Meds for depression

[Coachgeorge]

Wondering how many folks take medication for depression in addition to thyroid meds. I’m in range with my latest draw and all vitamins are good. I’m still symptomatic. It’s been suggested that it may be depression as I’ve been ill for quite sometime. Would appreciate comments to help me with my decision. Thank you

[SeasideSusie Remembering]

I’m in range with my latest draw

In range doesn't mean that you are optimally medicated.

What are your current results, with reference ranges?

When on Levo only, most people feel best when TSH is 1 or below and FT4/FT3 in the upper part of their ranges.

[Coachgeorge in reply to SeasideSusie]

9/23/19

T4 1.7 (.8-1.8)

TSH 1.29 (.4-4.5)

T3 3.1 (2.3-4.2) Meds 75 levo/5T3

I've posted asking for help but nothing seems to be working. I'm in bed a lot, very weak, chills, nausea, jitters. Symptoms are very severe. Dr. and daughter (a nurse) are suggesting I try antidepressants. I tried them, in the spring, (t4 was 2.39) and got worse.I'm afraid to try again because I was in worse shape than I'm in now. Their point is that I have nothing to lose.

[SeasideSusie Remembering in reply to Coachgeorge]

OK, so what I said before about where your levels should be doesn't apply as you take T3 with your Levo.

Is your T3 result for Free T3 or Total T3 test?

[Coachgeorge in reply to SeasideSusie]

I should add that my heart pounds but my heart rate is typically below 60. It jumps when I move around but that might be due to weakness from being bedridden for so long. I can’t have a bowel movement without stool softeners. I’m gluten free for a couple of weeks. Symptoms are less severe later in the day. I take .25 mg of Ativan 4x a day. I have an appointment with another internist who specializes In endocrinology in 10 days. It’s been suggested that it could be related to adrenals. I used to have some relief around 4:00 in the afternoon. Now, if I get any relief it’s not until 8 or 9 o’clock. I’m so desperate. I keep begging for help but am told it’s not my thyroid. They can’t find anything else wrong either. She’s run labs on every function of the human body and all suggest I’m healthier than I’ve ever been. I feel like I’m dying.

[SeasideSusie Remembering in reply to Coachgeorge]

You haven't said whether your T3 test is Free T3 or Total T3.

[Coachgeorge in reply to SeasideSusie]

Sorry free t3

[SeasideSusie Remembering in reply to Coachgeorge]

Sorry free t3

In that case you are undermedicated. When taking T3 one expects to see TSH low or suppressed and FT4 tends to lower as well.

If your T4 test is Free T4 then it's 90% through it's range which is very high for someone taking T3.

Your TSH is 1.29 which again is high for someone taking T3.

I would say you need a reduction in your Levo and an increase in your T3. Doses will require tweaking until the levels are right for you as an individual.

Ativan is Lorazepam, a benzodiazepine drug, and as such can be addictive if taken long term. Hopefully you have had advice about this.

[Coachgeorge in reply to SeasideSusie]

I’m aware of the problems with Ativan and it concerns me. However, at this point I’m afraid to stop. My plan was to get my thyroid straight then work on the Ativan. What you said makes sense to me. Would you think 50 T4 and 7.5 t3?

[SeasideSusie Remembering in reply to Coachgeorge]

Would you think 50 T4 and 7.5 t3?

Yes but don't change both at once. With your results I think I'd reduce the T4 first, wait a week or two for it to start reducing in your body, then add in the extra T3. Don't retest or change dose again until 6 weeks have passed since last dose change, you need to give the new doses time to stabilise your hormone levels.

I am not medically qualified, my suggestions are based on my own experience.

[Coachgeorge in reply to SeasideSusie]

Thank you. It’s frightening to adjust my meds but I don’t think I can get worse

[Coachgeorge in reply to SeasideSusie]

I should know the answer to this but I’m afraid I don’t. Will more t3 help lower my T4?

[SeasideSusie Remembering in reply to Coachgeorge]

Taking T3 tends to lower FT4 to a certain extent. But with your FT4 result being 90% through range, if those were my results I'd lower T4 by 25mcg before adding T3.

[Coachgeorge in reply to SeasideSusie]

Can’t tell you how much I appreciate the help. I know folks get inpatient with my ignorance. I ask for a lot of assistance. Thank you. I hope someday I’m able to give back

[Wetsuiter in reply to Coachgeorge]

i dont think folk on here feel impatient with you.

