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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by MM on December 23, 2004, at 5:00:15
I don't know if this is the right board to post this at, but I am seriously distressed that my weight is affected by my meds to the degree that it is, but I'm not sure which med or combination is doing it. It doesn't seem like pdoc cares. It doesn't seem like he believes me that it has something to do with the meds. It doesn't seem like he wants to work with my other doc (because I'm on synthroid/have low thyroid...suspect it might be because of meds...) in figuring out the best solutions for me. It also doesn't seem like he wants to listen to me when I say I don't like certain meds (when there are alternatives that are viable even).....In fact I don't even know how he chooses the meds he does because he asks me the same, simple, superficial questions each time and I could say "iunno" to all of them and he'd still switch my meds. It doesn't seem like he wants to get me up to the optimal functioning or the best/easiest/least side effects combination (where I feel good, not using the most meds possible........) I feel like my other doc doesn't want to help me either, but I guess that's not what this board is here for (to complain about that too). I already feel helpless and hopeless and when the people I go to for help don't listen it's soooo demoralizing. Sorry for ranting.....anyone have the same experiences? How do you or did you deal with them?
Thanks for reading.
Meg.
Posted by Sebastian on December 23, 2004, at 9:19:01
In reply to Pdoc doesn't want to solve the mystery.., posted by MM on December 23, 2004, at 5:00:15
Unresolved anger. The doc is trying to help. No meds are side-effect free. He's probably just happy you have a bunch of meds that work, doesn't want to loss that. Later the doctors listen more. They pick up stuff from anything, motions, talk. I would not even talk at all for the first 2 years with doctors. Your mental well being is more valuable that side-effects right now. Eventualy you just give up and take the meds. You will see a bad difference when you don't. What meds do you take?
Posted by Racer on December 23, 2004, at 13:11:58
In reply to Pdoc doesn't want to solve the mystery.., posted by MM on December 23, 2004, at 5:00:15
> I already feel helpless and hopeless and when the people I go to for help don't listen it's soooo demoralizing. Sorry for ranting.....anyone have the same experiences? How do you or did you deal with them?
>
> Thanks for reading.
> Meg.Ah, yes. That's a time honored tradition in medicine, you know -- not listening to the patient and denying side effects. Especially in psychoactive medications, since the people taking them are, by definition, mentally ill. Oh, and being female really increases the use of this methodology. You really should have planned that better. :-P
I've been told that my weight gain had nothing to do with the medications and that I really needed to get my eating under control to lose weight, because I was too fat. Thanks, Doc -- really appreciate the support. I've also been told that I should just continue taking meds as prescribed, no matter what the side effects. Hell, one doctor tried to prescribe three other medications to try to counter the side effects of the one AD she had prescribed which wasn't working in the first place!
You know that abbreviation on our charts, "WNL"? They say it means "Within Normal Limits"? Wrong, it really means "We Never Looked"!
How do I recommend dealing with it? Fire your doctor. Find a doctor who actually listens to patients -- believe it or not, that's in the official guidelines of the American Psychiatric Association. Listening to the patient and treating patients with respect.
If you can't fire your doctor, I guess I'd say try to talk to your doctor more assertively. Yeah, I know, it's so hard it's damned near impossible. But there are things you can do to improve the chances that you'll actually be heard -- even without having an Ear-Nose-And-Throat guy go in and check his hearing!
First, do a little homework on meds and side effects. There are a lot of resources online for that. Make a list of the side effects you can handle, and those that you're most averse to. For me, I cannot tolerate lowered blood pressure and weight gain, but I can handle a little anxiety or slight sedation. Make another list of all the meds you've tried, how effective they've been, and what side effects you had. And then keep a food and exercise journal for a week or two before your next appointment. Write down the time you ate, what you ate, and in what amounts, as well as any exercise, including walking from here to there, or doing heavier housework. Walk in there and say, "OK, I really can't handle this weight gain, and I need help with it. Either it's the meds, or it isn't, but I need you to help me with it. Here's what I've eaten, and what I've done, can you help me figure out what I can do if it's not the meds, or help choose a med that won't result in this weight gain if it is?" Something like that.
By the way, a lot of doctors just plain don't keep up with the literature, so your doctor may really and truly NOT KNOW that the meds he prescribes every day cause weight gain. He may not be trying to gaslight you about this.
What are you taking, by the way? Most ADs do seem to cause weight gain for a large number of people taking them, but there are some that are notorious for weight gain, and some that are less likely to cause it.
Best luck, whatever happens.
