Psycho-Babble Medication Thread 135769

Shown: posts 1 to 24 of 24. This is the beginning of the thread.

 

Low Thyroid and lithium - not a good combo

Posted by BarbaraCat on January 14, 2003, at 0:31:39

I've been taking lithium since February and it's helped alot, along with Lamictal. Was able to get off AD's on this combo. But lately I've been feeling tired, cold, etc. I've had low thyroid for many years and have been on thyroid meds, but the last blood test I got, my TSH levels were 7, which was high. So my doc increased the thyroid medication and my last test was 15! which was even higher (not good, levels should be between 2.0 and 4.0). Lithium is anti-thyroid, especially for people who already have problems in that area.

I already knew this potential problem and have been monitoring it but it's like all of a sudden I'm getting these bad TSH levels. Considering that I've just been through major intense stress with the sudden and tragic death of my Mother, it's probably not surprising that some of my physical systems are affected.

I've tried weaning myself off lithium, but the mania starts creeping back which is alot of fun at first, but then the dreaded mixed states threaten. I tried replacing lithium with Neurontin but no luck. So I'm back to lithium but I am concerned about what's going on with my thyroid. Hypothyroid is the pits and I do not need this on top of everything else. If anyone has any suggestions, I'd appreciate them, but mainly this is a head's up to others. - Barbara

 

Re: Low Thyroid and lithium - not a good combo

Posted by Noa on January 14, 2003, at 3:55:23

In reply to Low Thyroid and lithium - not a good combo, posted by BarbaraCat on January 14, 2003, at 0:31:39

I had a similar experience.
I took lithium for about 2 months, to help with refractory depression. It did start to work after about 3 weeks, but by about week six, I started feeling worse--depressed, fatigued, weak, achy, I had edema, etc. etc. I got my TSH done and it had gone up.
I decided to stop the lithium, and then found a good endocrinologist, after reading up on hypothyroidism. He told me I could have stayed on the lithium if I had wanted to, just upped the dosages of my thyroid meds. At that point, since I had already stopped, I decided to see how I felt after treating the thyroid problem more aggressively, which was his approach at that point. Treating the hypothyroidism is what finally got me to respond decently to the antidepressants. I started to feel better and better.

But I did not have the manic side of things to contend with, as you do. I wonder if there is more that you can do about the thyroid side of things before going off lithium.

Which thyroid meds are you taking?

 

Re: Low Thyroid and lithium - not a good combo BarbaraCat

Posted by Ritch on January 14, 2003, at 9:12:50

In reply to Low Thyroid and lithium - not a good combo, posted by BarbaraCat on January 14, 2003, at 0:31:39

> I've been taking lithium since February and it's helped alot, along with Lamictal. Was able to get off AD's on this combo. But lately I've been feeling tired, cold, etc. I've had low thyroid for many years and have been on thyroid meds, but the last blood test I got, my TSH levels were 7, which was high. So my doc increased the thyroid medication and my last test was 15! which was even higher (not good, levels should be between 2.0 and 4.0). Lithium is anti-thyroid, especially for people who already have problems in that area.
>
> I already knew this potential problem and have been monitoring it but it's like all of a sudden I'm getting these bad TSH levels. Considering that I've just been through major intense stress with the sudden and tragic death of my Mother, it's probably not surprising that some of my physical systems are affected.
>
> I've tried weaning myself off lithium, but the mania starts creeping back which is alot of fun at first, but then the dreaded mixed states threaten. I tried replacing lithium with Neurontin but no luck. So I'm back to lithium but I am concerned about what's going on with my thyroid. Hypothyroid is the pits and I do not need this on top of everything else. If anyone has any suggestions, I'd appreciate them, but mainly this is a head's up to others. - Barbara

Hi Barb, yep I've only got half a thyroid and lithium is really not an option for me anymore (it has been about four years since I have been on it). If you are easily getting mania returning and you tend to get "mixed" symptoms I would recommend Depakote. I know there is a weight gain issue there, but maybe you wouldn't require so much of it for that to be a problem?--Mitch

 

Re: Low Thyroid and lithium - not a good combo Noa

Posted by BarbaraCat on January 14, 2003, at 12:55:17

In reply to Re: Low Thyroid and lithium - not a good combo, posted by Noa on January 14, 2003, at 3:55:23

Noa,
I was on Armour for years as prescribed by a Naturopath, but was having some anxiety reactions from the T3 spike, although my TSH was normal at around 2.0. Recently I'm talking .112 mg levothyroxine (T4 only) which is what my primary care doc prescribed. I'm not convinced I don't need the T3 as well, but am willing to sit with the straight T4. In the meantime I'm taking thyroid supporting nutrients, like tyrosine. Just recently went off lithium and am trying to deal with the inner turmoil in other ways. From what I've been reading, lithium doesn't always negatively affect thyroid, only if there's already some problem with it.

