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Dr. Bob is Robert Hsiung, MD,
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Posted by Hygieia's Bowl on August 7, 2008, at 7:37:23
Does having messed up thyroid levels negate the effects of head meds?
When speaking of thyroid stuff, I think it's very important to work on that as contributing cause and maybe even the root cause but can't it be helpful and effective, in some, to treat both or are psych meds not effective in cases of thyroid disturbances?
I seek to understand....
Posted by raisinb on August 7, 2008, at 10:04:31
In reply to Thyroid problems and Head Meds, posted by Hygieia's Bowl on August 7, 2008, at 7:37:23
Have your thyroid levels been checked? Hyperthyroid can cause agitation and insomnia; hypothyroid can cause lassitude, weight gain. Both can lead to depression. Your doc should have tested for that before prescribing any psych meds (I think, anyway).
Posted by Hygieia's Bowl on August 7, 2008, at 10:36:10
In reply to Re: Thyroid problems and Head Meds » Hygieia's Bowl, posted by raisinb on August 7, 2008, at 10:04:31
Yep, mine are good.
My question comes out of a situation with my sister-in-law. When symptoms began with her, she had a good work-up and sure enough her thyroid was wacky. Despite working with an endocrin. and achieving the levels desired (although those levels appear, to me, to change with more frequency than most screening levels) she still struggles... she's better but still not, uh, "right" and her functioning is degrading. She firmly believes it is still all thyroid related and she doesn't believe her levels are okay for her despite alot of the physical manifestions improving.... maybe she's right but I believe treating her head stuff would help.
Her endocrin. strongly suggests the addition of a psych consult. She is not open to that idea.
Not proudly, I admit I had two reactions when all this began with her. My first was: envy - as she had something tangible, measureable and a "good" explanation for mayhem similar to my own entering her life. Second, keeping in mind she is my sister-in-law: "well, of course SHE couldn't have true mental illness..." I have dismounted from those high-horses and I would like to see her hear the hoofbeats and think what would be zebras for her.
Posted by Phillipa on August 7, 2008, at 10:53:45
In reply to Re: Thyroid problems and Head Meds » raisinb, posted by Hygieia's Bowl on August 7, 2008, at 10:36:10
Per my pdoc until levels are stable meds can control some but don't really work as they should as the same symtoms of thyroid disease are the same as psych problems. The thyroid feed-back loop controls all hormones in the boday starting at the pituiary, thyroid, adrenal glands and much more I don't know as it's difficult to understand at least to me. Seems the endos I've seen are only interested in numbers and not how the patient feels which should be the goal. My neice has a great one in another state that say to her most important is how she feels and since he goes by that she feels great. Since anxiety runs in the family she also takes a very low dose of zoloft. Phillipa
Posted by raisinb on August 7, 2008, at 11:19:30
In reply to Re: Thyroid problems and Head Meds » raisinb, posted by Hygieia's Bowl on August 7, 2008, at 10:36:10
You're probably right that she could benefit from a psych workup. It's my understanding that there are many physical symptoms that accompany thyroid malfunction. If those are lessening, or gone, then the remaining part might be psychological.
It isn't black and white of course. Maybe her thyroid was whack and impacted her mood for so long that she developed depressive/anxious thinking patterns/habits that remain. Or maybe it was the other way around--emotional malfunction caused less than optimal nutritional or exercise habits, which led to physical issues. Thyroid stuff is often caused or exacerbated by poor diet. I always believe depression has multiple causes and sometimes you just can't trace it to one thing; the important thing is to treat it from all angles so you have the best chance of feeling better.
I don't know anything about your SIL and I am not an expert, so take all this with a grain of salt. But to me that rigid it-has-to-be-this, I'm-not-this type of thinking sounds like a depressive symptom in itself (at least it's a common one of mine).