Posted by iris2 on December 23, 2004, at 15:07:16
In reply to Re: Pdoc doesn't want to solve the mystery.. » MM, posted by Racer on December 23, 2004, at 13:11:58
Thanks for the post. I am having this dificulty with both my endocrinologist and my family. In the past pdocs have notoriously treated me this way. I appreciate what you have written it validates my experience and has decreased my personal anxiety about the weight increase I have had from medication.
irene
Posted by MM on December 23, 2004, at 16:29:59
In reply to Re: Pdoc doesn't want to solve the mystery.. » MM, posted by Racer on December 23, 2004, at 13:11:58
I am on Trileptal (900 mg), Wellbutrin (50 mg, Buproprion), Lexapro (5 mg, although I'm calling my doc today to get off of it), Clonazepam (.5 mg, Klonopin), and Synthroid (50 mcg). I understand I'm gonna have to be on meds (BPII diagnosis) for the rest of my life, but I want to find the meds with the least side effects for me, or if weight is gonna be a side effect, that's a med I reconsider. Weight issues make me really depressed, and that's totally counterproductive. I will try your suggestion about the diary Racer, thank you (and thanks for understanding, although I'm sorry that you have to go through this stuff, too). Thanks.
Meg.
Posted by MM on December 23, 2004, at 16:31:17
In reply to Re: Pdoc doesn't want to solve the mystery.., posted by iris2 on December 23, 2004, at 15:07:16
Well, I'm glad my post helped you :). I'm sorry that you're having the same difficulties though.
Posted by Sebastian on December 23, 2004, at 17:03:06
In reply to Sebastian and Racer, posted by MM on December 23, 2004, at 16:29:59
I don't think any of those meds have weight gain side-effects. Wellbutrin usualy helps you lose weight. If you do a seach for the medicine, find the official web site and click on prescribing information. They list every thing. I also doubt they affect thyroid. Both my parents and both my brothers have thyroid, but I don't, I'm the only one taking this type of medicine for 8 years now.
Posted by MM on December 23, 2004, at 17:13:11
In reply to Re: Sebastian and Racer, posted by Sebastian on December 23, 2004, at 17:03:06
TY Sebastian. I'm not sure if it's any of the meds I take now that have affected my Thyroid...I've been on quite a few other ones and it's just I never had the problems associated with low thyroid until I was on the meds. Wellbutrin has never caused me a problem as far as weight, and none of the other ones did....but now I'm overweight and I don't know why (I cut out 600 calories a day about 3 months ago and haven't lost a lb). I'm not even sure it's meds (it could be some other problem; have been researching). I just wish someone would want to help me figure it out as I don'thave the same expertise and access that the docs do. Thanks again.
Posted by KikiCabell on December 24, 2004, at 9:25:48
In reply to Re: Sebastian and Racer » Sebastian, posted by MM on December 23, 2004, at 17:13:11
Meg:
I'm not totally familiar with all of your meds but Lexapro and the benzo can definitely cause weight gain. I have to take a Thyroid med, too, because of Lithium. Do you know if any of your meds have low thyroid associated with it? It's that if it is a med, which certainly sounds possible, I would think that your pdoc should prescribe something for it. Having to deal with multiple Dr.'s is tough. I know - my neurologist prescribes my anti-seizure med (it was probably the Wellbutrin that caused the seizures but I was taking 400 mg) and my pdoc everything else, including a stomach med.
Anyway, I wanted to empathize because I am the heaviest I've ever been and one can really beat up on oneself for the weight gain when it really is the meds. I have been told by my pdoc that some most likely actually change your metabolism! So don't beat up on yourself. A med change may take care of it.
- Kiki
> TY Sebastian. I'm not sure if it's any of the meds I take now that have affected my Thyroid...I've been on quite a few other ones and it's just I never had the problems associated with low thyroid until I was on the meds. Wellbutrin has never caused me a problem as far as weight, and none of the other ones did....but now I'm overweight and I don't know why (I cut out 600 calories a day about 3 months ago and haven't lost a lb). I'm not even sure it's meds (it could be some other problem; have been researching). I just wish someone would want to help me figure it out as I don'thave the same expertise and access that the docs do. Thanks again.
Posted by Racer on December 24, 2004, at 10:41:31
In reply to Weight Gain and Meds » MM, posted by KikiCabell on December 24, 2004, at 9:25:48
Most of the SSRIs can cause weight gain, so the Lexapro might be the culprit. Benzos also cause weight gain, so that might also be involved.
Here's a little from my own situation for you, regarding beating yourself up about the weight gain:
On nortriptyline, I gained about 70 pounds. The doctor told me it was my eating habits, of course. That was devastating.
On Paxil, I gained more than 50 pounds before I stopped getting on the scales. Again, it was devastating, and I hated myself.
On a combination of Effexor and Prozac, I gained around 50 pounds again -- didn't get on the scale after gaining about 45. Hated myself, miserable.
I'm currently in treatment not only for depression, but also for anorexia nervosa. You can bet weight gain is important for me, right? I have no idea what sort of body I have, whether I'm a fat person who becomes thinner -- as I always believe -- or a thin person who varies, or a normal sized person. I don't know, because I've never had a period during my adult life when I was not either fat from medications or thin from anorexia. And I blame myself for being fat, of course. It's terrible. My therapist pointed out that, if the meds caused me to gain weight, it was silly to blame myself. I can't get that into my head yet, but it seems like something for you to keep in mind when you're ready to beat yourself up about weight gain. If the meds are what's doing it, that's chemicals in your body changing things -- NOT you getting fat on your own.
I don't know if that helps any, but I hope it does ease the pressure you're feeling.
Meanwhile, good luck with the doctor.
