![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by amateur MD on June 20, 2004, at 11:40:43
Dear fellow sufferers:
I am posting here a series of emails, which tell the story of how I pulled myself out of a ten year odyssey of misery that almost resulted in my death.
Ten years ago, before having my thyroid out, I was a happy, healthy, debt-free person with lots of friends who liked to throw big parties on New Year's Eve. I was on a volleyball team, in a biking club and a theatre group, and active in local politics. My thyroid was removed while I was in graduate school. I was barely able to finish the program and never able to work in the field for which I had trained.
If it had not been for my strong faith in God and my belief that suicide is a grave spiritual mistake with serious consequences for our next life, I would not still be here.
I am not manic. I am off antidepressants for a week now. I am thrilled beyond words!
See my last email, to Dr. Bob, for a list of the wondrous changes I'm experiencing. This is truly a magical, joyous time for me!
6/5/2004 4:35:33 PM
I think I am a rapid-cycling Bipolar II. That means I don’t get real mania, just mild mania, but it alternates with severe depression. And, my nine years on SSRIs have made my mood fluctuations more severe and more rapid. This is one explanation why my years in psychotherapy haven't helped stabilize my mood -- I'm still taking mood-destabilizing drugs. See below:
Massachusetts General Hospital Psychiatry Update and Board Preparation
by Theodore A. Stern
published 1999
page 118:
“Frequently, individuals with bipolar disorder have been treated with antidepressants,
which can worse the course of the illness. Periods of antidepressant use are often correlated
with diagnostic information regarding manic symptoms. Other hints of a bipolar diagnosis
include an initial rapid response to antidepressant agents followed by a loss of response, treatment resistance to multiple antidepressant trials, or response to the addition of a mood stabilizer (like lithium) to antidepressants.”Page 120:
"Be cautious about emphasizing comorbid conditions. With the exception of substance abuse, the treatment of many comorbid conditions that occur with bipolar disorder can be deferred until the mood symptoms of bipolar illness are effectively under control. This is because many of the treatments can be mood destabilizers and worsen the course of bipolar illness. Also, it is usually self-defeating to emphasize borderline personality traits in the presence of current mood symptoms and unequivocal past mania. Research has shown that, during acute mood episodes, personality traits are exacerbated and personality disorders are evident until after the acute mood episode revolves. Thus a definitive diagnosis of personality disorder should often be withheld until a mood episode resolves. If a personality disorder can be diagnosed during periods of euthymia, then a true comorbid illness can be said to exist and more aggressive treatment for it be justified.”6/9/2004 4:54:02 PM
I was told on the phone today that I have been diagnosed as as having borderline personality disorder. I've been doing alot of reading about bipolar and borderline and have concluded that my problems are bipolar, not borderline. For one, I have no trouble at all being alone, and that is considered the "core" feature of borderline.
I've also researched it enough to determine what drug I should be on: lamictal (or lamotrigne)
"To explore the efficacy of lamotrigine in rapid cycling, a recent multicenter study has examined lamotrigine as a maintenance therapy for this population. The results indicate that lamotrigine may be a useful treatment for patients with rapid-cycling bipolar II disorder and that this drug has begun to address this unmet need."
6/13/2004 5:47:36 PM
I've been continuing my research today and have come upon something really amazing on the LEF site. Do you trust those folks? Do they know what they're talking about? Cause they may have helped me solve something important.
In my reading about rapid-cyling bipolar, they say that it is highly correlated with thyroid problems. I had my thyroid gland removed in August 1994. By the next June I was severely depressed (for no apparent reason, I was in grad school and things were going really well.) So in June 1995 I went on antidepressants for the first time.
To make a long story short, I think I'm deficient in T3. I take a tiny amount of T3 (3% of the total) but the thyroid gland puts out 7%, ie, the body is used to getting 7% of its thyroid hormone as straight T3, I've been giving it half of that!
Plus, stress, as well as antidepressants, can reduce the enzyme that is needed to convert T4 into T3. (I've learned today.) When people take an overdose of T4, they give them a certain stress hormone to block the T4 from converting into T3. Your body cannot use T4, it uses T3.
