I was at my breaking point yesterday and got an appointment to see a NP that I've been looking to make contact with. I'm at a loss as to what to do next but have to move forward in some way. So the long story is: I am without a family doc since he left his practice and I am hesistant to just pick a doctor and don't have the energy to keep making appointments until I find one I like plus with flex plan spending/end of the year approaching, I'm trying to get all my appointments in. Anyway, last year when I was at my worst I saw an absolutely wonderful NP in the walk-in clinic who gave me that push in the right direction and actually listend to me. I saw her yesterday and did not expect her to remember me from a visit over a year ago but she did by simply recalling a "very legnthy discussion that included a talk about Mayo." That discussion was about and hour and a half long in which she talked with my family doc after the appointment and said at the very least I should have a referral to Mayo or the UW Wisconsin Center if it would help me understand what I was going through even though she wasn't confident that they would find anything more wrong with me than the doctors here. She previously worked at Mayo and seemed to have an understanding of patients with "difficult" cases. This all happened before I found this forum and it was because of her that joined a colits forum on the Mayo website in which someone there gave me this site as an option. Of course, after reading all the posts here I didn't not take to traveling in search of the magic answer.
I told her about my severe eye pain that continues after the punctal plugs, OTC drops, Lotemax, and Restasis, my fatigue, and the list that goes on forever. I told her I wanted to look into my thyroid again and asked if we could go that route even though my numbers are "normal." She dug into my file and offered another blood test, if that's what I wanted, but I didn't see the point since I've been having it tested about every six months. She said she could not give meds when my numbers weren't even close to borderline and said even if I went to an endocrinologist she doubted if I would be able to get meds. I was at a loss and told her my brain fog, memory loss, etc was effecting my job performance. I questioned pre menopause, talked about my MC and diet, stress in general, histamine issues, my rheumatoid tests that came back normal,and jokingly that maybe I was just nuts. She asked if I had explored alternative medicnes and thought that may be a better fit for me. She brought up acupunture and functional medicine and I told her I had a doctor that practiced functional medicine but I stopped seeing him because it became too expensive. She shared some stories of her own and told me "it's coming"- the acceptance of alternative medicine and even for her, it's frustrating knowing that it's out there but not accepted yet (especially in our area). It was an unusually pleasant conversation but she flat out told me she didn't even want to bring up the next thought because she knows how I feel- but asked that I consider depression as an issue.
I've been down this road before and my general philopsophy (at least for myself) is that life is going to sh** on me and I just have to deal with it and I don't believe that taking a pill is the cure-all. I do know quite a few people who are on anti-depressants and I'm good with that too because eveyone is different but it isn't for me. She is well aware that I do not want ANY drugs for anything but again, I need to re evalute my thought process. I am stuck with very few options and it seems in my small town the medical opinions are so narrow minded that I am locked into not so great options. She simply stated that my long list of complaints seem to indicate markers of depression and would it hurt to try meds for three months. At the very worst she said if I saw no improvement within three months we'd know we went down the wrong road and wasted some time and some money. Even though I was not encouraged at all by the suggestion I was impressed that she didn't become arrogant or shove this at me as my only alternative in her expert opinon- it was simply an option to consider. I'm not convinced that all my issues are related to depression. She asked if I would be ok with not getting a recommendation immediately as she wanted to do a little research to be sure she was choosing the right type of RX for what I was describing. I told her it was something I would think about. I REALLY don't want to go down this road but am wondering if I should have a more open mind also. I didn't disagree with her as far as the depression goes.... I haven't know what it's like to "feel good" in over five years, the diet changes I've made have been an emotional obstacle, my son was dx with a serious liver disease, my job adds an incredible amount of stress to my life that I'm not sure is worth it, I've been dealing with empty nest sydrome and the list goes on. I've always believed that each person has their own hurdles in life that they have to deal and it's unfair to judge the merits of other peoples problems because to them, it's huge. I've been working on adjusting how I react to stress. Is there actual chemical/hormonal changes that occur in the body that can be made right by antidressants? It just seems that there's a pill for everything and I don't want to fall into that catagory but on the other hand, am I being just as narrow minded in not giving it a try to better the quality of my life and the family that I effect on a daily basis. My family is pushing for me to try it and it makes me wonder if I'm missing something (maybe their lives would be improved because I'm harder to live with than I thought?)
