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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Maxime on February 12, 2004, at 11:42:09
From bipolar disease to depression and psychosis, your thyroid can be the problem. Social anxiety .... thyroid.
Just a friendly reminder from someone who is going through thyroid hell to make sure your pdoc or whoever is treating you TESTS your thyroid before you start any psych meds.
There is a link at the top of this page about thyroid and depression. Be sure to check it out.
maxime
Posted by cupcake on February 12, 2004, at 23:38:16
In reply to Reminder - Check that thyroid, posted by Maxime on February 12, 2004, at 11:42:09
Yessssiree!! I am going through that myself. Even if you're already being treated, you may need to have your dosage adjusted. This is what happened with me...I just spent a whole year practically trying to figure out why I continued to feel so foggy and down and confused and forgetful and moody, despite increased levels of meds... I ended up having to be really insistent with doctors about getting my thyroid levels checked and re-checked. It turned out they were still low, I've had to have my Syntroid increased twice.
Anyway, thanks for the reminder!
Posted by noa on February 13, 2004, at 8:45:56
In reply to Re: Reminder - Check that thyroid, posted by cupcake on February 12, 2004, at 23:38:16
Yes, me too. Max, thanks for the reminder to all.
I first was treated for "subclinical" hypothyroidism by my former pdoc. The primary care doc would not have picked up on the thyroid problem at all based on the test results. But the pdoc was up on his lit about subclinical hypothyroidism and atypical depression, etc. He put me on cytomel at first, and then later added syntrhoid when my thyroid and depression got worse.
A couple of years passed and although the thyroid meds helped, I was still struggling with worsening episodes of recurrent major depression. It took a crisis--rapidly worsening depression simultaneous with worsening thyroid due to lithium for me to suddenly put two and two together. Because I kept having depressive recurrences, my pdoc started to hypothesize that I might have an illness in the bipolar family and because there was support for the idea that lithium could help boost the AD effects of my other meds, I tried lithium. I had 6 weeks of significant improvement followed by a sudden worsening of depressive symptoms. Pdoc had my thyroid checked again and it had gotten worse. That is when I decided to stop the lithium and go after the thyroid issue becuase it just seemed to be a clear connection to me.
I looked for info, and as it happened, this was a few weeks before Mary Shomon's book "Living Well With Hypothyroidism" came out. I found the reference to its upcoming release on the web and then started looking up more info. When the book came out, I read that cover to cover in a day and felt very validated. I found an amazing endocrinologist via Mary Shomon's web site www.thyroid-info.com.
The endo diagnosed primry hypothryoidism and explained that some patients with hypothyroidism and depression need to have it treated more aggressively than was the generally accepted approach. He went by symptoms, not just numbers. He had me gradually increase my synthroid dose until I did not notice any more symptom improvement and stop there. When I got to this point, my TSH was 0.3. He then wrote a long letter to my primary doctor to explain the approach, including to say that contrary to the conventional wisdom, having a low TSH in itself does not put the patient at risk for osteoporosis--it is hyperthyroid symptoms that do. That as long as I monitor my symptoms, and get my levels checked periodically, I'd be fine.
This made a huge difference in my recovery from depression. Finally, I started seeing improvemenet and better response to my medicatoins. The other hypothyroid symptoms also started improving---aside from the depression, cloudy headedness, fatigue, etc....there was extreme weakness, muscle pain, edema, etc.
So cupcake's comment about undertreatment is a good one--it was true for me and apparently happens a lot.
Posted by cupcake on February 13, 2004, at 14:17:16
In reply to Re: Reminder - Check that thyroid, posted by noa on February 13, 2004, at 8:45:56
noa -
i am so envious of your positive experience with the endocrinologist. i have an appointment with a new one coming up, and supposedly her practice is very focused on thyroid patients, so hopefully she'll be up on all the newer treatments and approaches.
the last (and only other) endo i went to, when i went complaining of all the typical hypo symptoms including abnormal weight gain, foggy thinking, lethargy, forgetfulness, thinning hair, etc., told me i should go focus on losing some weight, prescribed me glucophage without doing any lab work because he thought i had symptoms of PCOS, and told me to ask my psychiatrist what she did to stay in shape "because she always seems to look good."
on the second visit he finally did some blood work. when i inquired about whether i might respond better to another thyroid med besides synthroid, he told me to stop wasting my time "extrapolating about different medicines" and treatments and just focus on losing weight and lifestyle changes.
then of course, the next day he called to say that my blood work actually did reveal that my TSH was still high. ha, ha, HA, HA!!
i have a strong belief in lifestyle changes, healthy eating, and exercise as the best methods for maintaining good health, but i'm sick of hurried, absentminded doctors pegging me as a fat chick who just needs to go to the gym. i've been chubby basically my whole life, and i know that being fat does NOT cause hair loss, cracked skin, chronic depression, and memory loss!!!
i can't wait to find a doctor who will trust me to know the difference between fat and hypo!
sorry, i just had to vent a bit. :)
> Yes, me too. Max, thanks for the reminder to all.
>
> I first was treated for "subclinical" hypothyroidism by my former pdoc. The primary care doc would not have picked up on the thyroid problem at all based on the test results. But the pdoc was up on his lit about subclinical hypothyroidism and atypical depression, etc. He put me on cytomel at first, and then later added syntrhoid when my thyroid and depression got worse.
