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Mental Health (Expert Forum)
hypothyroidism & related depression
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD) , bipolar disorder , dementia , electroconvulsive therapy (ECT) , learning disabilities, memory, obsessive compulsive disorder (OCD) , panic , personality disorders, phobias , post-traumatic stress disorder (PTSD) , schizophrenia , stress , transitions, and work problems.
hypothyroidism & related depression
by Deanie__0, Aug 11, 1999 12:00AM
Posted by Deanie on August 11, 1999 at 22:04:02
In 1981, I was diagnosed with hypothyroidism. Symptoms were weight gain, cold intolerance, irregular periods (12-14 weeks apart), "moon face", and I believe an enlarged thyroid gland (not certain though; I was only 18 at the time and can't remember; don't think there was a goiter). I was placed on Synthroid for a year. Within the first six months, I had lost 15-20 lbs., periods became regular, and the moon face disappeared. At the end of the year, I was told that my blood levels were normal and taken off the Synthroid.
Repeatedly, in the years since, I have struggled with many of the symptoms of hypothyroidism...weight gain (I've gone from 105 lbs. to 180 lbs. since 1982), cold intolerance, very little sweating--even in 90 degree weather, dry skin, flaky nails, poor concentration and trouble with memory, constipation (though not to the point that it bothers me), fatigue, lack of motivation, thin hair, graying hair before 30 years old, off and on depression, reduced desire for sex, headaches, and leg cramps. Some symptoms I can't answer to because I am on the birth control pill...so obviously, my periods are very regular.
Two years ago, I saw a new primary care doctor who was willing to prescribe a low dose (0.025mg) of Synthroid. Within two weeks, I was seeing some improvements...I didn't get nearly as cold, the leg cramps went away, as did the headaches, I wasn't nearly as tired, even the dry skin went away, and I stopped crying at the drop of a hat. At the yearly follow-up, my doctor had left. The new doctor did not feel comfortable with my request for an increased dosage, and gave me a referral to the endocrinologist in our hospital. He, unfortunately, did not believe I had hypothyroidism, said my TSH was normal, discounted my past history and symptoms, and took me off the Synthroid. After a month and half, I thought I was going nuts...I was tired all the time, felt like I couldn't function, was depressed, couldn't think, couldn't stop crying. I went back to see him and though he did not want to, he did put me back on Synthroid at an increased dosage (0.05mg) and asked to see me in 6 months. At the follow-up (which was in Feb of this year), he asked me how things were going, told me to continue the meds, and said he would see me in a year. Needless to say, I couldn't believe it was the same doctor.
In late April/early May, I began feeling tired again, cold, was having headaches, felt very stressed though my schedule really hadn't changed any, skin was dry again, etc. I was feeling a lot like I did when he took me off the Synthroid, and thought maybe the dosage needed to be increased again. At my request, the doctor ordered a blood test which was normal--again. So he referred me back to my primary care doctor to make sure nothing else was going on.
After explaining all the symptoms to her, she ordered tests for anemia (I am borderline anemic and have been on iron pills in the past) and prescribed Paxil to treat the depression. Now I'm really frustrated, because I feel like I'm not being taken seriously. And I told her that I felt like she was treating the symptom, rather than the cause.
I guess my question is...is it possible to be hypothyroid and the tests not indicate it? Could it be that when I was diagnosed in the early 80's and then taken off the medicine that my thyroid system got screwed up? Why didn't it occur to the doctor in 1982 that the reason my TSH was normal was because I was taking Synthroid?
Everything I've read and been told is just screaming that I have hypothyroidism. Even my family history fits in...my paternal grandmother had severe arthritis (she was confined to a wheelchair for as long as I can remember until her death in 1981; though I've been told she was still walking when I was an infant); and my dad had pernicious anemia and can remember being hospitalized, and having to take shots, because his anemia was so severe.
I guess I'm just not certain where to go from here. I'd like to have my Synthroid dosage increased so that I can feel healthy and normal again. Even my endocrinologist says that my dose (0.05mg) is a very small dosage. But he refuses to see beyond my normal TSH and won't increase the dosage.
Is there any advice you can give to help me? I'm beginning to lose heart in this battle for my health.
Posted by HFHS.MD-AJ on August 14, 1999 at 16:27:34
Deanie,
Hypothyroidism, anemia, and depression may share similar symptoms such as weight changes, impaired concentration/memory, fatigue, amotivation, and decresed libido. You may find it helpful to consult a psychiatrist for thorough evaluaton. I will defer to your endocrinologist with regards to questions about your thyroid status. You may consider seeking a second opinion about this.
This response is provided for general educational purposes only. Always consult your physician for any health concerns.