Depression Meds
Moderators: Rosie, Stanz, Jean, CAMary, moremuscle, JFR, Dee, xet, Peggy, Matthew, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh
DebE, I'm sorry you're still feeling so unwell. I am starting to believe that if you think you have a thyroid issue you probably do. Just for the record, my niece just saw an endo at Mayo. Her TSH was 3 (their range is .5-5) but he still let her try some Synthroid. She's been suffering with hair loss, weight gain, depression, etc. He didn't believe she would be helped but she's hopeful. I personally believe that natural desiccated thyroid may be a better option and that is what I'm using. I'm of the anti-drug mentality too but don't feel the same about thyroid meds. I feel that it is just a component my body isn't producing properly so I'm supplementing. I am feeling better (most days) in spite of a lot of stressful stuff going on and my mood seems to be lifting. The other day I was at my son's house and all of a sudden thought, "I really feel good right now". I can't remember the last time I felt that way!
Deb
Deb
When you questioned your NP about premenopause, what did she say? Because, believe me, perimenopause can cause a lot of those symptoms you are experiencing. Brain fog, depression, aches and pain, digestive issues...the list is endless! Perimenopause affects your thyroid and adrenals too. A good endocrinologist/hormone specialist can help you. If you go to the website, PowerSurge, you will find many, many women who have the same experiences you are having.
I take bio identicals for my perimenopause and it has made a world of difference for me (along with the grace and help of God).
Blessings and prayers for you,
Mandy
I take bio identicals for my perimenopause and it has made a world of difference for me (along with the grace and help of God).
Blessings and prayers for you,
Mandy
DebE,
You've written a very well-thought-out, introspective post. And you've found a very caring doctor, who seems to know her stuff, and I agree with her that big changes in treatment methods will eventually be phased into mainstream medicine.
It's a shame that most doctors don't have a better understanding of the importance of proper thyroid functioning. While the thyroid's actual functioning is complex, it's basic job description is relatively simple, but how well it performs is critical to our long-term health, because it essentially serves as the accelerator/brake for our metabolic engine, and it probably affects every hormone produced by the body, in one way or another.
Doctors tend to overlook the fact that low thyroid function can masquerade as depression. They are afraid to prescribe a thyroid supplement when certain lab results appear to be normal, but they seldom hesitate to write a prescription for an antidepressant, whether it's actually indicated or not.
Forget TSH. That's important for textbook cases of hypothyroidism, but it doesn't fit many situations, and it's possible to be hypothyroid even though TSH results are normal. The big question is, "What are your Free T4 and Free T3 results?" (Not total T4 and/or total T3 — only the Free T4 and Free T3 results matter.) If either is below range, you are almost surely hypothyroid. And I agree with Deb, for uncommon cases, Armour, or one of the other natural dessicated thyroid supplements are superior to the synthetic thyroid supplements. The synthetic thyroid supplements often resolve the laboratory results, but they don't resolve the clinical symptoms for many of us. Do you have any of the following symptoms (disregard the constipation, of course, if you have active MC)?
Weakness
Fatigue
Intolerance to cold
Constipation
Weight gain
Depression
Joint or muscle pain
Thin, brittle fingernails and hair
Paleness
Slow speech
Dry flaky skin
Thickening of the skin
Puffy face, hands and feet
Decreased taste and smell
Thinning of eyebrows
Hoarseness
Abnormal menstrual periods
You asked what antidepressants can actually do, and that's a good question, because most of them have been shown in one way or another to be only marginally better than a placebo. However, the most popular antidepressants tend to increase serotonin levels, which helps to improve outlook and mood. Unfortunately, for many people, increased serotonin levels also cause D, but of course that isn't true for everyone.
And yes, hypothyroidism tends to be associated with perimenopause and vice versa.
Tex
You've written a very well-thought-out, introspective post. And you've found a very caring doctor, who seems to know her stuff, and I agree with her that big changes in treatment methods will eventually be phased into mainstream medicine.