> I had a similar experience.
> I took lithium for about 2 months, to help with refractory depression. It did start to work after about 3 weeks, but by about week six, I started feeling worse--depressed, fatigued, weak, achy, I had edema, etc. etc. I got my TSH done and it had gone up.
> I decided to stop the lithium, and then found a good endocrinologist, after reading up on hypothyroidism. He told me I could have stayed on the lithium if I had wanted to, just upped the dosages of my thyroid meds. At that point, since I had already stopped, I decided to see how I felt after treating the thyroid problem more aggressively, which was his approach at that point. Treating the hypothyroidism is what finally got me to respond decently to the antidepressants. I started to feel better and better.
>
> But I did not have the manic side of things to contend with, as you do. I wonder if there is more that you can do about the thyroid side of things before going off lithium.
>
> Which thyroid meds are you taking?

 

Re: Low Thyroid and lithium - not a good combo Ritch

Posted by BarbaraCat on January 14, 2003, at 13:14:32

In reply to Re: Low Thyroid and lithium - not a good combo BarbaraCat, posted by Ritch on January 14, 2003, at 9:12:50

Hi Mitch,
Thanks for replying. Depakote, huh. I don't think I'm getting the right response to lamictal anymore and don't tolerate ADs very well - been on all of them as well as the SNRI's and end up with mixed states everytime. Anxiety is a major component and I have way too much real honest to God stress in my life. I've been on all the benzos and clonezapam is probably the best, but it causes doldrums and I think my GABA receptors are clogged anyway. I understand Depakote helps smooth things out, but how does it do as an AD?. Do you have personal experience with it?

I'm really trying to minimize the little bit of this and that drug cocktail syndrome but would augment if necessary as long as it's not an SSRI. I'm still dealing with weight gain from Remeron (no longer taking that dud) and lithium -- just replacing one porkogenic substance with another, so the weight gain issue is moot. - BarbaraCat

> > I've been taking lithium since February and it's helped alot, along with Lamictal. Was able to get off AD's on this combo. But lately I've been feeling tired, cold, etc. I've had low thyroid for many years and have been on thyroid meds, but the last blood test I got, my TSH levels were 7, which was high. So my doc increased the thyroid medication and my last test was 15! which was even higher (not good, levels should be between 2.0 and 4.0). Lithium is anti-thyroid, especially for people who already have problems in that area.
> >
> > I already knew this potential problem and have been monitoring it but it's like all of a sudden I'm getting these bad TSH levels. Considering that I've just been through major intense stress with the sudden and tragic death of my Mother, it's probably not surprising that some of my physical systems are affected.
> >
> > I've tried weaning myself off lithium, but the mania starts creeping back which is alot of fun at first, but then the dreaded mixed states threaten. I tried replacing lithium with Neurontin but no luck. So I'm back to lithium but I am concerned about what's going on with my thyroid. Hypothyroid is the pits and I do not need this on top of everything else. If anyone has any suggestions, I'd appreciate them, but mainly this is a head's up to others. - Barbara
>
> Hi Barb, yep I've only got half a thyroid and lithium is really not an option for me anymore (it has been about four years since I have been on it). If you are easily getting mania returning and you tend to get "mixed" symptoms I would recommend Depakote. I know there is a weight gain issue there, but maybe you wouldn't require so much of it for that to be a problem?--Mitch

 

Re: Low Thyroid and lithium - not a good combo BarbaraCat

Posted by Noa on January 14, 2003, at 15:21:04

In reply to Re: Low Thyroid and lithium - not a good combo Ritch, posted by BarbaraCat on January 14, 2003, at 13:14:32

Barb, good luck. I hope you do find the right mood stabilizer for you.

BTW--I love the term you coined: "porkogenic" !!

 

Re: Low Thyroid and lithium - not a good combo BarbaraCat

Posted by Ritch on January 14, 2003, at 23:22:32

In reply to Re: Low Thyroid and lithium - not a good combo Ritch, posted by BarbaraCat on January 14, 2003, at 13:14:32

> Hi Mitch,
> Thanks for replying. Depakote, huh. I don't think I'm getting the right response to lamictal anymore and don't tolerate ADs very well - been on all of them as well as the SNRI's and end up with mixed states everytime. Anxiety is a major component and I have way too much real honest to God stress in my life. I've been on all the benzos and clonezapam is probably the best, but it causes doldrums and I think my GABA receptors are clogged anyway. I understand Depakote helps smooth things out, but how does it do as an AD?. Do you have personal experience with it?
>
> I'm really trying to minimize the little bit of this and that drug cocktail syndrome but would augment if necessary as long as it's not an SSRI. I'm still dealing with weight gain from Remeron (no longer taking that dud) and lithium -- just replacing one porkogenic substance with another, so the weight gain issue is moot. - BarbaraCat
>