>
> A couple of years passed and although the thyroid meds helped, I was still struggling with worsening episodes of recurrent major depression. It took a crisis--rapidly worsening depression simultaneous with worsening thyroid due to lithium for me to suddenly put two and two together. Because I kept having depressive recurrences, my pdoc started to hypothesize that I might have an illness in the bipolar family and because there was support for the idea that lithium could help boost the AD effects of my other meds, I tried lithium. I had 6 weeks of significant improvement followed by a sudden worsening of depressive symptoms. Pdoc had my thyroid checked again and it had gotten worse. That is when I decided to stop the lithium and go after the thyroid issue becuase it just seemed to be a clear connection to me.
>
> I looked for info, and as it happened, this was a few weeks before Mary Shomon's book "Living Well With Hypothyroidism" came out. I found the reference to its upcoming release on the web and then started looking up more info. When the book came out, I read that cover to cover in a day and felt very validated. I found an amazing endocrinologist via Mary Shomon's web site www.thyroid-info.com.
>
> The endo diagnosed primry hypothryoidism and explained that some patients with hypothyroidism and depression need to have it treated more aggressively than was the generally accepted approach. He went by symptoms, not just numbers. He had me gradually increase my synthroid dose until I did not notice any more symptom improvement and stop there. When I got to this point, my TSH was 0.3. He then wrote a long letter to my primary doctor to explain the approach, including to say that contrary to the conventional wisdom, having a low TSH in itself does not put the patient at risk for osteoporosis--it is hyperthyroid symptoms that do. That as long as I monitor my symptoms, and get my levels checked periodically, I'd be fine.
>
> This made a huge difference in my recovery from depression. Finally, I started seeing improvemenet and better response to my medicatoins. The other hypothyroid symptoms also started improving---aside from the depression, cloudy headedness, fatigue, etc....there was extreme weakness, muscle pain, edema, etc.
>
> So cupcake's comment about undertreatment is a good one--it was true for me and apparently happens a lot.
Posted by noa on February 13, 2004, at 14:36:35
In reply to Re: Reminder - Check that thyroid, posted by cupcake on February 13, 2004, at 14:17:16
UGH. Sounds like an awful experience.
I loved my endo. He spent a lot of time, unrushed, with me during each visit. He asked a lot of questions, examined me, took blood for testing, and answered all my questions thoughtfully. Then he took the time to write a long letter to my primary doctor about my condition.
He did end up prescribing glucophage as well, but only after testing--glucose tolerance test. He had a hunch about insulin resistance in the first exam and had me tested. BTW, he also had some other hunches about genetic disorders related to some of the PCOS-like symptoms and had me tested for these, as well. The other genetic endocrine disorders came up negative. PCOS was inconclusive but insulin resistance was positive.
Check out Mary Shomon's site www.thyroid-info where she has a page that has doctor recommendations from other readers. That's how I found my endo.
Posted by Gothmog on February 14, 2004, at 0:01:04
In reply to Reminder - Check that thyroid, posted by Maxime on February 12, 2004, at 11:42:09
The thing about thyroid problems and depression/bipolar is which came first, the chicken or the egg? I have been diagnosed as hypothyroid at the age of 38 at the same time as depression and anxiety, but while I can't say for sure when my thyroid became abnormal I remember fairly vividly when I started falling apart mentally. I was about 13. I hit the awkward age and never recovered from it. Was I hypothyroid then? A good question, but probably not. It would be nice to blame everything on my thyroid, and if taking Synthroid alone would make everything change, I would be thrilled. There are lots of studies linking thyroid problems with depression and bipolar disorder, but like most of the other physical markers that go along with mental illness, it isn't perfectly clear what the connection is. It may be that depression causes thyroid problems, and that isn't just my personal pet theory. I have heard it suggested before by those with the proper credentials. It may not be as unlikely as it sounds if you think about it. Anxiety resembles the hyperthyroid condition. If it lasts too long, maybe the body reacts by producing thyroid antibodies, because it is tricked into thinking the thyroid is enlarged or cancerous.
Posted by noa on February 14, 2004, at 16:06:53
In reply to Re: Reminder - Check that thyroid, posted by Gothmog on February 14, 2004, at 0:01:04
Yes, there seem to still be a lot of unanswered questions about all of this. And I've heard the question asked as to whether depression, like thyroid disease, might be an autoimmune disorder itself.
For me, there seems to be a kind of synergy between the depression, the hypothyroidism, and some reproductive issues, as well. And with the treatments. I didn't start responding sufficiently to antidepressants until my thyroid was treated adequately. It made a huge difference, but it's not like I can just drop the ADs now. I seem to need both ongoing.
BTW, with your depression onset at puberty, and thyroid illness, have you been checked out for other endocrine disorders?
Posted by Gothmog on February 15, 2004, at 4:45:11
In reply to Re: Reminder - Check that thyroid, posted by noa on February 14, 2004, at 16:06:53
> Yes, there seem to still be a lot of unanswered questions about all of this. And I've heard the question asked as to whether depression, like thyroid disease, might be an autoimmune disorder itself.
>
> For me, there seems to be a kind of synergy between the depression, the hypothyroidism, and some reproductive issues, as well. And with the treatments. I didn't start responding sufficiently to antidepressants until my thyroid was treated adequately. It made a huge difference, but it's not like I can just drop the ADs now. I seem to need both ongoing.
>
> BTW, with your depression onset at puberty, and thyroid illness, have you been checked out for other endocrine disorders?Depression an autoimmune disease? Interesting theory. I've heard that said about schizophrenia. I don't think I have had any tests done besides what is normally included in a check-up. I asked my family doc if there were any others I should have and he didn't think any more were necessary. Of course I should arrange to have more done.
This is the end of the thread.
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