hypo and depression

[bbabbles]

My doctor diagnosed me with hypothyroidism, TSH level 45, last October after I had gone to see her for depression. I am currently taking 50mg synthroid and 300mg Wellbutrin XL and after some rough spots have felt good the last 3 months.  Lately though I have just visited the doctor becauseI have been experiencing a racing pulse, light sensitivity, and have trouble sleeping (mind racing).  The doctor has now prescribed 25 mg Xanax 2x a day for panic attacks.I don't think I am having panic attacks because it happens at times when I am very calm and or happy.  I think she thinks I am crazy.  My bloodwork came back normal TSH 1.056.  I am not taking the xanax and worry about taking it and the wellbutrin, I feel like I am just fixing symptoms and not the problem.  Is this common? Are the symptoms I am experiencing unusual for someone in the normal range?  The only other symptom I have is I can eat just about anything and not gain any weight, which is nice but not normal, especially for me.  I am 43 about 5'5' and wiegh 128.  Thank you.

[straw_citizen]

If it was me, I would to rule out Hashimoto's with tests for antibodies combined with free T3 and free T4.  Synthroid provides only T4.  If T4 isn't converting to T3 adequately, you should be aware that 1) Synthroid may not be able to do what your thyroid needs and 2) T3 is sometimes used to treat panic and anxiety disorders (surprise).  In fact, it's well documented that thyroid symptoms are often confused with "mental" or "emotional" disorders including bipolar.  Been there, done that and never was bipolar for a minute.  As soon as T3 was added (Armour, though now on Thytrophin so I can get it as needed without a prescription), sailing was considerably smoother.  That led me to investigating remaining symptoms, some of which overlapped with adrenal fatigue.  Once adrenal fatigue was treated, thyroid meds were easier to adjust and adapt to.

[nessifly]

One more thought:  could it be side effects of the Wellbutrin?  It can be a very activating drug.

[nessifly]

I wonder if after being at a TSH of 45 for so long, 1 is just TOO LOW for you and you are experiencing hypERthyroid symptoms.  Maybe you should talk to your doctor about this possibility and maybe lower your Synthroid dosage.  I know that some people like to have their TSH lower than 1 to feel their best, others feel great if their TSH is around 4, etc.  Good luck!

[Mark Lupo, M.D.]

The TSH is pretty good -- tough to say it's related to thyroid.  You may have an anxiety disorder.  Some patients get agitated on wellbutrin -- this may be contributing.  I doubt it is inappropriate adrenaline production (pheochromocytoma) -- but can screen for this with plasma free metanephrines.