[cornelius]

#1018169

Hello! I am a young (29) mother of 4 young children (15 months, 3, 6 & 8 years) while enjoying being a stay at home mom at the moment. I have become increasingly concerned with my irritability when dealing with my children. I am currently taking Synthroid .175 mcg (?) after having RAI treatment in May 2005. My thyroid levels have only been within normal ranges during my last 2 pregnancies and my most recent bloodwork in November 2010 showed I was within normal range even though I don’t feel they are.
My mood has become more and more unfocused, easily aggitated, foggy, tired and I have regretfully been taking it out on my children. I am not beating them or anything, just lashing out more often than ever and definitely more often than I would like. I have been on Zoloft to help with depression for a few years and have gradually decreased dosage amts to 25 mg every 3 days (I tried stopping cold turkey last summer without knowing the horrible withdrawal effects that come with abruptly stopping the medication).
I would like to get off the Zoloft completely because sometimes I feel like I am a "zombie" in a way. That affect has worn off some since decreasing the dosage, however.
I go to see my psych dr tomorrow and was wondering if there are any suggestions to bring up about a different medication to help with my mood. My kids deserve a mother who isn’t always so anxious and tied up in other thoughts that she can’t stay focused long enough to have a normal discussion with them or can’t sit down long enough to read a couple stories before bedtime or play a board game without the thought of "there is something else I need to do so lets get this over with."
I hate feeling like I am not focusing enough on my children!!!!! It seems as though there is always something else I have to get done (laundry, dishes, cleaning, worrying about how to pay bills, etc). I know I should just tell myself that the small stuff can wait until after my kids are pleased and paid attention to, but it’s easier said than done. I have tried Xanax, but that doesn’t seem to help any. Just makes me tired really. I take Ativan at night to help with restless leg syndrome so I can at least get to sleep for a little while.
If anyone has any of the same feelings or any suggestions, I would greatly appreciate it!
(I joined ngfd.org a while ago, but have regretfully neglected to keep in touch with this discussion board. I wish I would have kept more in touch with the board because It is such a great relief to know there are others out there that suffer the same symptoms I may!!!! ” title=”Smile” />
Thank you.

Christa

[Bobbi]

#1063065

Irritability, if caused by our condition, typically occurs when we have too much thyroid hormone. I was lucky enough to have three teenagers when I was diagnosed. Lucky? Some folks wouldn’t agree, no doubt. But at their age, my kids were able to accept that my irritability had nothing to do with them. I know it wasn’t fun for them, but I made sure that they knew I was the problem, not them. I would tell them so, prior to bursting into tears, or yelling about a mess. "I know this isn’t your fault! But I am soooo upset. I just cannot stand this mess!" That sort of thing.

So, even though your kids are younger, you may need to try a similar sort of response to them when you feel yourself getting upset. Pause long enough to put your message into an "I" message: "I am upset," "I am tired and cannot clean up another mess," "I don’t like tripping over toy," etc. This is opposed to a "you" message: "You make me so mad…," "you never pick up your toys," "You are always spilling," etc. You may already do this sort of thing, but if you don’t, and can change your approach, it can be really helpful to help your family feel less verbally battered when your bad mood hits.

You mentioned that your thyroid levels are not always in normal range, so that is something to check. Fluctuating thyroid levels CAN increase irritability. Getting them stablized, always normal, is important. So, if you are not already doing this, make sure that you take your replacement dose first thing in the morning, before you take any other medications, with a glass of water, and wait at least a half hour before you eat anything. You might also have blood work done to check that you are still, indeed, well inside the normal zone for thyroid hormone. Sometimes, other medications can affect the amount of replacement that we need. It isn’t common, especially if we’re able to space the dose of the other medication away from our dose of thyroid hormone, but it does happen, and since you are going off the Zoloft, if it IS affecting your thyroid levels, you might need to be making concurrent adjustments with your thyroid dose.

Not all irritability can be caused by aberrant thyroid levels. Being the stay at home mother of four very small children is a demanding occupation. Staying on top of things takes either monumental organizational skills or amazing flexibility — or both. I only had three children. The third one seemed to add a level of chaos to things I had not anticipated — even though he was not a difficult, or challenging child. It’s just that three little people going in three directions is a lot confusing! Four…..Well, I give you and your babies hugs. I know it’s a lot of work.