[Coachgeorge in reply to Wetsuiter]

Thank you

[Catseyes235 in reply to SeasideSusie]

Surely lowering T4 when already undermedicated is going to cause worse symptoms??

[Coachgeorge in reply to Catseyes235]

I think it’s the t3 where I’m under medicated. When ever my T4 is in the upper range I’m sick. I think it just floats around and does nothing because my t3 is low,,,,maybe

[SeasideSusie Remembering in reply to Catseyes235]

Catseyes235

T4 is a storage hormone which has to convert to T3 which is the active hormone, and it's T3 that every cell in our bodies need. It's low T3 that causes symptoms.

When FT4 is at the very top of the range (in this case 90%) and FT3 low in range (in this case 42%) and we already know that she is not converting T4 to T3 very well and is taking T3 in addition to T4, then there's too much T4 and not enough T3 despite the fact that exogenous T3 is being taken. So the most sensible thing to do in this case is to reduce the amount of T4 and increase the amount of T3.

We are all individual in where we need the level of each of the hormones to feel well, so it's a case of experimenting to find those levels.

[Coachgeorge in reply to SeasideSusie]

I just woke up and thought of something else. Do folks ever alternate 50 and 75 day by day? I’m wondering if I need to be somewhere in the middle and since it doesn’t come that way, would 50 one day, 75 the next, then 50 work? Or is that ridiculous? I don’t do well when I’m in the upper range of T4. Then, I could see if I needed to increase t3. Just trying to come up with ideas. Thanks

[Catseyes235 in reply to Coachgeorge]

This was suggested to me by my doctor and I did do this for a while (100/125 ). before settling on upper dose.

[Coachgeorge in reply to Catseyes235]

Thanks for letting me know. Do you take t3?

[Catseyes235 in reply to Coachgeorge]

No...unfortunately am in U.K so rarely prescribed. You get to a certain age and they have another thing to attribute things to. As I'm generally okay apart from knees and AMD I have little chance. However it's the feeling that the difficulty with weight loss and low energy would benefit from T3.

[Coachgeorge in reply to Catseyes235]

I read about the t3 problems in the UK and it still perplexes me. Although, it’s not helping me much as no one seems to know how to prescribe.

[SeasideSusie Remembering in reply to Coachgeorge]

Coachgeorge

Do folks ever alternate 50 and 75 day by day? I’m wondering if I need to be somewhere in the middle and since it doesn’t come that way, would 50 one day, 75 the next, then 50 work?

Yes, that does work. I do it myself. I need 115mcg Levo and I only have 100mcg and 50mcg. Over a period of 5 days I alternate 100/125 (I cut a 50mcg tablet in half) and that gives me the dose I need.

[Coachgeorge in reply to SeasideSusie]

Thank you. I’m going to my regular internist today. I’m going to make the suggestion. I’m not taking any meds this morning. I was in bad shape yesterday. I have to do something to get this resolved. Either she changes my meds or calls the endocrinologist to get me in sooner.

[Coachgeorge in reply to SeasideSusie]

I just got back from the dr. I didn’t take any meds today. She wants me to skip tomorrow, too. Then go back to 75/5 thru Sunday. Going forward I’m to skip meds every Monday. Mathematically, she thinks that will get me to the same place I’d be if I alternated 50/75. Thoughts?

[SeasideSusie Remembering in reply to Coachgeorge]

75mcg x 6 days a week = 450mcg weekly.

Alternating 75/50 averages 62.5mcg x 7 days = 437.5mcg weekly.

So you would be taking more T4 if you take 75mcg x 6 days a week.

But your main problem is that your FT3 is too low and she's done nothing about increasing your dose of T3.

I don't think what has been proposed will help unless you add in more T3 eventually.

[Coachgeorge in reply to SeasideSusie]

How long should I wait to increase t3?

[SeasideSusie Remembering in reply to Coachgeorge]

As I mentioned in a reply above, if it was me I'd reduce the T4 first, wait a week or two for it to start reducing in your body, then add in the extra T3. Don't retest or change dose again until 6 weeks have passed since last dose change, you need to give the new doses time to stabilise your hormone levels.

