Has anyone else experienced anything like this before,
After a long awaited appointment with a consultant in General Medicine, I have come out with a prescription for Fluoxetine. Consultation lasted an hour and covered all aspects of health problems, and my life in general. He agreed my GP had done all possible to find correct levels of B12 and Levothyroxine and thought problem is likely to be with what he called "the cousins" of B12 or thyroid hormone, half way through the consultation he said he was 20% sure he knew what the answer was, At the end of the consultation he said he was 50% sure that it was an imbalance in a nerve transmitter in the brain, and gave me a prescription for Fluoxetine Oral Solution, which he said was an ingredient in a common anti-depressant, but could be used for other purposes, he also ordered a lot of blood tests to do with B12 and Thyroid levels which my GP was not able to do.
On looking at Google this is the main ingredient of Prozac, I have to take 1ml daily for a week, then 2 mls daily for a week, then 3mls daily for a week, 4mls daily for a week, up to 5mls daily for a week, At which I need to see GP to assess any changes. 5 mls ( 5mls of solution is 20 mg of fluoxetine) daily is the starting dose for Prozac for depression. What is concerning me now is whether he is seeing my symptoms as depression and not related to the B12 deficiency. I had not really considered my mental state as a problem, but reading up on depression and Prozac I am now questioning myself as to whether I am suffering from some sort of depression.
I now have an appointment in 3 weeks time with a neurologist concerning numb toes and tingling fingers, wonder what answers that will throw up.
Written by
scadman
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You do not have to take the prescribed medication. I would ensure you are correctly treated for the thyroid - how are your levels ? Do you have any recent test results with ranges ? Do you have Hashimotos ? Low T3 - the active thyroid hormone is often low in patients but rarely tested. You may be taking a good dose of T4 medication but is it converting into T3 ? T3 is needed in every cell of your body - trillions and trillions. So if the T3 level is low in the blood there is not enough to go around. The brain has first call - then the gut !
As your B12 is low I am presuming you have had Ferritin and VitD tested too. You need good levels for the the T4 to convert into T3.
I would question your treatments rather than question your state of mind
PS - Fluoride - as in Prozac - was used to suppress the thyroid in days gone by. Of course there are many types of fluoride .....
Fluoxetine is an SSRI which means that it works by affecting the way your brain processes serotonin - one particular neuro-transmitter.
The problem with the definition of depression is that it focuses on some physical characteristics that could actually be caused by a number of other conditions, including B12 and thyroid. It doesn't sound as if you are really depressed or suffering from anxiety - just that you have the physical symptoms that go with it.
B12 is used in the processes that reset neurotransmitters and some people, myself included, do find that we need higher levels of B12 for this process to run properly - I had decades of depression that got worse when I was started on B12 and then disappeared completely when I finally got the levels of B12 I needed. One thing I noticed when I was B12 deficient was that my reactions were a lot slower and it was an effort to get moving and also an effort to stop moving.
I was on fluoxetine for a while - it helped with anxiety about other people's driving - but that was it. However, people vary a lot in how they respond to SSRIs
Unfortunately SSRI's can deplete folate in some people - which will make anxiety and depression worse.
I think the doctor would have told you if he thought it really was depression. He is looking at a neurotransmitter. It can't really do any harm - you will be building up doses gradually - there can be side effects for some people so if you have any concerns don't wait until the dose has built up completely - go and see your GP.
Thanks for your reply, I was doing OK until 12 months ago, when I had surgery, I was not aware that have a general anaesthesia would affect B12 levels. I was told to continue with normal jabs (every 12 weeks) and it would be OK. But I have had no energy since then, fall asleep 2-3 times in the day, have had increasing memory problems, and developed painful joints. according to my partner I have also become irritable and argumentative . Blood tests by GP showed B12 and thyroid levels were normal, she did increase B12 to every 10 weeks, and increased levothyroxine dosage, this made little difference, hence the referral. The doctor did say the fluoxetine works on the brain to help utilise the B12 and Thyroid medication efficiently. He didn't say he thought I was depressed, but some of the questions he asked seemed to point that way. I don't think I have ever had a doctor consultation that lasted an hour before.
I think I will take the medication, at least until I get the blood test results, apparently there are different tests he ordered that only apply if you are already on B12 and Thyroid medication that GP's can't request.
will be good to see what comes out of the blood tests.
Personally I would have thought that it would have been more sensible to repeat loading doses if someone with B12 absorption problem has had nitrous oxide - this doesn't remove B12 from your blood but it does change the B12 in your blood into a form that your cells can't actually use - difficult one as you need to be sure that this also gets flushed out of the system and I'm not sure how you would do that ... loading doses might help with that as the body will be dumping lots of excess B12 quickly but the biochemistry at this point is a bit beyond me.
The above link takes you to a Research Paper indicating how the conversion of T4 into T3 is contributing to low mood ....
I read the Opening paragraph and then jump to conclusion if you find it hard going - as I do
Hence the importance of the T3 testing that is rarely done. So I would check out your FT3 levels BEFORE starting any anti-depressants - which could skew further thyroid results ....
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