Posted by Phillipa on August 7, 2008, at 13:50:13
In reply to Re: Thyroid problems and Head Meds » Hygieia's Bowl, posted by raisinb on August 7, 2008, at 11:19:30
Has she visited the thyroid boards? Good info there also. Lots of it also. Phillipa
Posted by Phillipa on August 7, 2008, at 14:06:13
In reply to Re: Thyroid problems and Head Meds, posted by Phillipa on August 7, 2008, at 13:50:13
Maybe search around here. Phillipa
HealthBoards.com Message Boards > Health Issues > Thyroid Disorders > HASHIMOTO'S AND LAB VALUES
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PDAView Full Version : HASHIMOTO'S AND LAB VALUES
--------------------------------------------------------------------------------LEXUSWEGG11-11-2002, 12:19 PM
MY DOC SAID HE IS 90% SURE ABOUT ME HAVING HASHIMOTO'S, THEY THOUGHT IT WAS LUPUS BUT NOW HE SAYS HASHIMOTO'S THYROIDITIS. I HAVE BEEN SICK FOR THE LAST 10 OR SO MONTHS WITH FEVER, JOINT PAIN AND FATIGUE BEING THE MOST COMMON. MY HEART RATE HAS BEEN STAYING AROUND 120 FOR THE LAST 3 MONTHS. THE LABS CAME BACK AND THE ANA WAS POSITIVE AGAIN, THIS TIME IT WAS ONLY 1:40 - HOMOGENOUS PATTERN, LAST TIME IT WAS 1:160 WITH SPECKLED. THE AB ANTIBODIES ARE AS FOLLOWS:
AB THYROBLOB 72.6 REF RANGE <1.0IU/ML
AB THY PEROXIDA 43.9 REF RANGE <2.0 IU/ML
TSH 1.62 REF RANGE .34-4.82
>T3 FREE 352 REF RANGE 230-420 PG/DL
>T4 FREE 1.4 REF RANGE .9-1.8 NG/DL
CAN THE ANTIBODIES CAUSE SYMPTOMS WITH EVERTHING ELSE IN NORMAL RANGE? I MEAN, MY DOC HAS REFERRED ME TO AN ENDOCRENOLOGIST (SPELLING) BUT WITH MY LABS IN NORMAL RANGE, IS THERE ANY REASON TO EVEN SEE A SPECIALIST? ARE THE ANTIBODY LEVELS SIGNIFICANT? I DON'T UNDERSTAND HOW TO READ THOSE, IS IT LIKE THE ANA READING? ANY HELP WOULD BE APPRECIATED!--------------------------------------------------------------------------------
ArtfulD11-11-2002, 12:46 PM
Hi LEXUSWEGG. Hashimoto's Thyroiditis is an autoimmune disorder in which antithyroid antibodies attack the thyroid gland tissue and prevent it from producing hormone.From the results you posted, your doctor tested you for two types of Antithyroid Antibodies: AntiThyroglobulin Antibodies - which attack the thyroglobulin protein -- a protein necessary to produce thyroid hormone) and Antithyroid Microsomal Antibodies - measured by the Antithyroid Peroxidase ("TPO") assay and also referred to as Anti-TPO antibodies.
Both of these levels were elevated in your recent test results, confirming the diagnosis of Hashimoto's thyroiditis that your doctor mentioned. Additional thyroid antibodies can also be tested, including Thyroid Stimulating Immunoglobulins (which can make a person Hyper). A person can have any combination of antibodies at any time.
The ANA also measures antibodies related to autoimmune disorders, but while an elevated ANA level may occur along with thyroid disease, it does not always indicate thyroiditis. This is why your doctor conducted the other tests.
Antibody-related Thyroiditis generally causes symptoms that fluctuate between Hypo and Hyper (or sometimes presents a combination of both). It is quite common for the symptoms to occur before the blood levels become abnormal; the presence of antibodies explain why the patient isn't "normal." Laboratory reference ranges for "normal" vary, but most adult females feel best when their TSH is at or below 1.0 and their Free T3 and Free T4 levels are in the middle of the lab's ranges. Adult males may feel best when their TSH is much lower (some prefer below 0.1).
Treatment typically consists of thyroid medication (as appropriate for the patient's blood levels and symptoms). It is best to see an Endocrinologist who specializes in Thyroid Disease and who is familiar with Antibody-related thyroiditis so that you will have a doctor who listens and treats your overall symptoms (rather than telling you that your blood levels are normal and that's all that matters).
Treatment is important because persistent antibodies will destroy the thyroid gland and may cause growth of additional tissue (nodules or cysts) as the gland tries to overcompensate for the missing hormone.
Supplements that may help include Selenium (maximum dose 200 mcg/day) and Maca. Recent studies have shown that Selenium may help fight thyroid antibodies while also helping the body to metabolize and absorb thyroid hormone. Maca (a type of Peruvian turnip) helps balance all the body's hormones and also supports the adrenals, which tend to become stressed during flare-ups of thyroiditis.
If you've not yet had a chance, read through our Information Archive thread. This three-page thread includes posts with symptoms lists, notes about thyroiditis and antibodies, supplements, and much more.
http://www.healthboards.com/ubb/Forum118/HTML/000005.html
Posted by Hygieia's Bowl on August 7, 2008, at 15:30:50
In reply to Re: Thyroid problems and Head Meds, posted by Phillipa on August 7, 2008, at 13:50:13
> Has she visited the thyroid boards? Good info there also. Lots of it also. Phillipa
Yes, she has spoke about that and she talks as if she's alright with the endocrin. she sees. From what she's reported to me, it sounds as if her thyroid treatment, followups and responses to meds are going as expected.
