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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 JahL on March 24, 2002, at 21:22:40
Hi.
I'm taking T3 + T4 (12.5mg + 50mg) for v. TR BPII. I was wondering what kind of response time (if at all) I might expect. Any responders out there; how long before you began to feel any benefit? How full was your response? Was it sustained?
To responders & non-responders alike; did thyroid meds at any time worsen your depression? Any side-effects worth mentioning (I'd ask my pdoc but apparently T3 isn't available in the UK. Obviously we have different thyroid glands over here)?
Thanks VM.
J.
Posted by Cmatt on March 25, 2002, at 5:43:41
In reply to Thyroid supplementation., posted by JahL on March 24, 2002, at 21:22:40
Don't know about your combination, but for standard levothyroxine (a.k.a. as Synthroid), a range of 12 to 17 days is a reasonable response time for a change to show. However, if the thyroid or thyroid medication is already functioning at an optimal level, a change may be noticed, but much less pronounced than if the body was in a state of hypothyroidism to start with.
Cmatt
Posted by Bill L on March 25, 2002, at 8:56:35
In reply to Thyroid supplementation., posted by JahL on March 24, 2002, at 21:22:40
I have never taken thyroid meds but I have read a lot about them. There are several:
1)T4 - Synthroid
2)T3 - Cytomel
3)Both - Thyrolar
4)Both - Armour (natural thyroid extract from animals)In people who are clinically hypothroid (ie the TSH level is above 4.0), thyroid supplementation can alleviate depression. T4 is mostly given for hypothyroid patients.
In people who are euthyroid (TSH between 1 and 4), thyroid suplementation alone will typically not alleviate depression although it might give some people more energy if their TSH is near 4. However if someone is taking an AD, thyroid supplementation (usually containing either T3 and T4 or just T3) can augment the effects of the AD to give more relief from depression in some patients, but not all.
To see if you are getting enough supplementation along with an AD, you can take enough to get your TSH near 1.0, but you should not go below 1.0.
Anyway that's my recollection of what I have read. But I'm not an expert
Posted by IsoM on March 25, 2002, at 11:53:56
In reply to Thyroid supplementation., posted by JahL on March 24, 2002, at 21:22:40
Speaking from experience. When you're initially diagnosed with hypothyroidism & prescribed hormone treatment, the doctor will probably err on the side of too little. It's standard for most. They're afraid of excessive bone loss in women. The more active your thyroid (naturally or through supplementation), the more calcium turnover causing osteoporosis in women, especially menopausal women.
Therefore, your doctor may initally underprescribe for you. In about a month, he'll want to recheck your TSH levels to see if they're satisfactory. Mine were considered fine after a month's treatment, but I noticed very little difference. I had to be somewhat insistent about getting him to increase the dose. I told him if I couldn't notice a difference, why bother giving me any. After the dose was increased, I noticed a difference within a week or two. You may have to do the same.
If you're going to be taking thyroid supplementation, make sure you increase your B complex vitamins & your calcium/magnesium/vitamin D combination as your body needs more with an active thyroid or the hormone supllementation.
You may intially find your response is absolutely wonderful before it evens out to just good. Your body can kick in with its own amphetamine-like hormone called PEA (phenylethylamine) which then releases dopamine making a person feel so good. That'll decrease in a while leaving you with the real response.
Side-effects: Bothering your family at the supper table as you keep pausing between mouthfuls to say "Mmmm! This tastes SO good!" My taste & appetite came back & everything tasted so good again. It was nice to enjoy my meals again. But don't worry - you'll probably lose weight even if you do eat more. Your metabolism will increase, burning calories better & your physical activity will increase too as you now have energy.
Like I said earlier, you'll initally feel *much* better, but I didn't find my depression worsened at all. I admit after the PEA effect wore off, I was a little disappointed but not depressed by any means.