Posted by Sebastian on December 24, 2004, at 20:37:09
In reply to Re: Sebastian and Racer » Sebastian, posted by MM on December 23, 2004, at 17:13:11
You didn't stop getting as much exercise, did you? Thyroid problems definitly effect your weight gain. Ok, when you take enough thyroid medicine, you burn the right number of calories. When you don't take enough medicine, you put on weight and don't burn the calories, and have no energy. That may be the problem.
Posted by MM on December 24, 2004, at 23:47:38
In reply to Re: Thyroid problems??, posted by Sebastian on December 24, 2004, at 20:37:09
Thank you again, Sebastian. I'm thinking the same thing (that it's my thyroid) after doing some more reading. I had my thyroid tested a couple months ago (after gaining) and it was normal, but this is a different doctor and I guess the other doctor I had put me on synthroid even though I was normal because I was in the low-normal range. I'm going to see my doctor again and ask what exactly my scores were etc. She ran a full blood workup on me, so it's not hypoglycemia or anything, and I guess since my thyroid is already low it could be reasonable that it would get lower? I'll have to read up more on that. Oh, and I am getting exercise, more the past few months. I jog a mile or two (sometimes 3) like 3-4 times a week, and do some strength training as well. My metabolism is usually pretty stable....I could go for a long time without exercising and as long as I don't really over do it with "bad" food then I won't gain, or if I do it's not much, just a couple lbs. When I was on Paxil and Depakote though I gained 50 lbs in 2 months, so it was fairly straightforward, and I got off the meds and the lbs flew off. I had been running 2 miles a day and cut out all sugar etc. and still nothing until I got off the meds, so maybe that makes me a little biased, but I have tried changing all my "bad" behaviors and have not lost one pound. So I'm thinking it's my Thyroid or PCOS (I have a few other symptoms of low thyroid as well as the weight gain, but it can look like PCOS too). Maybe I need to find a general doc who is more familiar with Bipolar and can work with me with the meds or maybe I need to find a different Pdoc. Anyway, I'm done rambling now, sorry; didn't mean for it to be so long. And thanks for your help.
Meg
Posted by MM on December 25, 2004, at 0:07:10
In reply to Re: Weight Gain and Meds, posted by Racer on December 24, 2004, at 10:41:31
Thanks Racer. I do get really frustrated with myself and feel like there must be something I can do to lose weight but I'm just not trying hard enough or doing the right thing. It's a very hard thing for me to accept, and has been really bad for my depression. I think, I'm 21; I should be able to wear shorts in public if it's hot, or some cute clothes sometimes. I already feel like a lepper most of the time because my life is, well not what I thought it would be and I'm not what I thought I would be, at all, because of my illness, so you add the weight gain and it's, well, not good for self esteem, and detrimental to trying to get back to "normal". I didn't get to enjoy my teens (as having this has been limiting my functioning since I was 14-15...well before that in some ways, but not as bad) so I feel cheated in a lot of ways. Being a girl, my body is automatically a part of my focus, because womens' bodies are focused on all the time and feeling "ruined" so young does make me bitter; I gained 50 lbs in 2 months when I was 17 due to meds, and that's not good for your body to gain weight so quickly. Anyway, I'm sure you know how those things go, and it's something I have to accept I guess. I don't mean to sound so sorry for myself, I know it's a common thing to gain weight with meds, but it sucks, don't it?
Posted by banga on December 25, 2004, at 16:08:47
In reply to Re: Weight Gain and Meds » Racer, posted by MM on December 25, 2004, at 0:07:10
A others said, both meds and hypothyroidism can cause weight gain. None of the meds you listed are notorious for weight gain, but each of us is different so you never know. But for sure, weight gain is a central sign of hypothyroidism. Two people close to me could not shed pounds despite eating correctly and exersise etc, and found out they had low thyroid levels. I have understood that the tests used to measure thyroid levels are not very reliable--
I just started a new med, nortryptiline, and I swear I have gained 5 pounds in 5 days. I am not kidding; I plan to find an official scale to record it so my pdoc can see. Not that she doesnt take it seriously, but just so she can see it is a big and immediate problem.
Obviously this weight gain is probably in part water gain. But it is really upsetting. If I keep on this med and keep gaining, what will be the result??
And I dont think it is vain to worry about weight gain--it can affect self-image, health, hell even expenses (the fitness club, exersise equipment, diet programs, new clothes each time you change a size).
Posted by MM on December 25, 2004, at 19:32:55
In reply to Re: Weight Gain and Meds, posted by banga on December 25, 2004, at 16:08:47
I was doing some reading last night on Bipolarworld.com and apparently Trileptal increases liver enzymes that metabolize estrogen, so it ends up decreasing estrogen, which causes or can cause PCOS...which looks a lot like what's been going on. Also, the liver enzymes metabolize medication, so any medication that you take will be metabolized faster than it's meant to be, so my Synthroid might not be as effective. I don't know what all that means as far as what I should do about it (switch Trileptal? to what? more synthroid etc.), but at least I THINK I have a reason for what's going on. Thanks so much for your posts.
Meg
This is the end of the thread.
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