I dunno, with the physical symptoms improving, it seems to me there's something else she could work on for the emotional stuff.... even if she could see it as an adjunct. I guess my thought processes are to if her emotional/functional dysfunction (and there is definately dysfunction) were entirely endocrine based, there should be more improvement in that way.
It's a tippy-toe kinda situation for me but I keep trying to get her to at least get the endocrin office to set up an appointment and go see a pdoc per the suggested consult... if she wants to phish-phish it after the visit then that's what she can do.
Posted by Hygieia's Bowl on August 7, 2008, at 15:37:25
In reply to Re: Thyroid problems and Head Meds » Hygieia's Bowl, posted by raisinb on August 7, 2008, at 11:19:30
> I don't know anything about your SIL and I am not an expert, so take all this with a grain of salt.
Sounded like good stuff to me.
> But to me that rigid it-has-to-be-this, I'm-not-this type of thinking sounds like a depressive symptom in itself (at least it's a common one of mine).Yes and who wants to be painted with the: "I have a mental illness just because..." brush? Although, I think I'm spinning toward the opposite.... I get a bad zit and want to blame it on my head (inner head) issues. : )... that's a different finding in me than most folks....
Posted by Hygieia's Bowl on August 15, 2008, at 21:51:03
In reply to Re: Thyroid problems and Head Meds » Hygieia's Bowl, posted by Phillipa on August 7, 2008, at 10:53:45
Watch out for the towel as I'm throwing it in, for now, on this situation.
Tonight, I had yet another rather painful conversation with my SIL. Oh boy...
While not a licensed pro in psych, it hit me hard tonight she has a big case of denial (well, that wasn't new hit) and is using the physical issue as a means to scapegoat using psych interventions to treat mental issues. I don't know that there's alot **I** can do to help with that.
Right now, I not feeling the compassion I should and I'm really feeling frustrated.
Posted by Phillipa on August 16, 2008, at 19:54:21
In reply to Re: Thyroid problems and Head Meds, posted by Hygieia's Bowl on August 15, 2008, at 21:51:03
We all have our own opinions of course as well as my endo and pdoc and this is what they say is the problem with me. So Guess I will follow their advise and keep cutting down on synthroid. As thirty pounds lighter. Not looking for compassion. Phillipa
Posted by Hygieia's Bowl on August 16, 2008, at 20:32:29
In reply to Re: Thyroid problems and Head Meds » Hygieia's Bowl, posted by Phillipa on August 16, 2008, at 19:54:21
My SIL's situation may be quite different from yours. She has an endo suggestion for a psych consult as I've discussed.
As far as my comment on compassion, I was, again, discussing my response at this time to my SIL. Basically, it's a difficult lesson to gleam that one who asks for help and rejects everything anyone suggests (as my SIL has) are accountable to what's continuing to go on with them. I'm not proud that her choices, yet continuing to struggle and complain, decreases compassion on my part but I'm being truthful - everyone has their limits and boundaries.
Posted by ja on August 19, 2008, at 17:13:46
In reply to Re: Thyroid problems and Head Meds, posted by Phillipa on August 7, 2008, at 14:06:13
Where could I find a site that has the thyroid components that are tested and what the ideal levels should be? I ask this because you say that males do better with a TSH of .1 or lower. I had Graves and take synthroid, but my TSH is is on the high range like 4-7, when it should not be higher than 5.5. The Dr. always says I'm fine, but my TSH has been above the the recommended range and my synthroid dosage hasn't changed in 2 yrs. I want to make sure that the synroid is working like it should. Also, I am taking Nardil. Do anti-depressants/MAOI's have any effect on the thryoid or how you process the synroid?
Thank you for your post and any information would be appreciated.
Posted by Hygieia's Bowl on August 19, 2008, at 17:26:56
In reply to Re: Thyroid problems and Head Meds, posted by ja on August 19, 2008, at 17:13:46
> Where could I find a site that has the thyroid components that are tested and what the ideal levels should be?
Try these:
http://thyroid.about.com/od/gettestedanddiagnosed/a/bloodtests.htm
http://www.aace.com/my.php?a=newActually, the blood levels considered WNL - per the Colleges of Endocrinology - seem to change almost as often as blood lipid levels, so it's sometimes difficult to get a good idea. Also, keep in mind these tests can be just the first step in coming up with a plan.
Posted by Phillipa on August 19, 2008, at 20:36:20
In reply to Re: Thyroid problems and Head Meds, posted by ja on August 19, 2008, at 17:13:46
Don't know about the nardil but Graves usually treated with radiation or surgery and then theyroid replacement. Most important is not the number but how you feel. Mary Soloman has a good site. Phillipa actually there are a lot of them. And I'm assuming you see an endocrinologist that specialized in thyroid? Mine doesn't he's more interested in diabetes. And throid fluctuates throughout the day. So what the number is at 8am may not be the same as later etc. Just search a lot of sites.