And here from the LEF website:
If you are T3 deficient, you will find your basal temperature to be below 97.8°F (normal throughout the day is 98.6°F).
I've seen plenty of endocrinologists and my blood levels are supposedly normal. But I've always wondered why my temperature has never gone back to normal. Prior to surgery, my body temp was a normal 98.6. Since then my temp ranges from 95.9 to 98, as measured in a a doctor's office. My weight increased by 25 lbs, despite swim team, biking, etc.
Seems like there's a good chance I've been caught in a vicious cycle: didn't take enough T3 after surgery, got severely depressed within a year, took antidepressants which even further diminished the available T3 in my body, life slowly spiraling down and stress levels rising, further decreasing available T3, leading to more stress, more antidepressants, less T3, aaaarrghhh!
Makes me really angry at all those endocrinologists who told me that "it's normal to have a fluctuating temperature." But is is normal for your temperature to drop 2-3 degrees after surgery and never go back up again????
I could be wrong, but I don't think so. I'm going to start taking more T3 and see what happens!6/14/2004 12:05:12 AM
Thanks for your support and enthusiasm P. It means alot to feel like I'm not all alone with this.
The one about T3 and body temp is at:
http://www.lef.org/protocols/prtcl-104.shtml
I think for now I'm going to hold off on the empower plus. It might make more sense to try to get my temp back up 98.6 and then see how I feel. But this is all very much in flux, I've learned a ton just in the past week. Thanks again for your generous offer!
PsychEducation.org (home)Thyroid and Bipolar Disorder
(revised March 2004)Introduction: why should you care about thyroid?
What is thyroid hormone?
What does thyroid hormone do?
Thyroid hormone as a treatment for bipolar disorder--------------------------------------------------------------------------------
Introduction: why should you care about thyroid?
(need a thyroid basics before we start? or a great thyroid encyclopedia?)
There is a clear connection between the process of thyroid hormone regulation and bipolar disorder. The problem is, this connection is only just now beginning to become evident, and how the connection works is basically a mystery. One study recently showed a strikingly high rate of autoimmune-caused thyroid problems in people with bipolar disorder, far more than you would expect to find.Kupka Thyroid problems are more common in the complex forms of bipolar disorder (mixed states and rapid cycling) than in classic bipolar manic patients.Chang And another study recently showed that people with low thyroid levels were less likely to get better when treated for their bipolar depression, whereas the ones with higher levels responded pretty well.Cole The mystery is getting more intense, but not clearer yet. At least we can say that thyroid function looks more and more implicated in some kinds of bipolar disorder.
Here's an example of that deepening mystery. (Oct. 2003) there are reports linking the entire stress hormone system (here are some basics on stress and depression) to changes in thyroid function. This part is really complicated. The short version, translating from two amazing reviews of stress and mental health, is that stress hormones interfere with the production of thyroid hormone and with the conversion of thyroid hormone to its active form. Tsigos, Charmandari
However, a few things are clear. People who have symptoms that look like "bipolar disorder" as explained on this website, have thyroid problems and have family members with thyroid problems at a greater rate than would be expected. Is that because the thyroid problems somehow actually cause "bipolar"-like symptoms? Could it be that some of what looks like "bipolar" is actually a thyroid problem? There may be some such folks. In addition, there are clearly cases which seem to be "bipolar disorder" for sure, that get better with thyroid hormones as part of the treatment. In many of these cases it is clear that thyroid hormone was not enough, by itself, to make mood "normal". So, for now I think it is safe to say that bipolar disorder has something to do with thyroid regulation in many cases, though not the majority; and that treating with thyroid alone is only rarely going to lead to full remission of symptoms.
6/16/2004 10:31:39 PM
P., you are so right. Yesterday I was TOTALLY rejoicing. I said to K. last night that I feel like they must have felt at Auschwitz when the Allies came and opened the gates. Just staring at that open gate, never believing that this day would come!
Today I feel more subdued. I have gone off my antidepressants and usually that involves a wrenchingly painful withdrawal period, so "subdued" is just fine. At the same time, things are tanking with the guy I've been seeing, so the fact that I'm not crying buckets is probably a plus!