I'm not sure what you mean by v. TR BPII. Very thyroid-resistant bipolar II? Damn those British thyroid glands - I wonder if the Canadian glands are similar? :-)
Posted by jazzdog on March 25, 2002, at 19:29:26
In reply to Thyroid supplementation., posted by JahL on March 24, 2002, at 21:22:40
Hi Jahl - nice to see you back here. I supplement with thyroid, but T4 only, because I'm too sensitive to T3. Essentially, I develop the symptoms of hyperthyroidism - sweating, racing pulse, tachycardia. Nothing alarming, and they reverse quickly when the dose is lowered, but if you notice these symptoms, then you're taking too much.
By the way, how's the derealization coming. Any breakthroughs? Are you still seeing the Maudsley folks?
- Jane
Posted by JahL on March 25, 2002, at 21:18:03
In reply to Re: Thyroid supplementation. » JahL, posted by jazzdog on March 25, 2002, at 19:29:26
> Hi Jahl - nice to see you back here. I supplement with thyroid, but T4 only, because I'm too sensitive to T3. Essentially, I develop the symptoms of hyperthyroidism - sweating, racing pulse, tachycardia.
Hi JD.
I'm thinking I may be a little sensitive to the T3 also. Hot flushes, racing pulse etc. How much T4 do you take?
> By the way, how's the derealization coming. Any breakthroughs? Are you still seeing the Maudsley folks?
NO. Trouble with the Maudsley is, and I've also heard this from one or two very eminent pdocs, it's very orientated towards psychology. At my last meeting, when it had become clear that their one & only suggestion of Lamictal + SSRI didn't work, they began talking about 'helping you to learn to live with your disability'. Whatever that means. Actually it means "We're throwing in the towel".
The last straw came when it transpired that they had written to my GP & requested that I be pulled off Klonopin even though I had made it very clear that the Lamictal, which stops me putting a hole in my head, doesn't work w/o it. Tolerance isn't an issue, I've been on the same tiny dose for two years. Typical Brit Benzophobics (there are even more of them over here). They were very keen to keep me on SSRIs tho', despite the fact that all ADs make all my symptoms (inc DP) worse. Fools working to standard drug protocols basically. They even tried to reclassify my BPII as a 'primary anxiety disorder', which, conveniently enough, they were investigating at the time.
For any Brit out there whos idea of treatment doesn't involve sitting in a circle and discovering your 'inner child', I would advise you steer well clear of this establishment.
It's a shame but one of the only two centres investigating this disorder is staffed by narrow-minded idiots. Anyway, Maudsley rant over.
I've forced myself on a list for all kinds of experimental treatments & procedures. Who knows, maybe one'll hit the jackpot. Keep you posted.
Oh, I've been taking Methadone (yeah, I know) 1.25ml tid for the last 4 months. Helps a little with most symptoms, including DP, and especially energy and cognition. Nothing dramatic, but noticable all the same.
J.
Posted by SLS on March 26, 2002, at 19:27:46
In reply to Thyroid supplementation., posted by JahL on March 24, 2002, at 21:22:40
> Hi.
>
> I'm taking T3 + T4 (12.5mg + 50mg) for v. TR BPII. I was wondering what kind of response time (if at all) I might expect. Any responders out there; how long before you began to feel any benefit? How full was your response? Was it sustained?
>
> To responders & non-responders alike; did thyroid meds at any time worsen your depression? Any side-effects worth mentioning (I'd ask my pdoc but apparently T3 isn't available in the UK. Obviously we have different thyroid glands over here)?
>
> Thanks VM.
>
> J.
Hi JahL.T3 (triiodothyronine) made me feel MUCH worse. I was taking imipramine and lithium at the time. T4 (thyroxine), on the otherhand, produced a mild improvement. I think T4 might be underutilized in treating depression.
- Scott
Posted by jazzdog on March 26, 2002, at 20:54:16
In reply to Re: Thyroid and DP. » jazzdog, posted by JahL on March 25, 2002, at 21:18:03
I'm taking 50 mg Eltroxin, which seems about right. The strange thing about T4 is that too much leaves you as fatigued and wiped out as too little. T4 is converted to T3 anyway - supplemental T3 really only seems to be useful when there's something wrong with the conversion mechanism.
Sorry to hear about your problems with the Maudsley. I was so encouraged that somebody, somewhere was taking dp seriously. However, they turned my shrink onto lamictal, so I guess it's not all a loss.
- Jane
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