It's a shame that most doctors don't have a better understanding of the importance of proper thyroid functioning. While the thyroid's actual functioning is complex, it's basic job description is relatively simple, but how well it performs is critical to our long-term health, because it essentially serves as the accelerator/brake for our metabolic engine, and it probably affects every hormone produced by the body, in one way or another.
Doctors tend to overlook the fact that low thyroid function can masquerade as depression. They are afraid to prescribe a thyroid supplement when certain lab results appear to be normal, but they seldom hesitate to write a prescription for an antidepressant, whether it's actually indicated or not.
Forget TSH. That's important for textbook cases of hypothyroidism, but it doesn't fit many situations, and it's possible to be hypothyroid even though TSH results are normal. The big question is, "What are your Free T4 and Free T3 results?" (Not total T4 and/or total T3 — only the Free T4 and Free T3 results matter.) If either is below range, you are almost surely hypothyroid. And I agree with Deb, for uncommon cases, Armour, or one of the other natural dessicated thyroid supplements are superior to the synthetic thyroid supplements. The synthetic thyroid supplements often resolve the laboratory results, but they don't resolve the clinical symptoms for many of us. Do you have any of the following symptoms (disregard the constipation, of course, if you have active MC)?
Weakness
Fatigue
Intolerance to cold
Constipation
Weight gain
Depression
Joint or muscle pain
Thin, brittle fingernails and hair
Paleness
Slow speech
Dry flaky skin
Thickening of the skin
Puffy face, hands and feet
Decreased taste and smell
Thinning of eyebrows
Hoarseness
Abnormal menstrual periods
You asked what antidepressants can actually do, and that's a good question, because most of them have been shown in one way or another to be only marginally better than a placebo. However, the most popular antidepressants tend to increase serotonin levels, which helps to improve outlook and mood. Unfortunately, for many people, increased serotonin levels also cause D, but of course that isn't true for everyone.
And yes, hypothyroidism tends to be associated with perimenopause and vice versa.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Mandy- anything menopause related was not really considered. I brought it up as a possibility and the conversation continued without addressing the possibility.
Tex- I looked back at my notes from June and the free T4 was at 1.1 and nothing for the free T3, it wasn't tested or the nurse didn't give me all my information. I should call back and ask. The numbers don't mean much to me and she was not budging on her opinion. Most of what you've listed apply to me except of course constipation. No weight gain, I talk a mile a minute but frequently have moments of my mind going blank in the middle of a conversation or not being able to articulate a specific word, no thickening of skin or hoarseness, and my periods are still like clockwork but seem heavier than in the past and sometimes linger for what seems like forever. Everything else seems to describe me to a T. The paleness has pretty much always been me, I remember going home "sick" in school because teachers would come up to me and ask if I was ok because I was so pale. Guess it came in handy as a tool to get out of class.
Tex- I looked back at my notes from June and the free T4 was at 1.1 and nothing for the free T3, it wasn't tested or the nurse didn't give me all my information. I should call back and ask. The numbers don't mean much to me and she was not budging on her opinion. Most of what you've listed apply to me except of course constipation. No weight gain, I talk a mile a minute but frequently have moments of my mind going blank in the middle of a conversation or not being able to articulate a specific word, no thickening of skin or hoarseness, and my periods are still like clockwork but seem heavier than in the past and sometimes linger for what seems like forever. Everything else seems to describe me to a T. The paleness has pretty much always been me, I remember going home "sick" in school because teachers would come up to me and ask if I was ok because I was so pale. Guess it came in handy as a tool to get out of class.
Well, if you put it that way . . . I'm not sure.Deb wrote:Just curious, Tex... do you think synthetic thyroid works for the majority of people?
I just assumed that if it didn't work for most people, there would be enough negative feedback that changes would be made in the program. But you may be right. Most doctors seem to be very good at ignoring their patients claims, when their laboratory results look good.It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
DebE,
With so many symptoms of hypothyroidism, my gut feeling is that you would probably benefit from a supplement, but if your Free T4 was 1.1, and your Free T3 was well within range, then I can certainly see your doctor's point that your lab results look fine. It would probably be tough getting a prescription.
