[Anonymous]

#1020172

Hi,

I had a thyroidectomy 15 months ago and I am still not feeling ‘well’. I feel like I am on a rollercoaster with many ups and downs. Going from feeling totally normal to feeling really crappy. My TSH is 0.3. I am on Cipralex (Lexapro in the U.S.A) as I am being treated for depression which started right after the surgery. I had never had depression prior to the surgery. I am not totally convinced that this feeling of unwellness is all depression though.

I am on synthroid 100mcg and I have read that many people never feel well on T4 replacement therapy alone. Any input would be appreciated.

Carla

[Anonymous]

#1076229

Hi Carla,

I’m so sorry you’re feeling badly! Your TSH level is pretty low ~ do you know where that value falls within the range of normal at your lab? The range of normal is really quite large, because different people feel “normal” on different points along the scale, so all points within that range can be classified as “normal” for someone. It may serve you well to explore different TSH levels and see if it makes you feel better. As long as you fall within the normal range, your doctor should be willing to let you experiment. It can be time consuming (you should take at least six weeks after changing your dose before you get your blood tested), but if it means you feel healthy the rest of your life, rather than ill, it’s worth the time spent.

Depression can come from the realization that you have a chronic disease, and it’s really common. It may also be partly due to the fact that you continue to feel ill. It’s kind of an “everything at once” feeling. Take medication if it helps you, because that can be a vicious downward spiral without help.

There are some people who take T3 in addition to T4 replacement, but that is an extremely volatile substance and can be tricky to manage. There have been people here who need it (for instance, if they have pre-existing liver damage, T3 may be helpful), and there have been others here who have tried it, liked it at first, and ended up abandoning it because they found themselves having particularly frightening side effects over time. It’s nothing to undertake lightly. Better to work with T4 and see what happens first, and investigate thoroughly before beginning T3 replacement. You may have other conditions that are complicating your GD recovery.

If you find that you feel “too hyper” on one T4 dose and “too hypo” on the next lower dose, remember you can take different doses on alternate days and your body will establish a “middle ground” between the two. The actual build up of T4 in our system takes about a week, so taking alternate doses would not make you feel “up” one day and “down” the next ~ as I said, it would average between the two.

Keep plugging away at it, you’ll get there!

~Ski
NGDF Assistant Online Facilitator

[Anonymous]

#1076230

I think the new values at lab range from .20 – 5.00. It used to be .40 – 5.00 but has recently changed. So, yes I am at the low end of normal. Do you know if being at the low end of normal a person has chance of bone loss?

I had my Cipralex (Lexapro) increased last week and I feel so much better so I have concluded that the problem has been depression probably more than my levels being low. I was surprised though as I didn’t realize the symptoms of depression can be so varied. I didn’t think feeling ‘off’ and ‘crappy’ could be depression. Funny my doctor didn’t diagnose it either. When I think of depression, I simply think of sadness and since it all happened so quickly after my surgery I thought it must be related to my thyroid levels.

Well thanks,

I appreciate your feedback and your timely response.

[Anonymous]

#1076231

Depression most definitely can be related to thyroid hormone levels, and a lot of lists of symptoms of either hypo- or hyperthyroidism will include it.

My knowledge about when bone loss kicks in is minimal — I know it happens while we are hyperthyroid, but I do not know if it is accelerated at the hyper end of normal, which is where you currently are. You would need to discuss that question with your endocrinologist.

Bobbi — NGDF Online Facilitator

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