I think this could well be the answer I've been looking for. I will be overjoyed if I can successfully go off antidepressants.
I did check my pulse today to make sure it's not going too high. It was only 60. Normal for adults is considered 60-100 so I'm certainly not hyper-thyroid.
I'm starting to think that the whole thing about thyroid blood tests is a bunch of hooey. They've been telling me for ten years that my blood levels are normal, yet my health and my life clearly headed south after losing my thyroid gland. From now on, I'll pay attention to the signals from my own body, not something in a lab test.
Here's another thing. Low T3 levels = low interest in sex. Antidepressants inhibit the conversion of T4 to T3. So is it any surprise that people on antidepressants lose interest in sex? Yet the whole medical establishment acts as though this has never occurred to them. And maybe, just maybe, the pharma companies that are making billions off of Prozac and Zoloft and all the rest, don't want us to know.
Thanks for caring, P.6/19/2004 4:28:49 PM
Hello Dr. Bob --
My case, as far as I can tell, is pretty unusual -- in that I have cured myself of rapid cycling bipolar II just by doing tons of research and adjusting my dose of T3 slightly upward. I had my thyroid gland removed ten years ago, was diagnosed with major depression 10 months later and put on Zoloft. I developed IBS, migraines, and gained 25 lbs despite being (very active).
My life has spiralled down ever since. I went from being in a highly competitive grad program to being unable to even hold a waitress job.
Eventually it got to the point where I could no longer afford health insurance so my only hope of saving myself was to find the answer on my own. I self-diagnosed as rapid-cycling bipolar II, and soon found out that thyroid problems were implicated. I increased my dose of T3 by 50% and my depression vanished. The changes:optimism, energy and ambition are back
thinking is clearer and faster
mood is stable
craving for carbohydrates is gone
can again digest many foods that formerly caused severe bloating
no longer lactose-intolerant
have gone off my antidepressants with no withdrawal symptoms
sex drive is back
colors are brighter
food tastes better
music sounds betterI look around now at the devastated landscape of my life -- $90,000 in debt and my career and relationships destroyed -- with horror and regret. I lost a decade. I endured agony living with "normal" thyroid blood levels (according to the endocrinologists, who have now lost all credibility in my book.)
I almost killed myself many times. As my relationships, career and health hit bottom, even my family lost faith in me and gave up on me as a loser. I've had many a day when my sole accomplishment was that I didn't shoot myself.
I am still tweaking my T3 levels so any current threads on this topic or resources you can point me to would be appreciated.6/19/2004 11:20:35 PM
I'm sorry, but I'm no longer able to continue to answer all my email personally (and even this message may be very delayed). Online resources you might consider include...
...please also consider seeing a health care professional in person. If you already have, please contact him or her about these issues. If
you already have done that, too, you might consider obtaining a second opinion in person. Web sites do of course have their limitations. Good luck!
Bob
Posted by Tony C. on June 20, 2004, at 12:20:49
In reply to Miracles happen!, posted by amateur MD on June 20, 2004, at 11:40:43
"If it had not been for my strong faith in God and my belief that suicide is a grave spiritual mistake with serious consequences for our next life, I would not still be here."
I agree with you 200% - I was suicidal, and only craved death, but my belief in God, and me realizing from my belief in Him, and His Son I KNEW there would be consequences should I have killed myself, and I realized if I did, it was to late to say "OH NO !!!" Cause you can't comeback then it is to late. Of course I agree with Bob's belief, and mine. I do not want to seem preachy to people, I am just agreeing with the poster. Bob I am down 20% on my med, and doing pretty darn good I am THRILLED !!! I reccommend Meds. I do not know why we suffer horrible depression, and others don't, but we must remember Earth is NOT Heaven. Maybe those of us who suffer more, will eventually have a bigger reward, and be healed.
Sincerely - Tony C.
Posted by Maximus on June 20, 2004, at 16:18:26
In reply to Miracles happen!, posted by amateur MD on June 20, 2004, at 11:40:43
Hi,
I'm glad you're feeling better.
