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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by dreamboat_annie on February 14, 2007, at 11:13:34
So, I've been doing pretty good on 10mg - 15mg of Lexapro, with the exception of low energy and fatigue (both of which pre-dated Lexapro). About two years ago, following a physical illness that went untreated for a number of months, I went from the energizer bunny to constant fatigue. I have tried almost every supplement imaginable, and nothing helps. My pdoc gave me Ritalin, but it made my heart race, so I couldn't take it.
I have had my thyroid tested (including Free T4 and Free T3) and the results are normal, although my TSH has gone up, but not into the hypo range (I was always about .5, and I felt great at that level - full of energy, optimistic, confident - but now it is about 1.5).
I have read that augmenting with Cytomel can help the anergic side of things and can also enhance the effects of an SSRI, and was wondering what others thought about my broaching the possibility of a Cytomel trial with my pdoc. Has anyone had success augmenting with Cytomel (or Armour for that matter) where fatigue and low energy were problems?
Any advice or guidance would be much appreciated.
Thanks so much.
Posted by Phillipa on February 14, 2007, at 11:43:49
In reply to Would like some advice please, posted by dreamboat_annie on February 14, 2007, at 11:13:34
Since I'm having the thyroid problems myself I'm interested to see what others say. But the new norm is between l-2 for TSH. Have you thought of chronic fatigue? Love Phillipa
Posted by blueberry1 on February 14, 2007, at 20:35:41
In reply to Would like some advice please, posted by dreamboat_annie on February 14, 2007, at 11:13:34
Ask for a week's supply of provigil and try that. ??? At remedyfind.com and askapatient.com you'll find lots of people who like provigil for the antifatigue effect. With most people it doesn't have nearly the physical stimulation heart racing stuff of other stimulants, but boosts energy and wakefullness and often helps ssris work better too.
Posted by Jimmyboy on February 14, 2007, at 23:08:52
In reply to Would like some advice please, posted by dreamboat_annie on February 14, 2007, at 11:13:34
Have you considered that you may have CFS ( Chronic Fatigue Syndrome)? A big indicator of that is that it happens after an illness... The treatments for that overlap with depression ( depression is very common in CFS sufferers)...but CFS treatments can be differant than ones for straight up depression , like antiviral drugs, hormone therapy, improving your immune system, lifestyle changes, etc.
JB
Posted by dreamboat_annie on February 15, 2007, at 1:06:43
In reply to Re: Would like some advice please » dreamboat_annie, posted by Phillipa on February 14, 2007, at 11:43:49
Thanks, Phillipa. I have thought about chronic fatigue, but, with the exception of fatigue, I don't have the symptoms of cfs (no low-grade fever, no swollen lymph nodes, no headaches, no muscle pain . . .). I just got knocked down with the flu and it's taking me longer than I would have expected to recover. I am on antibiotics now for a lung infection, so maybe that's why I am feeling even more fatigued than usual. Who knows :-(
I hope you can get your thyroid problems resolved. Take care.
> Since I'm having the thyroid problems myself I'm interested to see what others say. But the new norm is between l-2 for TSH. Have you thought of chronic fatigue? Love Phillipa
Posted by dreamboat_annie on February 15, 2007, at 1:08:31
In reply to Re: Would like some advice please, posted by blueberry1 on February 14, 2007, at 20:35:41
Thanks so much, blueberry. I see my pdoc on Saturday, so I am going to raise provigil and the thyroid option with him.
> Ask for a week's supply of provigil and try that. ??? At remedyfind.com and askapatient.com you'll find lots of people who like provigil for the antifatigue effect. With most people it doesn't have nearly the physical stimulation heart racing stuff of other stimulants, but boosts energy and wakefullness and often helps ssris work better too.
Posted by dreamboat_annie on February 15, 2007, at 1:16:42
In reply to Re: Would like some advice please, posted by Jimmyboy on February 14, 2007, at 23:08:52
Thanks, Jimmyboy. I have seriously been considering CFS, although, with the exception of the fatigue, I don't fit profile (as I said in my response to Phillipa: no low-grade fever, no swollen or tender lymph nodes, no muscle aches or pains). My temperature, actually, runs on the low side (lately around 86.5 and sometimes lower) and I have low blood pressure, which is why I was leaning towards thyroid. Perhaps it's adrenal fatigue. I am just getting over the flu with upper respiratory infection and am on antibiotics, so perhaps that could explain the increased fatigue. It never used to take me this long to get over a respiratory infection (it's been almost two weeks!) and, it's the first one I have had in about 7 years :-(
Well, I am increasing my intake of Vitamin C and will add some extra B-5 and B-1 and then see what else can help with adrenal fatigue and/or possible CFS.
Thanks again. Take care.
> Have you considered that you may have CFS ( Chronic Fatigue Syndrome)? A big indicator of that is that it happens after an illness... The treatments for that overlap with depression ( depression is very common in CFS sufferers)...but CFS treatments can be differant than ones for straight up depression , like antiviral drugs, hormone therapy, improving your immune system, lifestyle changes, etc.
>
>
> JB
>
>
Posted by Phillipa on February 15, 2007, at 18:34:52
In reply to Re: Would like some advice please » Jimmyboy, posted by dreamboat_annie on February 15, 2007, at 1:16:42
Annie ask you doc to add an ANA to any blood drawn. It will show if you have an autoimmune disease and hasimotos thyroiditis is autoimmune. I even lost my sense of taste and smell and found out that is autoimmune too. I also think CFS may be too not sure on that one. But there are hundreds of autoimmune diseases . Love Phillipa I tend to lean toward the thyroid too with the low temp and mine started with being sick very sick.
Posted by KayeBaby on February 18, 2007, at 2:00:59
In reply to Re: Would like some advice please » Jimmyboy, posted by dreamboat_annie on February 15, 2007, at 1:16:42
I would definately follow up on the thyroid and adrenals (can you get your cortisol levels tested?) You might be having trouble bouncing back in regards to these glands.
If you know that you feel best at a certain TSH level and it is higher than that now a trial of cytomel or armour wouldn't be outrageous to request. CFS can very well be secondary to adrenal or thyroid trouble.
A short trial of thyroid hormone is safe if you watch your pulse and don't have any conditions that might contraindicate it.
I'd try that before taking other meds that may just mask the problem and allow it to possibly worsen.
This is my understanding and experience.
Take Care,
Kaye
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