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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by HMK on April 9, 2002, at 9:31:07
Is there a link between hypothyroidism and rapid cycling? I've posted my concerns here yesterday- I take Effexor, Geodon, Valium, and Neurontin to control my bipolar II. I have also been diagnosed in the past few months with hypothyroidism.
Well, I missed my last appointment to have my thyroid (TSH) levels checked and now I'm cycling like never before- I go 1 day normal, 2 days nervous/hyper, 1 day crying all day, repeat. I've never done this before and am not sure if its related to my TSH levels.
Am scared about this new pattern! Any imput would be appreciated.
Heather
Posted by Ritch on April 9, 2002, at 22:56:49
In reply to Rapid cycling and thyroid disorders, posted by HMK on April 9, 2002, at 9:31:07
> Is there a link between hypothyroidism and rapid cycling? I've posted my concerns here yesterday- I take Effexor, Geodon, Valium, and Neurontin to control my bipolar II. I have also been diagnosed in the past few months with hypothyroidism.
>
> Well, I missed my last appointment to have my thyroid (TSH) levels checked and now I'm cycling like never before- I go 1 day normal, 2 days nervous/hyper, 1 day crying all day, repeat. I've never done this before and am not sure if its related to my TSH levels.
>
> Am scared about this new pattern! Any imput would be appreciated.
> HeatherI would rather miss a therapy session than an endo appt. :-) Get your thyroid profile tests done-no excuse in missing those! There appears to be some positive correlation with adding thyroid hormone (T3, T3+T4) and a subsequent *reduction* of cycling. IOW, treating hypothyroidism might *reduce* cycling. I would still suggest getting the hypothyroidism "controlled" first, then see what happens to your cycling. If it gets better, consider bolstering your thyroid meds. If that doesn't help much then consider the mood stabilizer add-ons. Get the general medical condition stabilized first thing. Why take a bunch of extra medications if most or all of this is stemming from a hosed-up thyroid syndrome?
Mitch
Posted by noa on April 10, 2002, at 15:24:44
In reply to Re: Rapid cycling and thyroid disorders » HMK, posted by Ritch on April 9, 2002, at 22:56:49
I think probably yes, there is a connection.
Posted by HMK on April 11, 2002, at 10:53:27
In reply to Re: Rapid cycling and thyroid disorders » HMK, posted by Ritch on April 9, 2002, at 22:56:49
I got my TSH levels back and they were in the normal range- 3.98! Now I can't figure out why I'm on this roller coaster. Do individuals with depressive illness need to have different thyroid functioning levels than the general populace? I was so sure that my rapid cycling was due to my thyroid functioning!
Can't take trileptal (blurred vision so bad I couldn't drive, nausea), Depakote (weight gain), or lithium (hypothyroidism). What mood stabilizers are left besides Neurontin which I already take?
Posted by Ritch on April 11, 2002, at 15:17:27
In reply to Re: Rapid cycling and thyroid disorders » Ritch, posted by HMK on April 11, 2002, at 10:53:27
> I got my TSH levels back and they were in the normal range- 3.98! Now I can't figure out why I'm on this roller coaster. Do individuals with depressive illness need to have different thyroid functioning levels than the general populace? I was so sure that my rapid cycling was due to my thyroid functioning!
>
> Can't take trileptal (blurred vision so bad I couldn't drive, nausea), Depakote (weight gain), or lithium (hypothyroidism). What mood stabilizers are left besides Neurontin which I already take?That TSH level would be considered to be "sub-clinical hypothyroidism" by the endocrinology people nowadays. Anything above 2.0. I wouldn't say you are finished with the idea of thyroid augmentation unless you were down closer to 1.0 anyhow. Some folks have went lower than 1.0 with good results and minimal side effects (Noa-from what I remember).
There is still Lamictal which lots of people seem to like (I haven't tried that one myself). There's Topomax and Gabitril. Hey, they are worth a trial IMO. I had some bad cognitive sfx from TOP and tiagibine, but I have some fairly prominent ADHD symptoms. You didn't mention Tegretol-there's another one. Zonegran and Keppra are newer AED's that might be worth trying (I haven't tried those yet). Have you tried adding one some Klonopin? That settles down agitation significantly. Depakote has been the one to get my temper under control the best. Maybe if you could add a tiny dose of Depakote (125mg) and get some T4 added on (bringing your TSH down to about 1.0)-you wouldn't gain any extra weight?
hope this helps,
Mitch
Posted by noa on April 11, 2002, at 16:09:05
In reply to Re: Rapid cycling and thyroid disorders » Ritch, posted by HMK on April 11, 2002, at 10:53:27
> I got my TSH levels back and they were in the normal range- 3.98! Now I can't figure out why I'm on this roller coaster.