I'm suffering from hypothyroidism and my dx is bp II. Since i've added 7-Keto DHEA to my regimen, i'm not the same guy. I feel 100% better. 7-Keto DHEA increases T3 by 30% minimum and increases slightly the testosterone level.
That means:
* more energy
* better libido
* smaller dose of antidepressant needed
* ability to lose weightIt is a great stuff in my opinion.
Posted by Tony C. on June 20, 2004, at 18:29:45
In reply to Re: Consider 7-Keto DHEA seriously... » amateur MD, posted by Maximus on June 20, 2004, at 16:18:26
Hi again, I have always wondered if I have an underlying condition that caused my Severe Depression, and Extreme Anxiety. I really had ALOT of Symptoms of Hypo Thyroid my tsh was 5.9 stiff neck and shoulder muscles, hoarse voice, food intoloerances, stiffness everywhere you name it, slow thinking, SLOW heartbeat, anxiety etc. THEN I took Serzone, got better eventually, and then my TSH was 2.2 - I mean I asked my Doc if Serzone/Nefazodone was masking a hypo thyroid condition meaning was it making my Thyroid and Tsh look like 2.2 and I am worried as I gradually ease off my TSH will climb again. Please tell me some advice Amateur MD
Sincerely - Tony C.
Posted by amateur MD on June 20, 2004, at 20:45:08
In reply to Re: Consider 7-Keto DHEA seriously... » amateur MD, posted by Maximus on June 20, 2004, at 16:18:26
Hello Maximus, I actually do take a little DHEA although I've never heard of the 7-Keto variety. Do you have a brand name for me or an explanation for why it is better/different than plain old ordinary DHEA? Do you have any links or resources you could point me to re this 7-Keto stuff?
I'm now totally off both Zoloft and Effexor and not missing them at all! Good riddance!
Tony, sorry, but I pretty much put everything I know into that one long email. I found out enough to diagnose and cure myself, I'm not claiming to have advice or cure for anyone else! Although I have heard that depression alone can lower thyroid levels, although no one seems to know how that happens.
My next move is to look into Armour natural thyroid. With the cytomel there are too many ups and downs. I want to be nice and smoooooooth.
> Hi,
>
> I'm glad you're feeling better.
>
> I'm suffering from hypothyroidism and my dx is bp II. Since i've added 7-Keto DHEA to my regimen, i'm not the same guy. I feel 100% better. 7-Keto DHEA increases T3 by 30% minimum and increases slightly the testosterone level.
>
> That means:
>
> * more energy
> * better libido
> * smaller dose of antidepressant needed
> * ability to lose weight
>
> It is a great stuff in my opinion.
>
Posted by Maximus on June 21, 2004, at 14:40:42
In reply to Re: Consider 7-Keto DHEA seriously..., posted by amateur MD on June 20, 2004, at 20:45:08
> Hello Maximus, I actually do take a little DHEA although I've never heard of the 7-Keto variety. Do you have a brand name for me or an explanation for why it is better/different than plain old ordinary DHEA? Do you have any links or resources you could point me to re this 7-Keto stuff?
7-Keto DHEA is a metabolite of DHEA that will not convert into testosterone and estrogens. That means it provides most of the advantages of DHEA (such as a strengthened immune system, enhanced memory, protecting the heart, fighting off stress, etc.) without the safety concerns associated with increasing the sex hormones.
BTW, i'm taking the brand name NOW!
Here's some abstracts:
http://www.humaneticscorp.com/7keto/7ketoabstracts.html
Posted by Dr. Bob on June 22, 2004, at 16:17:24
In reply to Re: Consider 7-Keto DHEA seriously... » amateur MD, posted by Maximus on June 20, 2004, at 16:18:26
> I'm suffering from hypothyroidism and my dx is bp II. Since i've added 7-Keto DHEA to my regimen, i'm not the same guy...
Sorry to interrupt, but I'd like to redirect follow-ups regarding DHEA to Psycho-Babble Alternative. Here's a link:
http://www.dr-bob.org/babble/alter/20040613/msgs/359153.html
Thanks,
Bob
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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