My intro... - VERY LONG - URLs and resources

[Guest guest]

Momto7kidlets wrote:

>> I am struggling with depression and am desperately looking for some help. I

>> don't believe that because raising seven children alone would be hard, I love

>> him, he really does love me, but screwed up, etc.

>> Also are there any other suggestions for depression? I am on a quest to fix

>> myself since the medical community is failing me.

Pam wrote:

> Also, how is your thyroid? If you lack zest and energy, feel depressed, it

> could be your thyroid gland that's underactive. Other common symptoms of

> hypothyroidism include painful and excessive menstrual periods, nervousness,

> unexplained weight gain, low sexual desire, memory loss, dry and scaly skin,

> and sleeplessness. Hypothyroidism occurs in one out of eight women by the age

> of fifty. If do have hypothyroidism, avoid oral contraceptives and

> tranquilizers, as they deplete thyroid function.

~~~~~~~~~~~~~~~~~

 

Michelle,

 

In addition to Pam's good advice on cutting back or eliminating all sugar

and white flour (all refined foods), and Liz' advice on SSRIs or

supplements, I'd like to quote a doctor (MD) who has a lot of insight into

interrelated hormonal problems, depression and thyroid. You really need to

find someone like him who will consider the whole picture, who treats

symptoms and not labs, and who will listen to you:

 

BEGIN QUOTES

 

Re: Emotional problems. The severe effects that untreated hypothyroidism

had on the moods and behavior was first written about in the 1830s. In 1888,

the definitive paper was published in Britain and it described psychiatric

disturbances that ranged from depression and anxiety to frank hallucinations

and aggressive behavior. It is a very real possibility that emotional

problems are due to thyroid problems. An Electroencephalogram ( " brain wave

test " ) can often detect the metabolic encephalopathy (damage to brain

function) that hypothyroidism causes.

 

" I never thought that I would feel this way, but I now think that untreated

or inadequately treated hypothyroidism are the worse unrecognized health

problems in the USA today.

 

" The $2-$3 pill antidepressant sales people will bring in lunch, sweet talk

the staff, and have expensive CME (continuing medical education)

infomercials at the most posh restaurant in town. And, those boys (and

girls) get paid a bonus based on the increase in sales of the product in

their territory.

 

" Still worse, the antidepressants don't work well, or give you bizarre side

effects if you are low on thyroid.

 

" Time intensive Medicine is expensive. It is expensive to purchase and it is

expensive to deliver. Yet I feel that that I've been able to earn my keep by

putting a dent in the 60% of all women who get hysterectomies, many for bad

periods which are very often due to the undiagnosed and untreated

hypothyroidism.

 

" I like to think that we saved a few folks a trip to Coronary Care Units

because heart attacks are twice as common among the hypothyroid. I've seen

people who habitually miscarry be able to successfully complete a pregnancy

once on enough thyroid. Dr. Arem said that about 25% of those referred to an

infertility clinic really have thyroid troubles.

 

" My all-time favorite is the young man who was on a Heart Transplant waiting

list, until the depression and a suicide attempt landed him a consult with

me. He was hypothyroid, too. He's back in college, now.

 

" I'm not advertising because I am swamped. But, I sincerely urge anyone who

feels that they are low on thyroid to get it taken care of. Having wasted a

big part of my life as hypothyroid, I can honestly say that I had no idea of

how much life that there really is. None of these are my ideas, they had

been successfully managing most of these problems in the 40s. "

~~~~~~~~~~~

Another Q & A from the same source:

 

<< Why on earth has it taken this long for someone to listen and put me on a

correct dosage? >>

 

" Please convey my highest regard and respect to your doctor. Your

observation is accurate: The most common problem that I have also seen on

the thyroid boards and in my own life is that 1. Hypothyroidism is not

diagnosed, 2. It is not treated adequately and 3. Too many docs use numbers

from the labs instead of brains. Labs too often get heard, while patients

get ignored and charged exorbitant rent on the depressive prison of

hypothyroidism.