Posted by Phillipa on August 19, 2008, at 20:43:46
In reply to Re: Thyroid problems and Head Meds » ja, posted by Phillipa on August 19, 2008, at 20:36:20
First link froze my computer. But free T4 is the most important. And it's Shoman. Google on own. Phillipa Guess my computer doesn't have the program but I google a lot of her sites.
Posted by ja on August 20, 2008, at 10:13:28
In reply to Re: Thyroid problems and Head Meds » ja, posted by Phillipa on August 19, 2008, at 20:36:20
Thank you for the info. I looked at the about.com.thryoid site and found it very helpful. I found it interesting that they have now changed the ranges in TSH, but many dr's still abide by the old one. I hope by dr. will address and adjust the synthroid, because I have been struggling lately. I am taking the smallest amount of levothryoxin for 2 yrs. and I personally don't think it is enough.
Posted by Hygieia's Bowl on August 20, 2008, at 10:24:19
In reply to Re: Thyroid problems and Head Meds, posted by ja on August 20, 2008, at 10:13:28
Go for it if you think that's what you need to do.
Yes, I find they do change around those ranges IMO rather often.
Did you have any problem with the about dot com link I posted? I did not. I had a IT person look at it from just as a reader to PB and using my sign in without any difficulties.
Posted by ja on August 23, 2008, at 13:26:03
In reply to Re: Thyroid problems and Head Meds, posted by Phillipa on August 19, 2008, at 20:43:46
Why is T4 the most important? I have a high T4. I am going to see my Endo next week and would like to know what to tell him. Do supplements, herbs, or medication effect the thyroid in anyway? I am currently taking all 3. I am taking Nardil and it is working fairly well. I have had fatigue and brain fog for a while and I think this is thryoid related. I have recently gone from 60-90 mg on Nardil. My doc said take 30 mg 3x a day, but would it be ok to take 45mg in the morning and at night? I have also just gone from .025 levothryoxin(the smallest dose precribed) to .50. I am hoping this will lower my TSH and T4 as I have heard that closer the TSH is to 1.5 the better you will feel. I have noticed that this is true by looking back at my blood test.
Posted by Phillipa on August 23, 2008, at 19:38:32
In reply to Re: Thyroid problems and Head Meds, posted by ja on August 23, 2008, at 13:26:03
Free T4 is more important and I'm opposite of you as feel better higher. Tsh is very low now and Free T4 is off. I feel like I'm dying I hope it's thyroid seriously. Could you babblemail me and then I can find a study and send it to you? Love Phillipa ps and I would like to exchange stories. I know nothing about nardil. Sorry.
Posted by GizmoChick on August 27, 2008, at 19:55:32
In reply to Re: Thyroid problems and Head Meds » ja, posted by Phillipa on August 23, 2008, at 19:38:32
Cognitive issues and depression are very common with Hypothyroid. T3 plays a huge role for me there. When I switched from T4 only to Armour Thyroid (which includes T3) the improvement in my depression was dramatic. In addition to TSH and T4, request a test for Free T3. Some people have trouble converting T4 to T3 in which case their blood tests would indicate lower levels of T3 relative to T4.
Posted by Phillipa on August 27, 2008, at 23:12:57
In reply to Re: Thyroid problems and Head Meds, posted by GizmoChick on August 27, 2008, at 19:55:32
Do you have a link that explains the T3 and T4 as that is always what confuses me the most. It's a very difficult concept the thyroid loop. Thanks Phillipa Think my neice sent me some. Will see what's in that folder. Phillipa
Posted by GizmoChick on August 28, 2008, at 12:14:24
In reply to Re: Thyroid problems and Head Meds » GizmoChick, posted by Phillipa on August 27, 2008, at 23:12:57
<<Do you have a link that explains the T3 and T4>>
Basically, the thyroid hormones consist of a tyrosine molecule with iodine molecules attached to them. If 4 iodine molecules are attached, you have T4...3 iodine molecules - T3. Its T3 thats required at the cellular level (and especially in the brain). Most of the T3 comes from conversion from T4, which occurs mostly in the liver and kidneys.
A search on t4 t3 conversion will generate a ton of info that will keep you reading for a while. You also might find some interesting results from a search on triiodothyronine (T3)cognition mood .Heres a decent overview of Hypothyroidism... includes a good outline of the thyroid hormones, T4, T3 conversion, interplay between thyroid, hypothalamus and pituitary glands, etc.: http://www.salugenecists.com/genpage.php?tname=disease&dbid=21
Posted by Phillipa on August 28, 2008, at 21:44:59
In reply to Re: Thyroid problems and Head Meds, posted by GizmoChick on August 28, 2008, at 12:14:24
Thanks so much been gone all day just home. Phillipa
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