Regarding not gaining weight — that's not an issue, because MC can certainly trump typical hypothyroid weight gain.
What about your eyebrows? Is the outer third missing, or do they appear normal from one side to the other?
Tex
With so many symptoms of hypothyroidism, my gut feeling is that you would probably benefit from a supplement, but if your Free T4 was 1.1, and your Free T3 was well within range, then I can certainly see your doctor's point that your lab results look fine. It would probably be tough getting a prescription.
Regarding not gaining weight — that's not an issue, because MC can certainly trump typical hypothyroid weight gain.
What about your eyebrows? Is the outer third missing, or do they appear normal from one side to the other?
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Please, please have your hormones checked! Perimenopause can last for years, before reaching menopause. If your hormones are out of whack, then so is everything else! I am advocating bio identicals, not a synthetic HRT. Truly, give this a serious consideration. You may find that balancing your hormone levels will help balance your adrenals and thyroid, not to mention a host of other symptoms, such as depression, brain fog, etc.
Mandy
Mandy
Tex, I was surprised that I look in the mirror everyday and never even noticed that my eyebrows are considerably thinning. Yes, the outer third of my eyebrows are sparse- there's eyebrows there so I'm stuck obsessing about them now trying to decide if I'm reaching for answers but after running to my photo albums, I can see there is a difference although they are not totally missing.
Mandy- I'm waiting for a call back yet from the NP I saw earlier in the week, maybe I'll ask her to humor me and have them tested. Is that all that has to be said- to check my hormone levels? I found out the hard way when I asked a year ago to have my thyroid tested that I needed to specify not just the basic test. And speaking of adrenals.... I'm sure I didn't do myself any favors last year when I expidited my taper off prednisone.
Mandy- I'm waiting for a call back yet from the NP I saw earlier in the week, maybe I'll ask her to humor me and have them tested. Is that all that has to be said- to check my hormone levels? I found out the hard way when I asked a year ago to have my thyroid tested that I needed to specify not just the basic test. And speaking of adrenals.... I'm sure I didn't do myself any favors last year when I expidited my taper off prednisone.
DebE,
IMO, the disappearance of the outer third of eyebrows is a very strong indicator of hypothyroidism, regardless of lab test results, and I would think that any NP should feel the same way. It sounds as though your eyebrows are definitely headed that way, so it's only a matter of time before they remove any doubt. Comparison photos might help to convince your NP of what's happening.
Unfortunately, most doctors are not very good at diagnosing early stages of medical issues. They like to wait until the evidence is so clear that virtually anyone could make the diagnosis, especially if it's contrary to lab results.
Te
IMO, the disappearance of the outer third of eyebrows is a very strong indicator of hypothyroidism, regardless of lab test results, and I would think that any NP should feel the same way. It sounds as though your eyebrows are definitely headed that way, so it's only a matter of time before they remove any doubt. Comparison photos might help to convince your NP of what's happening.
Unfortunately, most doctors are not very good at diagnosing early stages of medical issues. They like to wait until the evidence is so clear that virtually anyone could make the diagnosis, especially if it's contrary to lab results.
Te
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Thanks Tex and Mandy,
I appreciate the information. I've haven't heard back from her yet, which is ok because I told her to take her time doing her research and gave the ok to take the whole week since it is a holiday. Maybe I can reach a compromise with her in taking what she recommends for three months with the agreement that we look into thyroid and hormones if I'm not finding considerable relief. This isn't my preferred path of treatment but I also don't want to jump from doctor to doctor since I've already found that it creates hard feelings with the original health care providers.
I appreciate the information. I've haven't heard back from her yet, which is ok because I told her to take her time doing her research and gave the ok to take the whole week since it is a holiday. Maybe I can reach a compromise with her in taking what she recommends for three months with the agreement that we look into thyroid and hormones if I'm not finding considerable relief. This isn't my preferred path of treatment but I also don't want to jump from doctor to doctor since I've already found that it creates hard feelings with the original health care providers.