[Coachgeorge in reply to SeasideSusie]

Thank you. I thought you’d mentioned that earlier. I have trouble following responses on my phone. Appreciate you

[Coachgeorge in reply to SeasideSusie]

Another thought as I just took my 2.5 of t3 about 40 minutes ago. Right now I feel like my skin is burning and my bloods on fire.

[Ralph1985]

i Also suffer from depression from time to time and low motivation to do just about anything, that being said it’s gotten much better as I seen my levels getting close to optimal rather than just being in range, and I’m not even at optimal levels yet. Also I was feeling really depressed and anxious a while back and it turned to be an hpylori infection and who knew it would cause all those feelings accompanied with nausea and headaches and just a feel of general ill, I got that problem addressed and doing a little better now.

[Coachgeorge in reply to Ralph1985]

What is that infection?

[MaisieGray in reply to Coachgeorge]

H.pylori is helicobacter pylori, bacteria in the sticky mucus that lines the stomach. It's very common and in the majority who have it, it doesn't cause any problems; but some can end up developing ulcers in the stomach or in the duodenum, which in some cases can bleed or even perforate, so definitely not a nice thing to have.

[Coachgeorge in reply to MaisieGray]

That sounds terrible. Thanks for letting me know

[greygoose]

Depression isn't a disease, it's a symptom. Usually a symptom of some hormonal imbalance, very often thyroid. As Susie said, you are under-medicated. No-one was ever ill due to anti-depression deficiency. And, very often they just don't work, or can make things worse.

And, quite frankly, I think anyone who's been through what you've been through would be depressed! Doctors so often put the cart before the horse. Suggesting that depression is causing your symptoms is illogical. Depression is just another of your symptoms, all caused by thyroid - if you actually are depressed.

[Coachgeorge in reply to greygoose]

I don’t feel depressed. I feel sick of being sick

[SeasideSusie Remembering in reply to Coachgeorge]

I don’t feel depressed. I feel sick of being sick

In that case should you be considering anti-depressants? I would be looking to optimise my thyroid.

[Coachgeorge in reply to SeasideSusie]

I’m so against the antidepressants. They made me worse but no dr. Has been able to help me. I dread every day of my life. I’m physically miserable. I wish I could get in sooner to see the endo. I want to make the med change because I think you are right. I’m just frightened

[Mamapea1 in reply to greygoose]

My thoughts exactly GG 👍 x

[Catseyes235]

I have taken mild antidepressants a couple of times in my life due to various circumstances leading to stress and depression and benefitted greatly, taking them for around a year each time and episodes about 15 years apart. Just got me through a bad time. Sometimes it’s difficult not to blame everything on your thyroid as it can be all encompassing!

That’s not to suggest you are not undermedicated though, so maybe see if a top up doesn’t help as you do seem to have hypo symptoms. I was recently told I was overmedicated on 150mcg Levo decreased my meds to 100 and pretty soon felt cold and tired so went back up to 125 even though way below range. Good luck !

[Coachgeorge in reply to Catseyes235]

Thank you! Like you, I took antidepressants when my sister passed leaving an eleven month old baby. They worked and I got off them. This seems to be a little different. They want me on them when my thyroid is jumping all over the place. They tried it in the spring, complete disaster. No idea what to do so I’m trying to go in with suggestions

[HowNowWhatNow]

Hi Coachgeorge,

I feel like a different person post-thyroid (Hashimoto’s) than I did pre. I don’t seem to be undermedicated. But sometimes the disjunct between the very capable, energetic person and the forgetful, easily tired, more optimistic person that I am makes me down. That Quantum Leap feeling.

I’m not sure whether it’s mild / clinical but am currently investigating.

From the last time I looked at the literature, there are lots of people with thyroid conditions who become depressed. How much is causal/ correlation/ misdiagnosis, I don’t know. As i’ve tried to explain to my GP before, a condition that slows down your entire metabolism would seem likely to be aligned to depression .. she maintains they wd be two separate things.

A subject we could probably discuss all day.

Hope you find your solution soon.

[Coachgeorge in reply to HowNowWhatNow]

Thank you. I appreciate you taking the time to share.

[Coachgeorge]

I’m sorry, I’m so negligent in giving all the information. I’m hoping that will improve with time. She wants to increase t3 but wasn’t comfortable doing both at once. We looked over my past results and noted that whenever my T4 gets close to the top of the range, I have setbacks. We did talk about which one to start with and it’s probably my fault that we went with levo first.