 

" When you realize that the terrible dangers of inadequately treated

hypothyroidism range from painful, heavy menses, to premature heart attacks

and strokes, depression, and elevated lipids; it is frightening to imagine

the number of people who are suffering or dying from the general ignorance

of the medical profession. Virtually everyone I have seen for hypothyroidism

manifested by fatigue, depression, or fibromyalgia has already been offered

a trial of an antidepressant. "

~~~~~~~~~~~~

Another Q & A:

 

<< Please enlighten me as to what I can expect ie. scans, labs, meds.

Looking forward to your insight. >>

 

" Depending on your doc, you can expect anything from

 

1. Someone who does a blood test on you, ignores the fact that you have

more signs and symptoms of endocrine problems (Thyroid and Adrenal, and

maybe Ovary) than they teach in Med School these days, and either orders

more tests (perhaps a scan-it doesn't hurt) or tells you (based solely on

labs) you have nothing organically wrong and then tried to put you on an

antidepressant.

 

2. Or you might luck out and get someone who knows that patients are more

complex than blood tests, and who will sit down and LISTEN to your story,

take a good history, do an exam, and then order blood work. He or she will

base the diagnosis on what you said more than on the labs, will believe you

and your knowledge of your body, and will give you a careful trial of

medication if it is indicated.

 

" I wish I knew some way that you could guarantee that you'd get the right

type, but the next best thing is to know how to evaluate your doc. Look at

Mary Shomon's thyroid information site at

http://thyroid.about.com/cs/basics_starthere/

She has some really good insights into the Medicine Game, and her book on

thyroid is even better [Living Well With Hypothyroidism - What your doctor

doesn't tell you... that you need to know].

 

" When people stop accepting poor care, it will improve. "

~~~~~~~~~~~~

 

Another quote:

 

" Most docs who listen to the patients they treat will candidly admit that if

you go by the " right TSH, " you will usually be undertreating your patients.

 

END QUOTES

 

The above are comments from a Board Certified M.D. [Neurology/Psychiatry]

who now helps mostly those with thyroid, adrenal and related disorders.

~~~~~~~~~~~~~~~~~~~~

 

Don't accept medical advice that grinds you down or brings treatment

options to a halt. There is much you CAN do. Just don't lose heart.

Knowing more than your doctor on the subjects you suspect relate to your own

health is vital.

 

Then it's vital to find a doctor you can work with, and who will listen to

you. One who not only knows what to test for, but how all the hormone

systems are interrelated.

 

Michelle wrote:

> I do have Hashimoto's hypothyrodism, so I have that checked regularly. I have

> never had my hormones checked - how would I get that done? Just ask my

> doctor?

 

I'm assuming you are on thyroid meds. It is not always a simple matter to

titrate meds to achieve the correct dosage, and meds for depression skew

results. Some people can't convert the most commonly prescribed med (T4

such as Synthroid) to the working hormone, T3 in the body. Some docs look

at the lab results, and pronounce you " normal " because the test is within

range and ignore your symptoms of thyroid disease. Some refuse to consider

(or are ignorant of the fact) that you may not be able to convert T4 to T3.

Some don't realize that you may have too high levels of reverse T3, which

prevents the proper use of T3, the working hormone.

 

Other hormone levels that should be checked are estradiol, progesterone,

testosterone, DHEA, cortisol. Thyroid hormone tests should include TSH,

antibodies, free T3, total T3, free T4, total T4 and possibly reverse T3

(rT3). Start a health diary and record your test results, along with the

ranges the laboratory uses for each test.

 

Remember, that many docs out there diagnose by tests alone. If you have one

of these, find one who will look at SYMPTOMS as well, and look at the whole

picture. Someone who will listen to you and work with you.

 

Here are some URLs to help you " know more than the doc " :

 

~~~~~~~~~

http://thyroid.about.com/health/thyroid/mbody.htm

Mary Shomon - A good resource on thyroid problems including many links to

other pages which are worth following up. Mary is the author of " Living

Well With Hypothyroidism - What your doctor doesn't tell you ... that you

need to know. "

 

~~~~~~~~

http://thyroid.about.com/library/weekly/aa102797.htm?terms=top+docs

Mary Shomon's guide: Who are the Top Docs?

What makes a Top Doc? Someone who listens? Someone who doesn't just manage

you based on your TSH levels? Someone who doesn't keep you waiting for hours

for an appointment. It's very different for everyone! But for the past

several months, readers of " Sticking Out Our Necks, " my email newsletter,

have been sending in information on Top Docs, the doctors they really like

and recommend in their quest for good health while living with thyroid

disease. Maybe one of these doctors is the right one for you!

 

~~~~~~~~~~

http://thyroid.about.com/cs/testsforthyroid/

Mary Shomon's guide to thyroid disease. Tests for Thyroid Disease.

Information about tests to diagnose thyroid disease, including the TSH, T4,

T3, TRH and thyroid uptake tests.

 

~~~~~~~~~~~~

http://thyroid.about.com/gi/dynamic/offsite.htm?site=http://www.thyroid%2Din

fo.com/articles/docdon.htm

" Getting What You Need From Your Doctor: Challenges of Thyroid Care " - Mary

Shomon interview Don " Doc Don " Michael, M.D. He practises holistic medicine

in South Bend, Indiana, went to Wayne State University School of Medicine,

completed a neurology residency, and later completed one in psychiatry. He

was Board Certified by the American Board of Psychiatry and Neurology in

Psychiatry.

 

