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johnlawrenceaspden comments on A Medical Mystery: Thyroid Hormones, Chronic Fatigue and Fibromyalgia - Less Wrong
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TSH had been in the 3+ range, with T3,T4 in the low end of normal, probably for a decade before I started any treatment - I started with dessicated thyroid.
Your experience with the iron is interesting - I checked ferritin levels and they were ok, so I didn't go in that direction.
Two grains brought TSH down around 2, and brought T3,T4 to upper half of their ranges. One thing interesting. I was going through a bad time emotionally and financially when I started, and I went up to 3 grains to try to get TSH down to around 1.5. That brought TSH to 0, and brought me to the worst depression of my life. I tend toward anhedonia and flat emotions, and I kind of wonder if I was just finally "getting in touch with my feelings" - i.e., I had things to be unhappy about, and was finally actually feeling them.
From my reading, apparently a depressive crash is common enough to be notice by people starting on thyroid hormones. I don't recall a doctor ever mentioning this, but I did see it at thyroid support sites. Something for you to be aware of, particularly if you're upping your doses on your own say so.
I was off of any meds for a year, and when I next tested TSH was up to 5, though free T3, free T4, reverse T3 were technically still in the low normal range. I've started back on 2 grains. Last test that only brought TSH down to ~4, but I didn't test T3,T4 so I don't know how they're doing.
I've got more fiddling around to do.
Not indefinitely. If you pull back TSH levels < 2.0, and you still have symptoms, then maybe you have some other problem. My philosophy on hormones is to get them in a "good" (not just "normal") range. If you still have some issues, then you start looking around.
Yeah. If you've got a health issue, do something about it. I regret the time I haven't spent doing something. No regrets, even when experiments went awry. Much better than doing nothing.
Hi Dan, I can confirm your observations and I thank you for them. Not a depressive crash, but a sudden and totally unexpected intensification of my normal emotions over the last few days, on 21mg/day of desiccated thyroid. It was quite obvious from the inside, thanks to your warning. No hyper symptoms at all. I've been watching for them.
I contacted a friend with some experience of psychiatric diagnosis, and he and I agree that I'm showing some of the symptoms of a mild bipolar disorder. I may have caused it, or that may have been the problem all along. The down phase looks like CFS, apparently, and is quite common. But who knows?
He's advised me to stop obsessing about this problem, and I'm going to try.
For obvious reasons this should be my last comment on the matter for a while!
Sorry to waste everyone's time. Pray for me, those of you who believe that it will help.
Once I'm completely sure that I'm capable of thinking straight, I might come back and re-read what I've written to see how much sense it makes. How embarrassing to go mad in public.
Thank you all. Talk about reasoning under uncertainty!
That's a better description of what I experienced. It was depression in the sense of an intensification of anxiety and sadness, not in the sense of lethargy and apathy. Also, I think I was having heart palpitations.
The thing is, I think the symptoms you list are Hyper symptoms. I googled HYPERthyroid symptoms, and sometimes saw mentions of bipolar, crying fits, and mood swings, along with the usual heart palpitations and anxiety.
I wonder if sudden increases in thyroid levels at low basal levels can have some of the same effects as long term high basal levels. That's consistent with some models of psychiatric meds - at low basal levels, you're upregulated to compensate, so that initial bumps are equivalent to high basal levels until your system downregulates.
I don't mean to feed the obsession, but at the time the worst aspect was feeling in the grips of some psychological problem I didn't understand, instead of merely just having a reaction to meds. As I hazily recall, I think I backed off on the dosage and the symptoms went away a few days thereafter.
Take care of yourself.
Oh. Just got some lab work back. TSH down to 2.2. T3 mid range. DHEA/Progesterone/T/E2 all right where I want them (I'm big on life extension and HRT). Yay!
Dan, again I hear you and agree. I thought I was being so careful. What a fool I am.
Good luck! Be careful. Note the awe-inspiring lack of smugness with which I pretend to greet your news.
In case anyone is worried, my attorney (who really really should know, and who spotted me going off the rails at almost the same time that I did) advises me that I am no longer any more mad than usual, and gives me permission once again to contemplate the question of the thyroid.
I still have a feeling that I am experiencing my emotions full strength for the first time in ten years, and I have forgotten how to do that. Another bloody skill to learn.
Personally, I have found not thinking about this to be a most relaxing hobby, and I intend to do more of it in future.
I have found great solace in sport, history, literary theory, ancient mythology, and popular music. And much unexpected wisdom there!
Those of you who prayed, thank you. It appears to have worked.
Those of you who did not, well, I wouldn't have bothered either. But were you scared to try the experiment? If so, and you did not, you are far from the way. As are we all.