Please see info at the about.com thyroid page, or in the thyroid and depression folder at PBtips at yahoogroups. (link at top of Babble page)
There is new research that for many people the "normal" range is not really normal for them, and that any TSH over 2 is highly predictive of thyroid illness being diagnosed in the future, ie when more "obvious" signs emerge.
Remember that "normal" is a statistical norm, not necessarily the right level for a particular individual. The range is .5 to 5 or therabouts. When my TSH was over 3 I was a basket case. My endocrinologist set the thyroid med levels so that my TSH is below 1. He paid more attention to my symptoms than to the statistical norm. But too many doctors rely on the statistical norm without paying attention to the symptoms.
>Do individuals with depressive illness need to have different thyroid functioning levels than the general populace?
Good question. According to my endocrinologist's letter to my Primary Care doctor 2 years ago--YES.
Somewhere in the archives there is a post of mine with an excerpt from that letter.I really do recommend you see some of the resources. Two book suggestions, also, are Living Well with Hypothyroidism and The Thyroid Solution. There is a new one out but I don't know the title.
Posted by 2sense on April 14, 2002, at 8:48:57
In reply to Re: Rapid cycling and thyroid disorders » Ritch, posted by HMK on April 11, 2002, at 10:53:27
3.98 is not what I would (and a lot of actual hypothyroid endocrinologist specialists would call) a 'normal' TSH -- at least not according to endocrinologist who specialize in hypothyroidism -- between 1-2 is when one feels best. There is another site called: top thyroid docs (in the U.S. or something) -- here is the link: http://thyroid.about.com/library/weekly/bldoc-pa.htm
It is firstly a thyroid site and secondly lists all the states and thyroid doctors patients (there are boards there also) believe are top notch.
Second question for you: what has been your experience with Neurontin. I have just been diagnosed with a 90% chance of MS (I had optic neuritis 3 years ago, nothing on the MRI) then cold turkeyed Klonopin had a grand mal seizure and then an abnormal EEG and MRI showed tiny lesions (not even one 1/2 the size of a small regular MS lesion -- whatever that means) -- but the EEG found a predispostion to seizures (seizure focus in left temporal lobe) so the neurologist is putting me on Carbamapazine (Tegretal not the XR) -- which sounds deadly and I have an re-entry electrical heart problem so an electrophysiology study and cath ablation is in the very near future.
My friend in NY has epilepsy and is on Neurontin and says she has no side effects -- what is your take and do you know anything about the other anti-seizure med (not the Klonopin).
Thanks --
Sue
Posted by HMK on April 15, 2002, at 8:19:42
In reply to Re: Rapid cycling and thyroid disorders » HMK, posted by 2sense on April 14, 2002, at 8:48:57
My experience with Neurontin has been quite good. I have had literally no side effects from it even from the beginning. I take 400 mg. three times a day. I also take Effexor XR, Geodon, and Valium to control my bipolar II. I find the Effexor and Geodon to be quite activating so the Neurontin is used primarily just to calm me down. I've found it to be only moderately effective for controlling my mood cycles which I'm having trouble controlling lately.
Hope this info helps- let me know if you have any other questions.
Posted by 2sense on April 15, 2002, at 14:50:34
In reply to Re: Rapid cycling and thyroid disorders » 2sense, posted by HMK on April 15, 2002, at 8:19:42
Thank you for answering. Have you had weight gain and/or loss? What about the dreaded sexual side effects -- my friend swears she has none. I am on hold for the nth time with the nth doctor.
Thanks for the information.
Anticonvulsants as mood stabilizers seem to be the in thing (as is bi polar) please I am not saying it isn't real or that people truly have it because I know people who do and medications truly help them -- I am frustrated because of insurance restrctions and all doctors (like any profession) are not created equal (i.e., A students, versus C students, versus whatever -- okay now back to the taxes ... they are making me loopy :-))
Posted by HMK on April 15, 2002, at 14:56:18
In reply to Re: Rapid cycling and thyroid disorders, posted by 2sense on April 15, 2002, at 14:50:34
I have had some weight gain over the past year but doctor has told me that it was probably due to another medication I was taking (Risperdal). As for sexual side effects, the only thing I know is that I have absolutely no libido to speak of. This could be related to the thyroid disorder or the high prolactin levels I have due to my use of Geodon. Who knows- I just know that I don't have any sexual desire at all. Good luck to you!
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