~~~~~~~~

http://www.hsc.missouri.edu/~daveg/thyroid/thy_test.html

Explanation for some of the thyroid function tests.

 

~~~~~~~~

http://www.endocrineweb.com

This claims to be the Largest web site for Thyroid, Parathyroid, Adrenal,

and Pancreas disorders. It contains good explanations of how the endocrine

system functions.

 

~~~~~~~~~

http://www.healthy.net/library/articles/schacter/hypothyr.d.htm

An excellent article on The Diagnosis and Treatment of Hypothyroidism

by Michael Schachter, M.D., P.C.

 

~~~~~~~~~~~~~

http://www.ama-assn.org/sci-pubs/journals/archive/jama/vol_273/no_10/sc4291.

htm

JAMA - medical journal - thyroidism

This medical resource recommends only T4 (levothyroxine) as a treatment. I

don't agree with this, but there is other useful information on the site.

 

~~~~~~~~~~~~~

http://www.thyroidmanager.org/

THYROID DISEASE MANAGER

This site provides very authoritative insights about thyroid. The site

is maintained by thyroid experts from around the globe. More technical

but very resourceful especially the diagnostic and treatment algorithms.

 

~~~~~~~~~~~~~

http://www.thyrolink.com/

Merck. Similar to Thyroid Disease Manager. Also techical but reflects

international agreeemnts on guidelines.

 

~~~~~~~~~~~

http://thyroid.about.com/library/weekly/aa021199.htm

from the February 11, 1999 issue of the New England Journal of Medicine

(Volume 340, Issue 6, Page 0488)

" Effects of Thyroxine as Compared with Thyroxine plus Triiodothyronine in

Patients with Hypothyroidism " - Reports on the results of research that

found that " treatment with thyroxine plus triiodothyronine improved the

quality of life for most [hypothyroid] patients. "

 

AND and interview with Dr. John Dommissee, on the same subject:

 

http://thyroid.about.com/library/weekly/aa092299.htm

John Dommisse, M.D. Interview - Thyroid Disease - 09/22/99 An Interview

with John DOMmisse, MD - " Effects of Thyroxine as Compared with Thyroxine

plus Triiodothyronine in Patients with Hypothyroidism " by Robertas

Bunevicius, Gintautas Kazanavicius, Rimas Zalinkevicius, Arthur J. Prange,

Jr.. Research was conducted by the Institute of Endocrinology, Kaunas

Medical University, Kaunas, Lithuania along with the Department of

Psychiatry, School of Medicine, University of North Carolina, Chapel Hill.

 

~~~~~~~~~~~

http://www.meddean.luc.edu/lumen/MedEd/Medicine/endo/thyroid.htm

A slide presentation with very good insight into thyroid disorders

 

~~~~~~~~~~~

http:www.aace.com

AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS

 

~~~~~~~~~~~

http://www.merck.com/pubs/mmanual/sections.htm

MERCK MANUAL OF DIAGNOSIS AND THERAPY

Section 2. Detailed info on most endocrine disorders and other body systems

too.

 

~~~~~~~~~~

http://www.rxlist.com/

RXLIST - The Interned Drug Index

A drug searcher with complete details including drug interactions. Just type

either generic or brand name. Only drugs available in U.S.

 

~~~~~~~~~~~~

http://www.rxmed.com/index.html

RXMED

Similar to RxList but may not contain drugs not available in U.S. To

search go to " Prescribing Information "

 

~~~~~~~~~~~~~

www.fda.gov/cder

- then to drug info

- then to one of the selections there

FDA info on all thyroid drugs on the market for FDA-approved prescription

drugs. This gives manufacturer + address, brand name, generic name,

strengths, history, etc. All in one little table.

 

~~~~~~~~~~~~

http://cp.gsm.com/fromcpo.asp

CLINICAL PHARMACOLOGY 2000

Comprehensive info on drugs. Requires registration

 

~~~~~~~~~~~~~

http://www.emedicine.com/emerg/index.shtml

eMedicine - For thyroid emergencies and others as well

 

~~~~~~~~~~~~~~

http://www.ncbi.nlm.nih.gov/PubMed/

PUBMED (MEDLINE SEARCH)

Medical searcher

 

~~~~~~~~~~~~~~

 

Many docs are resistant to change, or discussion with patients. The best

approach is to go armed with as much information as you can, and insist on a

doctor who is willing to work WITH you.

 

Joan McPhee, not an M.D.

mcpheej