had this happen? Was it easy to fix? Did you have to stop taking lithium? I wasn't too thrilled to be started on a drug this toxic but I think it's been helpful. To put it another way, I think I would feel better if I wasn't feeling awful because of the thyroid condition.
I'm also taking Marplan, Klonopin, Risperdal, Neurontin, and Florinef.
Posted by katia on March 24, 2004, at 13:22:00
In reply to Lithium and thyroid, posted by Ilene on March 23, 2004, at 20:53:30
To piggyback, I too experienced possible hypothyroid after my brief trial with Lithium in December. I was only on it for about a month/5weeks. And since then, I've been dieting and eating well, but maintain at my heavy weight (for me) and am inching up. My hair also seemed to start to fall out some.
Ummmmmm. My question too. Has anyone else experienced this so quickly on Li? I'm off of Li. now and still experience this.
Katia
Posted by Ilene on March 24, 2004, at 13:49:21
In reply to Re: Lithium and thyroid » Ilene, posted by katia on March 24, 2004, at 13:22:00
I talked to my internist today. He thinks the lithium triggered circulatory problems because I have chronic fatigue syndrome. (He says most endocrinologists don't understand CFS.) I'll be seeing him on Friday.
I also saw my psychiatrist and got the thyroid test results. The thyroid hormones T3 and T4 are abnormal, but the TSH is normal.
So I'll have a lithium level test on Friday, maybe more thyroid testing, and the two docs will talk. I think the lithium is doing me some good and I don't want to stop taking it.
Katia, what kind of thyroid testing did you have?
Posted by katia on March 24, 2004, at 13:50:49
In reply to Re: Lithium and thyroid » katia, posted by Ilene on March 24, 2004, at 13:49:21
HI,
Just the normal TSH. But that was pre-LI. I should get another one done. But even that is not very comprehensive.
Katia
BPII Trileptal 300mg
Lamictal 5mg tirtrating up
Posted by Ilene on March 24, 2004, at 17:09:24
In reply to Re: Lithium and thyroid » Ilene, posted by katia on March 24, 2004, at 13:50:49
You should get at least TSH and free T3 and T4. I know there are more sophisticated tests, but I don't know too much about them. I'm really glad the hospital did those tests for me.
Here's some interesting info:
Posted by noa on March 25, 2004, at 19:59:23
In reply to Re: Lithium and thyroid » Ilene, posted by katia on March 24, 2004, at 13:22:00
I took lithium for a few months a few years ago. After about 2 weeks, my depression started to lift nicely. Then, after 6 weeks, I started to get depressed again, and starting falling fast. Plus, I began to have a number of other hypothyroid symptoms or increase in symptoms. My TSH went up substantially. I decided to discontinue the lithium and investigate the thyroid angle of my depression. My endo, who really helped with the thyroid problem told me that if I had wanted to, I could have continued on the lithium, but we would have needed to adjust my thyroid meds accordingly.
Posted by noa on March 25, 2004, at 20:00:33
In reply to Re: Lithium and thyroid » katia, posted by Ilene on March 24, 2004, at 17:09:24
Thanks for the link to the info.
Posted by Ilene on March 25, 2004, at 20:39:27
In reply to Re: Lithium and thyroid, posted by noa on March 25, 2004, at 19:59:23
> I took lithium for a few months a few years ago. After about 2 weeks, my depression started to lift nicely. Then, after 6 weeks, I started to get depressed again, and starting falling fast. Plus, I began to have a number of other hypothyroid symptoms or increase in symptoms. My TSH went up substantially. I decided to discontinue the lithium and investigate the thyroid angle of my depression. My endo, who really helped with the thyroid problem told me that if I had wanted to, I could have continued on the lithium, but we would have needed to adjust my thyroid meds accordingly.
Did you take thyroid hormone? Which one? Did it help your depression? Was it a permanent fix?
Posted by noa on March 26, 2004, at 18:08:43
In reply to Re: Lithium and thyroid » noa, posted by Ilene on March 25, 2004, at 20:39:27
>Did you take thyroid hormone? Which one? Did it help your depression? Was it a permanent fix?
