Good appointment with new psychiatrist. He did not make any changes pending his reviewing C/T scan from last fall, review of thyroid labs, lithium level check, and EEG. We liked him - He and his physician assistant spent 2.5 hours talking to us.
Also, seems we have a winner with the ob/gyn that we are working with on the thyroid/hormone side. Daughter was in hospital the last full week of October with destabilized mood - ob/gyn called me to check on her and evaluate the role the thyroid medication may have had in that. He was so upset to think he may have caused it (he didn't - other factors in play).
Got gp to give us an order for some additional testing too:
folate - 17.3 (>4.5)
B12 - 820 (200-900)
ferritin - 38.1 (20-324)
lithium - 0.4 trough (0.5-1.5 therapeutic range)
Lithium is low. She had been riding right at the low end of the range when tested 1 and 2 weeks after starting the medication. That would be a definite contributor to her recent complete lack of appetite. We also believe that the lithium has sent her eczema into an absolute tizzy (based on timing...).
Looks to me like the folate and ferritin aren't quite where they need to be.
Note that she started Armour thyroid 30mg on October 18 and vitamin D3 5000IU/day on October 15. Thyroid panel scheduled for first week of December (that is just over 6 weeks after starting thyroid med), but no retest on vitamin D3 scheduled yet. Checking D3 again at first of December would be about 6-7 weeks which doesn't seem like quite long enough.
I saw in her test history in her online portal that there were limited thyroid tests run in November of 2015 (along with CBC/Comprehensive panel/mono screen - all normal):
TSH - 2.89 (.3-3.8)
fT4 - 1.06 (.8-1.8)
Called the gp we were with at that time because I didn't have notes about why we did those tests...and I just couldn't remember. Doc's notes indicate that she was sleeping 12-14 hours a day, not eating, and extremely fatigued. It obviously resolved some time following that because there was not follow up testing or appointment.
Using Creighton fertility monitoring and basal body temps to identify timing of hormone tests for estradiol/progesterone. I didn't know she was having heavy cervical mucus her entire cycle - would soak a medium flow menstrual pad each day. (Can be related to a hormonal imbalance or thyroid dysfunction.) Also low basal body temps in first half of cycle (96.7-97.1) - possibly indicative of thyroid dysfunction. Yesterday we did first draw in a series to evaluate the estradiol/progesterone levels. Anyone know much about those kind of tests and the results thereof?