Barb, that sounds sooo familar. Depakote works as an "AD" for me *only* when I am predominantly experiencing mixed symptoms like you get. It takes away the agitation and hostility and that lifts my mood. However, during my seasonal major depressions (twice a year), I've got to add *something* to keep from sleeping too much (which Depakote is AGGRAVATING) otherwise the resulting hypersomnia snowballs and intensifies the depression. I tried reducing the Dep. dosage this time around and I slept more normally, but I was also more agitated. This is a total stab in the dark, but... you might find that a *little* Depakote (with a careful and observant cross-taper with lithium) with your thyroid augmentation and continuing with your Lamictal might work out very well. Just keep in mind that if you add some Depakote that will cause your Lamictal blood levels to rise (for good or ill). I've got this hunch that since Depakote works so well for my agitative, mixed, hostile episodes, and that Lamictal works so well for depression, and thyroid augmentation helps for rapid-cycling, that a combo of Depakote+Lamictal+thyroid might be a decent solution.----Mitch

 

Re: Low Thyroid and lithium - not a good combo

Posted by Pfinstegg on January 15, 2003, at 10:23:59

In reply to Re: Low Thyroid and lithium - not a good combo BarbaraCat, posted by Ritch on January 14, 2003, at 23:22:32

I didn't see mentioned whether "thyroid supplementation" included T3 as well as T4- other than the original Armour medication, which contains both. I think, from my own experience, that it is very important in treating depression with associated thyroid abnormalities to take both T3 and T4- and the ideal TSH to aim for is at the very low end of normal- mine is presently 0.84, which my endocrinologist considers ideal. It's hard for me to say definitely that this has helped. as I am also taking fish oil, and am just finishing up a successful course of TMS. Truthfully, I think every one of these things has been important..

Pfinstegg

 

Re: Low Thyroid and lithium - not a good combo Ritch

Posted by BarbaraCat on January 15, 2003, at 14:29:06

In reply to Re: Low Thyroid and lithium - not a good combo BarbaraCat, posted by Ritch on January 14, 2003, at 23:22:32

Thanks, Mitch.
Your input is always helpful. Getting a little more sleep and chill factor would be a nice change since I'm so wired and strung out these days. My 'depressions' have that sludgy dopey feeling for only as long as I need to recupe from over-amped stress reactions and then I spin out into panic and agitation. This is a cycle I'm very sick of and if I have to use meds, well then, I'd let to at least get the right suckers. Been going through this for over 20 years and enough already.

I've stopped lithium all together. In reading some articles over the web, there's a chance of lithium permanently damaging the thyroid and using large amounts of supplementation suppresses whatever thyroxine is there naturally. So my suggestion to my pdoc will be Lamical, thyroid (both T4 and T3) along with Depakote (just a smidge). Thanks again. - Barbara

> > Hi Mitch,
> > Thanks for replying. Depakote, huh. I don't think I'm getting the right response to lamictal anymore and don't tolerate ADs very well - been on all of them as well as the SNRI's and end up with mixed states everytime. Anxiety is a major component and I have way too much real honest to God stress in my life. I've been on all the benzos and clonezapam is probably the best, but it causes doldrums and I think my GABA receptors are clogged anyway. I understand Depakote helps smooth things out, but how does it do as an AD?. Do you have personal experience with it?
> >
> > I'm really trying to minimize the little bit of this and that drug cocktail syndrome but would augment if necessary as long as it's not an SSRI. I'm still dealing with weight gain from Remeron (no longer taking that dud) and lithium -- just replacing one porkogenic substance with another, so the weight gain issue is moot. - BarbaraCat
> >
>
> Barb, that sounds sooo familar. Depakote works as an "AD" for me *only* when I am predominantly experiencing mixed symptoms like you get. It takes away the agitation and hostility and that lifts my mood. However, during my seasonal major depressions (twice a year), I've got to add *something* to keep from sleeping too much (which Depakote is AGGRAVATING) otherwise the resulting hypersomnia snowballs and intensifies the depression. I tried reducing the Dep. dosage this time around and I slept more normally, but I was also more agitated. This is a total stab in the dark, but... you might find that a *little* Depakote (with a careful and observant cross-taper with lithium) with your thyroid augmentation and continuing with your Lamictal might work out very well. Just keep in mind that if you add some Depakote that will cause your Lamictal blood levels to rise (for good or ill). I've got this hunch that since Depakote works so well for my agitative, mixed, hostile episodes, and that Lamictal works so well for depression, and thyroid augmentation helps for rapid-cycling, that a combo of Depakote+Lamictal+thyroid might be a decent solution.----Mitch

 