I take synthroid and cytomel. Yes, they helped my depression immensely. But they do not replace antidepressants for me. Thyroid hormones made it possible for me to finally start responding to the antidepressants. Permanent? I'm not sure what you mean. For me, thyroid meds are maintenance. I anticipate that I'll always be on them.
Posted by Ilene on March 26, 2004, at 19:37:01
In reply to Re: Lithium and thyroid » Ilene, posted by noa on March 26, 2004, at 18:08:43
> >Did you take thyroid hormone? Which one? Did it help your depression? Was it a permanent fix?
>
> I take synthroid and cytomel. Yes, they helped my depression immensely. But they do not replace antidepressants for me. Thyroid hormones made it possible for me to finally start responding to the antidepressants. Permanent? I'm not sure what you mean. For me, thyroid meds are maintenance. I anticipate that I'll always be on them.What I meant was whether you experienced poop-out.
I saw my internist today. I thought my thyroid problem would be an easy fix, but it won't be. I seem to have either euthyroid sick syndrome or Wilson's syndrome, which seems kind of flaky to me. I might take cytomel (T3). More details in my "Dear Diary" thread on social.
I.
Posted by katia on March 27, 2004, at 2:16:59
In reply to Re: Lithium and thyroid » Ilene, posted by noa on March 26, 2004, at 18:08:43
Hi Noa,
When you say ADs finally work for you, what did they do before for you? Are you bipolar or unipolar?
Katia
Posted by noa on March 27, 2004, at 10:19:35
In reply to Re: Lithium and thyroid » noa, posted by Ilene on March 26, 2004, at 19:37:01
No, no poop out as far as the thyroid hormones go. I haven't even needed much in the way of adjustments over the years. But this is something to keep in mind, because different things can affect thyroid functioning, like stress or other illness, etc. Sometimes people need to adjust the other way, too--ie, they don't need as much thyroid med anymore.
BTW, I haven't had poop out on Effexor or Serzone, either, which are the ADs in my cocktail. Perhaps I shouldn't "jinx" it by mentioning it. ;- )
Good luck. BTW, did you actually get your thyroid numbers (some docs interpret differently)?
Posted by noa on March 27, 2004, at 10:29:35
In reply to Re: Lithium and thyroid » noa, posted by katia on March 27, 2004, at 2:16:59
Depression, not BP. I have "Double Depression", ie, Recurrent Major Depression and Dysthymia. The ADs had always had some effect, but not enough. Prozac worked for a while, then pooped out. Paxil, same thing. Plus I had a hard time with the SEs. Wellbutrin--couldn't take the tinnitus. Effexor--worked well, but kept having recurrences of major depression. Plus couldn't tolerate higher doses due to SEs. Combo of Effexor and Serzone--better, but still quite dysthymic and still had recuuring major episodes. Somewhere in there, I had started taking cytomel, and then both cytomel and synthroid, BUT not enough, apparently. Then doc tried me on Lithium in addition, which gave me 6 weeks of improving mood, followed suddenly by one of my worst depressions. Had thyroid tested again at that point because in addition to the depression, the other hypothyroid symptoms had gotten much worse all of a sudden, too (extreme fatigue, muscle pain, edema, total cotton-ball-brain, etc.), and sure enough my TSH had gone up. This was due to the lithium. I decided to discontinue lithium and pursue the thyroid angle. Saw great endo who gradually had me raise the synthroid dose until I felt better, bringing my TSH down way lower than any doctor had ever recommended before (0.3). It was then that I felt the ADs began to work. Later, I was able to lower the Effexor dose some, but it's clear to me that I still need both the ADs and the thyroid hormone meds. BTW, the endo told me that had I wanted to continue the lithium, I could have, and we just would have adjusted the thyroid meds accordingly. So if I were BP, I would have done that but with just the depression, not hypomania or mania, I didn't need it, since the ADs and thyroid meds worked for me.
This is the end of the thread.
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