[cornelius]

#1063066

Thank you for your response, Bobbi. I appreciate your suggestions. It’s hard when all I want is for my children to be happy and FEEL loved yet I am lost in a mist of anxiety and irritability. I will use your suggested measures of using "I" statements more often.
As for my always fluctuating thyroid levels, this has been ongoing for many years. Like I said, the only time they have ever been Normal is while I was pregnant. I get bloodwork about every 6-8 weeks and have my medication adjusted accordingly. However, because the new dosages take approx 6 weeks to even start making any effect, it makes it hard to ever get it just right. Another stick in my spokes is that I live in a small town and the closest endo is an hour away….so needless to say, I don’t get to his office as often as I should. My family dr was handling my case locally until she came to a point where she didn’t feel comfortable switching my doses as often as we were (about every 8 weeks.) My most recent labs were done in November and the endo sent a letter stating to "stay on the current dosage regimen–.175 6 days a week of the levothyroxine. I ran out of the meds last week and tried to get a refill, which the endo denied until I am seen in the office an hour away!!!!! I am a little p.o.’d about that, since they are well aware that I live far away. They saw my bloodwork results, so what the heck do I have to be seen in the office for???!!! Just another addition to the stressfulness of a thyroid disorder I guess!
Anywho, thanks again for your response. I greatly appreciate it. Talk soon.

[snelsen]

#1063067

Hi Christa, nice to meet you. I hope my post is not too fragmented, but there is a lot to think about for you!
1. Zoloft. Sorry you had the experience of discontinuing the drug abruptly. The doc and the pharmacist let you down, but not fully educating you about stopping any anti-depressant. They need to be tapered very slowly. But since you have been on Zoloft a number of years, I question if that is the cause of your feeling zombi-like? Don’t know, just wondered what you thought.

About Synthroid. My experience with my endo is to be very very conservative before making a dose change. He likes to wait at least ten weeks, prefers 12, for a lab. i am to call him if my subjective symptoms are really changing a lot (getting really hypo, getting really hyper, fast pulse, anxious jittery, and I just know I feel newly crappy. Then we do get a lab, and usually discuss together what to do. The thing about Graves’ is that it TAKES SO LONG to feel the changes, and pretty darn long to have the labs reliably reflect what is going on to responsibly make the changes.
I want to be sure that you know it should be taken first thing in the morning on an empty stomach with water. My strategy for this is to have the med and a glass of water by the bedside, and if I wake up in early morning, I take it. To combat remembering if I did/didn’t, I have the bottle upright before I take it, and put it on its’ side after I take it. Of course another way is to have a pill box with the days. And vitamins and calcium supplements should not be taken after Synthroid for at least 4 hours. I say all of this because at one time i was taking it on a full stomach, empty stomach, etc, and the reslt was that the labs were not reliable from blood draw to next blood draw.
Gosh! Any way you can make this easier on yourself by having the labs drawn where you live, and faxed to the endo?
I hate to see you without any Synthroid! I suggest you call the endo office, explain that you have NO MED! I am sure he would not want that! This sounds like a communication breakdown, and a bad one. If she wants you to stay on the meds, you need a refill. Was it written for only one month with NO REFILL written on the bottle. Any chance for a misunderstanding here? So, my question to you, is what can you do to resume taking the med? Plus, the labs won’t tell anything, because you have been off the med for a week.

My dear, you have your plate full with 4 kids under 8. I have no idea if this will help with the conflicting feelings you have about wanting to get stuff done, and thinking about it when you are with your kids. But here goes. When I had little kids, I had a good friend who had three kids, all of them under 6. Audrey made herself crazy by cleaning, sorting, was irritable, felt guilty for yelling,etc. I, on the other hand, was so laid back, if I didn’t get the baby and the 2 year old dressed for the day, I was fine with it. One day, at the playgound, another mother told us she was a perfectionist, until one day a friend asked her if she wanted "Her house was clean" on her tombstone. That really helped her let go of a lot. One thing that helped me, was to "lay out" my kids clothes the night before so I did not have to think in the morning. (except for the days when I did not dress the younger two! ” title=”Smile” />
I think Bobbi gave some good advice with the "I feel, I am" statements. Better than ones that begin with "you." But I know what you mean, and I have "been there." I was hyper+++ after my first baby, went undiagnosed for almost three years. it was hell, and I felt like I was the mother from hell, and terribly guilty.

I do realize the constraints of a small town and the commute to see the endo, and all the complexity of doing that with 4 kids. But it is not really a bad thing that he wants to see you. Lots of people on this site would envy you!
I know this is long, I really want to tell you I do understand, and can relate. Each day seems like a year until we get this Graves’ tiger tamed.
Shirley

[Bobbi]

#1063068

A couple of things, Christa. You said something about having to be on the meds for six weeks BEFORE they start to work. If that is what you are thinking, it is not quite correct. The meds start working immediately. What doesn’t happen for six weeks to three months is for the TSH to catch up and register how well the dose change is working.