Re: Low Thyroid and lithium - not a good combo BarbaraCat

Posted by Ritch on January 15, 2003, at 23:37:53

In reply to Re: Low Thyroid and lithium - not a good combo Ritch, posted by BarbaraCat on January 15, 2003, at 14:29:06

Barb, will you let us know how this goes? I want to know for sure! Be careful with the Depakote+Lamictal combo. I wouldn't take more than 125mg per day of Depakote for at least a couple of weeks to see how you react to it, just an opinion. What Lamictal dosage are you on? You *might* want to click DOWN the dosage on Lamictal a tad when you start the Depakote to try to keep your Lamictal blood levels similar before/after the Dep. addition. You might want to raise those concerns with your pdoc to find out just what that TAD would likely be. If you can easily obtain Lamictal blood levels before/after that could be really helpful. You don't want to confuse adverse effects with an indirect Lamictal serum level boost as a result of the Depakote add-on. As far as the lithium goes... I got hypercalcemia (abnormally high serum calcium), just before my endocrinologist found a thyroid tumor, while I was on lithium (after many years of use). I wound up with half of my thyroid surgically removed with the tumor (because my mother had thyroid cancer with her 2nd thyroid surgery), and I went off lithium and onto Depakote as a result. The only stickler I have with my current pdoc is the notion of adding on a little T3/T4 (not going below the bottom of a normal TSH level). I am taking a little L-tyrosine and it definitely helps. I am going to double it starting tomorrow.----Mitch

> Thanks, Mitch.
> Your input is always helpful. Getting a little more sleep and chill factor would be a nice change since I'm so wired and strung out these days. My 'depressions' have that sludgy dopey feeling for only as long as I need to recupe from over-amped stress reactions and then I spin out into panic and agitation. This is a cycle I'm very sick of and if I have to use meds, well then, I'd let to at least get the right suckers. Been going through this for over 20 years and enough already.
>
> I've stopped lithium all together. In reading some articles over the web, there's a chance of lithium permanently damaging the thyroid and using large amounts of supplementation suppresses whatever thyroxine is there naturally. So my suggestion to my pdoc will be Lamical, thyroid (both T4 and T3) along with Depakote (just a smidge). Thanks again. - Barbara

> > Barb, that sounds sooo familar. Depakote works as an "AD" for me *only* when I am predominantly experiencing mixed symptoms like you get. It takes away the agitation and hostility and that lifts my mood. However, during my seasonal major depressions (twice a year), I've got to add *something* to keep from sleeping too much (which Depakote is AGGRAVATING) otherwise the resulting hypersomnia snowballs and intensifies the depression. I tried reducing the Dep. dosage this time around and I slept more normally, but I was also more agitated. This is a total stab in the dark, but... you might find that a *little* Depakote (with a careful and observant cross-taper with lithium) with your thyroid augmentation and continuing with your Lamictal might work out very well. Just keep in mind that if you add some Depakote that will cause your Lamictal blood levels to rise (for good or ill). I've got this hunch that since Depakote works so well for my agitative, mixed, hostile episodes, and that Lamictal works so well for depression, and thyroid augmentation helps for rapid-cycling, that a combo of Depakote+Lamictal+thyroid might be a decent solution.----Mitch
>

> > > Hi Mitch,
> > > Thanks for replying. Depakote, huh. I don't think I'm getting the right response to lamictal anymore and don't tolerate ADs very well - been on all of them as well as the SNRI's and end up with mixed states everytime. Anxiety is a major component and I have way too much real honest to God stress in my life. I've been on all the benzos and clonezapam is probably the best, but it causes doldrums and I think my GABA receptors are clogged anyway. I understand Depakote helps smooth things out, but how does it do as an AD?. Do you have personal experience with it?
> > >
> > > I'm really trying to minimize the little bit of this and that drug cocktail syndrome but would augment if necessary as long as it's not an SSRI. I'm still dealing with weight gain from Remeron (no longer taking that dud) and lithium -- just replacing one porkogenic substance with another, so the weight gain issue is moot. - BarbaraCat

 

Re: Low Thyroid and lithium - not a good combo

Posted by Noa on January 16, 2003, at 5:36:32

In reply to Re: Low Thyroid and lithium - not a good combo BarbaraCat, posted by Ritch on January 15, 2003, at 23:37:53

Mitch, btw--my endo also has me on an aggressive thyroid treatment program--to keep my TSH below 1. He had me increase my synthroid (and keep my cytomel dose where it was), increasing a little bit every week until I saw no further benefit in how I felt. When I reached that point, he had me go back down to the previous level (where last improvement was seen). Unlike most doctors, who go strictly by whether the TSH is "within normal limits"(which, of course, does not necessarily mean normal for me), this doctor (the endo) paid a lot of attention to how I felt. What a difference. When the thyroid thing was finally under control, that was when I started to really respond well to the antidepressants.

When I asked him about the risks of hyperthyroid and osteoporosis, he told me that if I felt any symptoms of hyper, I would just call him and we would adjust the medication accordingly, but that he was not worried about that happening. About osteoporosis, he said that while many believe it is low TSH that will put one at risk for osteoporosis, he said that really it is actually being hyperthyroid that does this--ie, only if I develope hyperthyroid symptoms.

 

Thanks Noa, I will keep that in mind re: thyroid (nm)

Posted by Ritch on January 16, 2003, at 9:27:49

In reply to Re: Low Thyroid and lithium - not a good combo, posted by Noa on January 16, 2003, at 5:36:32

 

Noa, Ritch: Low Thyroid and lithium

Posted by BarbaraCat on January 16, 2003, at 15:14:12

In reply to Re: Low Thyroid and lithium - not a good combo, posted by Noa on January 16, 2003, at 5:36:32

Thanks for the reminder about Depakote and Lamictal, Mitch. I remember reading about adverse reactions with these two and doubt my conservative pdoc will put me on both. Jeez, when is someone going to develop a one-stop shopping med? Something like a pint of fine single-malt Scotch without the sloppiness, hangover and booze breath.

Noa, can't remember, but did you try Armour or another natural thyoid ever and if so, is the synthetic working better? Did you go on Cytomel after you first tried T4 alone? I'm tempted to go with T4 in the morning and add a slice of Armour just to get the T3 circulating again, but that will just screw up my test results. I'll also start beefing up on my Tyrosine as well. I'm also going to insist upon a referral to a hopefully good Endo, because my doc, while a nice guy, is not skilled enough to handle my tweaky constitution.

Do you know about thyroid.about.com? It's a great site. One article I came across recently is the relationship between bipolar and Hashimoto's thyroiditis, which is diagnosed through an antibodies test. The thyroid alternately goes hypo and hyper causing spikes that aggravate or mimic bipolar disorder. Lithium has been implicated in aggravating Hashimoto's. The fact that Mitch had to have part of his thyroid removed is suspicious of this. Another possibility is a **parathyroid** disfunction, which controls calcium levels.

What is needed is to ask the question 'why is it that thyroid disorders are now such an epidemic?'. It seems to me that the Pituitary (HPA axis) is the physical starting place for all this stuff and stress, emotional and environmental, is the culprit that knocks it out of whack. Endo-disruptors of all sorts abound and getting to the bottom line rather than symptom relief is what's not being addressed, don't you think?

 

Re: Noa, Ritch: Low Thyroid and lithium

Posted by Noa on January 16, 2003, at 16:03:10

In reply to Noa, Ritch: Low Thyroid and lithium, posted by BarbaraCat on January 16, 2003, at 15:14:12

Barb, to answer your questions--

No, I didn't try the Armour. I don't eat poultry, beef, pork, etc. so I would have a problem with the Armour. Cytomel and Synthroid were and are the only thyroid meds I've used. The thing I wonder about Armour is whether the amount of T3 vs. T4 is standardized, since it is made from dessicated pig thyroids, and is it easier to be precise with the synthetics? I don't know enough about Armour, though, so it is just a question.

I started with T3, actually, because it was originially my pdoc who suggested it to boost my ADs when I was not responding sufficiently to them. He did this on the basis of anecdotal reports that T3 can help boost AD effect, especially in people with subclinical hypothyroidism. So, he had me get my thyroid testing done and I was borderline (ie, subclinical) with a TSH of 4.5. The cytomel helped, wiht improvement within a week, but some time later, the effect dwindled, so he added the synthroid (after testing my thyroid levels again) based on new research that some people with subclinical hypothyroid should aim for TSH of around 2. I think then that my TSH stayed in the 2 to 3 range (which, now I know is too high for me). It was only after the lithium thing (when my TSH went back up to about 4) that I actually went to see an endo.

Which, btw, was because of the lithium thing in connection with the thyroid problem--I guess it was so clear to me that when the lithium made my thyroid more hypo, my depression worsened terribly (in addition to all the physical symptoms), so I became more curious about the thyroid factor in the depression, and went searching for info. I discovered Mary Shomon's web site (thyroid-info.com) and saw the ad for her book. After reading her book, I went to the about site, which she moderates. She has a link on the thyroid-info.com site (which is linked to about.com, too) to a page where people give endo recommendations. That is where I found my endo, who is great. Have you ever had a doctor spend 90 minutes with you on an office visit? And listen to how you feel--using that as an important measure of the level of the problem, rather than relying solely on a single test? And only charge $75? And do follow ups, and do other tests to look into other possible causes to rule them out? And then write a 3 page letter to your primary care doctor, detailing his findings and recommendations?