Like Shirley, I am concerned that you haven’t had your meds for a while. That is completely unacceptable. Try to keep in mind when you are talking with someone at your endo’s office, that the person on the phone may not be a doctor, or even a nurse. They are a telephone receptionist usually. And completely unqualified to make medical decisions. Usually, I ask for at least the nurse practitioner. (See, this has even happened to me.) And I challenge that person to tell me that it is OK for me to go without replacement hormone for whatever amount of time it’s going to take to get in to see the doctor. The person who answers the phone, and the nurse practitioner, too, have the doctor’s policy firmly in their mind, and will often try to enforce those policies without thinking of the consequences unless we call them on it. I don’t believe ANY consciencious (sp?) endo would make you go any length of time without an Rx, but a telephone receptionist might. We must push back just a little.

[cornelius]

#1063069

Bobbi…my endo is the one who informed me that the meds don’t "take effect" for 6 weeks…perhaps I misunderstood this and believed that it takes that long to actually FEEL the effects. Unfortunately, I am not really sure what "normal" feels like.

I was diagnosed with hyper-thyroidism when pregnant with my 2nd child. I was about 6 weeks pregnant and down to 84 pounds from a norm of 95-100. I read an article in a parenting magazine about thyroid issues and said to myself "I have all of these symptoms!" I immediately called my family dr (who is no longer my dr) and said I want to be tested. Her response was "Those are typical pregnancy symptoms." I demanded to be tested anyway, and sure enough, I was severly hyper. I was sent to a specialist (an hour away), put on PTU while pregnant (Class D med during pregnancy), plus had to drive the hour trip twice a month to see the endo and have an ultrasound (could never get the appts scheduled for the same day-ARG!) Anywho, my daughter was born very healthy, YAY! Shortly after she was born is when I had more tests done that lead to my diagnosis of Grave’s Disease. I was HORRIFIED to say the least. About 3 months after my diagnosis, my fiance was caught cheating and I left him….long story. I think I live in a world of stress, which doesn’t help matters much!!!!

When I went to the pharmacy for a refill on my script, they told me the dr denied my refill until I was seen in the (hour-away) office. I then called the office and the receptionist said the same thing, yet can’t get me in until Feb. I currently have a stash of .137’s on hand that I am taking, so I have SOME synthroid in my system, though it is not enough. I was taking .175’s 6 out of 7 days. I am a little twerked about it, too, but feel at a loss right now. My family dr whom I was very close with recently moved out of state and her replacement won’t refill my script, either. I wish I could find a new dr, but there is only one endo in the nearest city (Rockford, IL) who will accept the state medical card. I do get my labs drawn here in town at our local clinic and the results are faxed to the endo, so I don’t understand why they can’t refill….I will call tomorrow and speak to someone else about it (per Shirley’s advice! Thanks!).

I, too, am upset that the dr who put me on Zoloft didn’t expain the risks of stopping the med. I have been slowly tapering off for nearly 8 months! The behavioral health dr put me on Prozac 20 mg daily…hopefully it will help. I do believe that the Zoloft is what was making me feel zombie-like, however, I guess I could be wrong.

I am aware and follow the guidelines of taking synthroid in the morning, with water and on an empty stomache. I take mine when I get up with my 2 school ager’s and they get their vitamins at the same time. So, they remind me and I remind them! ” title=”Smile” /> When I was pregnant and breastfeeding, I took my prenatal vitamins in the evenings so the two didn’t interact. I purchased the book "Graves Disease in Our Own Words" which has given me alot of insight and helpful tips that my endo did not share with me. If either of you would like to borrow this book I would be more than happy to mail it to you! ” title=”Smile” />

Thank you so much for taking your time to "chat" with me. It is really hard sometimes to grasp the idea that I am so young with this disease. No one in my family (that we are aware of) has been affected by thyroid issues, but then again, there are SO many people who go undiagnosed!!! Everytime a friend of mine mentions a symptom I am so very familiar with I tell them "GET YOUR THYROID CHECKED!!!"

On another note….I have started all my kids on a very strict schedule of getting out clothes for the next day, packing backpacks, same-time every night bedtimes, etc. to help with my irritabilities in the mornings, which also helps me to have some "down time" before I drift off for the night.

Again, thank you so much for your insights!! Greatly appreciated and will chat again soon!!!

~Christa

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