 

Re: Noa, Ritch: Low Thyroid and lithium Noa

Posted by BarbaraCat on January 16, 2003, at 20:00:17

In reply to Re: Noa, Ritch: Low Thyroid and lithium, posted by Noa on January 16, 2003, at 16:03:10

Noa,
I'm a frequent flyer at Mary Shomon's thyroid site, it's wonderful. God, I'd love to find an endo like yours. He doesn't happen to be in the Portland, OR area? To answer your questions about Armour, the scoop for a while was that the levels were inconsistent, but that isn't true any longer. The lab constantly monitors quality and consistency so that no longer is a valid consideration, even though the Synthroid folks would like to keep that rumor alive. What is a problem is that the ratio of T3 is too high to T4 and so can cause hyper symptoms - my free T3 was much higher than T4. Wasn't doing my anxiety level any good, along with the fact that I'm also vegetarian (except for fish). So I gave into my doc's T4 protocol. I've never responded well to my previous T4 only regimens and did much better with the combo, so cytomel seems like the ticket.

I've definitely noticed my depression coming back in spades. I've been under pretty constant intense stress and thought it was due to that, but started feeling chilled all the time and symptoms of fibromyalgia aches returning. No wonder, since my TSH was 7 when I tested 8 weeks ago and 15 six weeks later! I'd like to get between 1.0 and 2.0, but my doc thinks 4-5 is OK. What can I say, a nice guy, but real party-line. What's puzzling to me is that I've been taking lithium for a year now and only recently has my thyroid done this. I was only taking 600mg a day, so other factors (such as my out of sight stress level) might be contributing.

Sigh, I really need to find a good endo who is cognizant of nutrition and affective disorders. I don't think my HMO is the place I can expect such a jewel like you found. I'll most likely go to Mary's site and spring for a visit out of pocket as a consult for my primary care doc. - Barbara

 

Re: Noa, Ritch: Low Thyroid and lithium BarbaraCat

Posted by Pfinstegg on January 16, 2003, at 22:05:10

In reply to Re: Noa, Ritch: Low Thyroid and lithium Noa, posted by BarbaraCat on January 16, 2003, at 20:00:17

Hi.. Your TSH is getting so high! Do you have to stay with Lithium, or is another mood-stabilizer a possibility?

My endocrinologist thinks that an important aspect of treating depression is keeping the TSH between 0.5 and 1.0, and also using cytomel as well as synthroid, in case you are a person who doesn't convert the synthroid to T3 naturally. (I'm sure this is all stuff you know ).It didn't resolve my depression, but I do think it helped it become less severe after about a month. (And after 15 TMS treatments I am feeling great- I just have to keep putting that into my posts, as I know not many people have had it, so it's basically an unknown).

I hope you can get your TSH low again!

Pfinstegg

 

Re: Noa, Ritch: Low Thyroid and lithium BarbaraCat

Posted by Ritch on January 16, 2003, at 22:35:41

In reply to Noa, Ritch: Low Thyroid and lithium, posted by BarbaraCat on January 16, 2003, at 15:14:12

> Thanks for the reminder about Depakote and Lamictal, Mitch. I remember reading about adverse reactions with these two and doubt my conservative pdoc will put me on both. Jeez, when is someone going to develop a one-stop shopping med? Something like a pint of fine single-malt Scotch without the sloppiness, hangover and booze breath.
>
> Noa, can't remember, but did you try Armour or another natural thyoid ever and if so, is the synthetic working better? Did you go on Cytomel after you first tried T4 alone? I'm tempted to go with T4 in the morning and add a slice of Armour just to get the T3 circulating again, but that will just screw up my test results. I'll also start beefing up on my Tyrosine as well. I'm also going to insist upon a referral to a hopefully good Endo, because my doc, while a nice guy, is not skilled enough to handle my tweaky constitution.
>
> Do you know about thyroid.about.com? It's a great site. One article I came across recently is the relationship between bipolar and Hashimoto's thyroiditis, which is diagnosed through an antibodies test. The thyroid alternately goes hypo and hyper causing spikes that aggravate or mimic bipolar disorder. Lithium has been implicated in aggravating Hashimoto's. The fact that Mitch had to have part of his thyroid removed is suspicious of this. Another possibility is a **parathyroid** disfunction, which controls calcium levels.
>
> What is needed is to ask the question 'why is it that thyroid disorders are now such an epidemic?'. It seems to me that the Pituitary (HPA axis) is the physical starting place for all this stuff and stress, emotional and environmental, is the culprit that knocks it out of whack. Endo-disruptors of all sorts abound and getting to the bottom line rather than symptom relief is what's not being addressed, don't you think?


Barb, thanks for this excellent post! The hypercalcemic (high serum calcium) condition was discovered months before the thyroid tumor. My GP was then indeed concerned about the the *parathyroid*. That was when I got CAT-scans of that which turned out OK. All I know is that I developed allergies to stuff I never was allergic to before and got hives (big time). I had to go to the ER about it and was put on prednisone high-dose "burst" therapy to stop the hives. The hives relented and when I went to GP, got blood workup where they discovered the hypercalcemia. Then I got CAT-scanned and it was negative. Later on I developed a detectable enlargement in my left thyroid and the tumor grew very rapidly (incidentally, this was immediately after quite a bit of stressful conditions). The thing grew from the size of pea to the size of large jawbreaker in the course of about three weeks. The entire left-side of my thyroid was removed with the tumor. My Mom had thyroid surgeries twice. One was at the age I had this one, and the other was ten years later when it was cancerous. Hashimoto's thyroiditis-an antibodies' test? Going to bring that up with my PCP--thanks!---Mitch

 

Re: Low Thyroid and lithium Pfinstegg

Posted by BarbaraCat on January 17, 2003, at 0:08:51

In reply to Re: Noa, Ritch: Low Thyroid and lithium BarbaraCat, posted by Pfinstegg on January 16, 2003, at 22:05:10

I agree it's getting too high too quickly and have stopped lithium. I'm taking Lamictal but it's not helping with anxiety as lithium was and all benzos lose their efficacy very quickly. Not sure where to go at this point but will bring it up with my pdoc. I'm really really really viewing this whole pharmaceutical jungle with a jaundiced eye, however the thyroid issue is crucial to address.

How did you get approved for TMS or did you pay out of pocket? If you can provide a link to your past posts I'd appreciate it. I've had a strong feeling that so much of what I, at least, am dealing with is as much electrical as chemical. I'm ready to start pulsing heavy duty Radio Shack magnets on my left frontal lobe. But maybe the key is to adopt the Buddhist path of non-judgment and non-attachment - life is suffering and clinging and expecting otherwise is the surest path to more suffering. My worst fear is fear and meds don't seem to be exorcizing that particular demon. - Barbara

> Hi.. Your TSH is getting so high! Do you have to stay with Lithium, or is another mood-stabilizer a possibility?
>
> My endocrinologist thinks that an important aspect of treating depression is keeping the TSH between 0.5 and 1.0, and also using cytomel as well as synthroid, in case you are a person who doesn't convert the synthroid to T3 naturally. (I'm sure this is all stuff you know ).It didn't resolve my depression, but I do think it helped it become less severe after about a month. (And after 15 TMS treatments I am feeling great- I just have to keep putting that into my posts, as I know not many people have had it, so it's basically an unknown).
>
> I hope you can get your TSH low again!
>
> Pfinstegg

 

Re: Low Thyroid and lithium Ritch

Posted by BarbaraCat on January 17, 2003, at 0:17:41

In reply to Re: Noa, Ritch: Low Thyroid and lithium BarbaraCat, posted by Ritch on January 16, 2003, at 22:35:41

Mitch,
I know you've been through alot, and have been on quite a varied med regimen. I didn't know about the extent of your thyroid condition. That's major stuff. I have a friend who had a cancerous growth removed from most of his thyroid and has dealt with severe mood disorders. Such an important little gland. Well, I guess they all are. Many good blessings of health your way. - BCat

 

Re: Low Thyroid and lithium

Posted by Noa on January 17, 2003, at 5:38:58

In reply to Re: Low Thyroid and lithium Ritch, posted by BarbaraCat on January 17, 2003, at 0:17:41

Ritch, you have been through a lot. Kind of scary, I would think. Is your thyroid functioning more or less stabel now, with the meds?

Barb, re cytomel--my endo had me split the dose in 2 because he said it is short acting, so dosing only once a day could cause spiking which could cause palpitations. I never had the problem, but I do follow his advice--beside the spiking, there is the problem, of course, of not having enough of the T3 during the second 12 hours of the day. I hope you are able to find a great doctor.

Good luck, both of you!

 

Re: Low Thyroid and lithium

Posted by Ritch on January 17, 2003, at 9:46:36

In reply to Re: Low Thyroid and lithium, posted by Noa on January 17, 2003, at 5:38:58

> Ritch, you have been through a lot. Kind of scary, I would think. Is your thyroid functioning more or less stabel now, with the meds?
>
> Barb, re cytomel--my endo had me split the dose in 2 because he said it is short acting, so dosing only once a day could cause spiking which could cause palpitations. I never had the problem, but I do follow his advice--beside the spiking, there is the problem, of course, of not having enough of the T3 during the second 12 hours of the day. I hope you are able to find a great doctor.
>
> Good luck, both of you!

Thanks Barb and Noa, I see an endocrinologist once a year since all that happened and my TSH level (the last two yearly visits) has been around 1.4. I'm supposed to get a scan done later this year (the deal where you take the iodine pill, etc.). The endo I have seen throughout all of this is real conservative and doesn't like thyroid supps. in the absence of clear hypothyroid symptoms and "normal" TSH. My pdoc doesn't want to rock the boat with my endo and write for thyroid augmentation, and I can understand that. My pdoc has electrolyte levels run every so often and everything has been pretty even, except I had a normal-high potassium last time. The hypercalcemia was weird, because one test it was qauite high, and then the next it was just a high-normal, then another was normal. It was bouncing around. It makes me wonder if my TSH and electrolytes are jumping about all of the time. When I had standard EEG done, it was normal except for a small "flat-spot" (left frontal lobe) that was probably a head injury when I was a kid. Sometime in the near future I would like to do a 24-hr. sleep-deprived EEG (which was encouraged-but I couldn't afford it at the time), and a polysomnogram (since my Mom had nocturnal seizures). Thanks for the responses!

 

Re: Low Thyroid and lithium BarbaraCat

Posted by Pfinstegg on January 17, 2003, at 12:27:08

In reply to Re: Low Thyroid and lithium Pfinstegg, posted by BarbaraCat on January 17, 2003, at 0:08:51

Hi BarbaraCat.. I don't know how to provide a link to my former posts (showing my computer ignorance). Most of them probably wouldn't be too helpful, anyway, as I was mostly gathering information- about cortisol and HPA axis dysregulation mainly.

I did find a place to receive TMS from a psychiatrist in private practice, and did have to pay the costs of the treatment, although the psychiatrist's other fees were paid by insurance. The cost for 3 weeks of TMs was $1650. It worked so well, though that it seems a small price to pay.

I do hope you find good, effective treatment, too: if I can provide any more information about the TMS I'd be glad to.

Pfinstegg

 

Re: Low Thyroid and lithium Pfinstegg

Posted by BarbaraCat on January 17, 2003, at 13:12:34

In reply to Re: Low Thyroid and lithium BarbaraCat, posted by Pfinstegg on January 17, 2003, at 12:27:08

Hi Phinstegg,
So glad these treatments were effective for you -- you're the first person so far I've heard positive real results from it. BTW, how long has it been since they 'took' and to you anticipate any refresher treatments?

I'll be seeing my pdoc next week and will ask him if he knows of anyone doing TMS. I can already guess that my HMO will not pay for it but want at least a recommendation from pdoc for someone in the Portland, OR area. If he doesn't come with anything useful, I'll probably be back in touch with you for websites or anything else you can think of so I can begin my own search. If you have any suggestions and want to send them along, I'm very interested.

I'd also be interested in what you found out about cortisol/HPA axis stuff since in my opinion, that is the key to all this misery. But don't trouble yourself if it's not at your fingertips. The trickiest part in providing a link to a previous post is first finding that post but once you do you can always get it's identifier from the URL in the address box.

1. First locate the previous post and click on the link to open it.
2. Copy the contents of the address box at the top of the screen (just click in the address box to highlight the http://www. etc., then hold down the the Ctrl key on your keyboard and press 'c').
3. Open up the form replying back to the person requesting it, or as a new thread if you're starting one.
4. Paste the copied address into the message area (hold down Ctrl key and press 'v').

Sorry if this is overly instructive but best not to assume things. BArbaraCat

> Hi BarbaraCat.. I don't know how to provide a link to my former posts (showing my computer ignorance). Most of them probably wouldn't be too helpful, anyway, as I was mostly gathering information- about cortisol and HPA axis dysregulation mainly.
>
> I did find a place to receive TMS from a psychiatrist in private practice, and did have to pay the costs of the treatment, although the psychiatrist's other fees were paid by insurance. The cost for 3 weeks of TMs was $1650. It worked so well, though that it seems a small price to pay.
>
> I do hope you find good, effective treatment, too: if I can provide any more information about the TMS I'd be glad to.
>
> Pfinstegg

 

Re: Low Thyroid and lithium BarbaraCat

Posted by Pfinstegg on January 17, 2003, at 17:48:34

In reply to Re: Low Thyroid and lithium Pfinstegg, posted by BarbaraCat on January 17, 2003, at 13:12:34

Hi BarbaraCat.. no, those instructions were not too detailed: I need all the help I can get for that sort of computer stuff! Even with the instructions, I feel quite challenged, and, as I am pressed for time right now, let me refer you instead to two threads just below yours, which have summaries of the stuff I've learned about cortisol and TMS:

Omega 3 Questions- Sedona January 15

Cortisol Testing- Dinah January 15

The TMS began working, gradually, from the first treatment, and I was essentially in remission for the last 10 days (of a course of 15 treatments). Now, I'm considered to be in complete remission. I don't know what will happen in the future, but I can have "booster" treatments in the future if I need them.

The very best of luck to you in your search- be sure to post me if you want more detailed information on how to find TMS.

Pfinstegg


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