[lhc11]

in reply to: antianxiety drugs #1064040

(continued, from above):

I guess my point is this: what I think GD, like many other diseases (but, because of Graves’ definite anxiety component, perhaps more powerfully than most) shows us is that the line between the body and mind is a fine if not practically non-existent one. Many psychological problems have, we now know in stunning detail from decades of research, a biochemical side; a physical problem can be caused, or worsened, or even alleviated, by the mind (cf. the much-touted benefits of meditation/yoga). Anxiety is anxiety–in the end, it doesn’t in fact matter if its root cause is psychological or physical when the awful way it makes you feel is the same. So if Xanax–a drug that technically calms the mind–helps one deal with an anxiety problem that has "merely" physical roots (i.e., the hyperactive thyroid)–then I say, so be it, and aren’t we lucky to have it at our disposal. Same goes for the psychotropic SSRIs, though as I’ve said, they were of no help to me with the Graves (and I wish they had been!). Xanax is in fact prescribed to be taken *as needed* for anxiety; SSRIs are a more long-term commitment, taking longer (usually at least 6 weeks) to have any effect, and needing to be taken daily in order to maintain their effect once it is achieved. As Shirley has said, all of these drugs–Xanax, SSRIs–need to be discontinued slowly rather than abruptly stopped.

I feel very strongly that anti-anxiety medications and anti-depressants save lives and, even when it’s not that dire, that they can help one through very rough times–and there is no question that the hyper phase of GD is one of the roughest of times (in my experience and, as far as I can tell, in the experience of most other people on this site). Short-term use of Xanax, monitored by a doctor and taken only when needed, will not hurt you and it might help (with the important caveat that the taking of it and other such drugs MUST be monitored regularly by a doctor, whether primary care, psychiatrist, or both).

I am not recommending that anyone take a medication he or she feels is optional and is uncomfortable with; but I am saying that one should not feel badly about choosing briefly to rely on something like Xanax to get through a terrible time. Yes, it can be addictive–but someone who is worried about that is actually not all that likely to get addicted to begin with.

I will get off my soapbox now. (Marta, by the way, it is a known thing that anxiety for most people is much worse in the morning and subsides by the afternoon–that has always been the case with me, and your experience with it is very typical. I hope you feel some relief soon!).

[lhc11]

in reply to: antianxiety drugs #1064039

I wrote a very long post that the board won’t take, so I am going to divide it up into two.

As someone who has been on both anti-anxiety medication and anti-depressants in years before the onset of my Graves’ disease and was also prescribed them during my recent bout with the hyper phase, I feel it is practically my social responsibility to comment on this thread. Please note that the following remarks (many of which align with Shirley’s comments, just at greater length) represent my personal experiences and opinions only and should not be taken as medical advice, which can only be given by a qualified doctor. Here goes:

First, while it is true that we live in an over-medicated society in which too many doctors are too freely handing out "happy pills" to those experiencing simply normal sadness, there are those who truly can and do benefit from both benzodiazepines (i.e., anti-anxiety medications like Xanax) and SSRIs (like Zoloft and Prozac and Lexapro and…..). I have been one of those people. Xanax–years ago, prescribed under the watchful eye of psychiatrist, and along with my own worries about potential addiction and my consequent care in taking it–helped me immensely while Zoloft was kicking in. Zoloft is itself prescribed for both depression and anxiety (and often for the depression that can result from out of control anxiety), and once I was on the right level of Zoloft, I was able to not take Xanax at all–indeed, I didn’t even remember what it felt like to need it. I stayed on Zoloft until I got pregnant last year–that is, for seven years. I have no regrets about this whatsoever. The medication helped me to be not an over-medicated person, but rather the best version of myself. And I honestly believe that it saved my life. (And yes, I also saw a psychotherapist for most of those seven years).

I was in a very different place in my life when I (slowly) discontinued Zoloft upon learning of my pregnancy last summer, and I was fine for 5 months (even after a traumatic miscarriage [boy, that’s redundant])–that is, until the Graves hit me. At that point, I went back on Zoloft (because, of course, I initially thought my anxiety was a return of my anxiety disorder, and they do say that one should try not to cycle on and off psychotropic drugs for fear of relapse, which is what I initially thought was happening to me). I was also given a new Xanax prescription. I then had a strange reaction to my previously much-trusted Zoloft–palpitations, tremors, nausea–so my (new) psychiatrist had me start Prozac instead, with the same results (palpitations, tremor), leading me to beg him to let me try the Zoloft one more time (which he finally did). I did then start to feel better, but by that point the ATD’s had brought me close to euthyroid anyway, which is what I now believe really made the anxiety (and palpitations, and tremor) go away. However, the Xanax did work–and it did help, immensely, throughout the time that I was hyperthyroid and anxious. Yes, I took more than I have ever had to take before (about 3-4 mg per day, when I had once only needed a maximum of .25 mg at a time, maybe 2x per day), and I was quite concerned about that. But I was as careful as I could be, and my psychiatrist assured me that when the time came to wean me off, we would do so. As it turns out, as I said above, the anti-thyroid meds finally kicking in were what (seemed to make) the anxiety decrease, and I was able to wean myself off Xanax without his help (and he did in fact over-medicate me–he also had me on an anti-psychotic (supposedly so that the Zoloft would work better, and so I would need less Xanax, which I just *knew* I did not need, was very uncomfortable taking, and ultimately simply stopped). Since right after my thyroid surgery in June, I also weaned myself off Zoloft again because, well, I wanted to see if in fact my anxiety disorder had returned, or if it was all the Graves. So far, it would seem it was the Graves–I have a lot of stressful things going on in my life right now, and I am feeling terrific on nothing but Synthroid and a vitamin. I fully expect that at some future point in my life I may need to turn to Xanax and Zoloft again–and when that time comes, I will see my doctor about it–but that time is not now.
(to be continued in next reply)

[lhc11]

in reply to: Hi- new with a few ?’s #1064105

Hi Pinky — I too had a (missed) miscarriage at 10 weeks followed the next day by a d&c, so I do know exactly what you’re talking about, and I’m terribly sorry that you went through it twice! As for posts–you should also be able to search for them using someone’s username, so in my case: lhc11.

All best to you,
lhc11

[lhc11]

in reply to: Hi- new with a few ?’s #1064103

Dear Pinky,

First, I am so very sorry to hear about your losses. I had a miscarriage myself last September and know how hard it is. I was diagnosed with GD the following (that is, this past) spring, and what no one knows is whether the pregnancy activated the disease or whether the disease caused the miscarriage–but for sure, I was never going to be able to conceive while hyperthyroid. I am someone who opted for surgery for a variety of personal reasons, and if you’ve done the word-searching on this site you have probably already found my May postings about my agonizing over the treatment choices and finally reaching a decision. I would stress that yes, *you* are the patient and the choice of treatment is yours, but you might want to find out if your doctor is pushing towards RAI because there isn’t a good endocrine surgeon where you live, or because it’s simply what "most" people do to treat their Graves in this country. (For what it’s worth, my thyroid surgeon said they are seeing an increasing number of women of child-bearing age choose surgery, but then again the university hospital to which I have access has one of the most highly rated endocrine units in the country–I was very lucky). Like Shirley, I have no regrets about my decision to have surgery. In my case (and this should not be taken as any kind of prognosis for anyone else), my levels were in just-outside-of-normal range a month after surgery (actually, the FT4 was normal and the TSH was a little low, but not terribly so, we were given the go-ahead to try conceiving), and in normal range in two months–I did yoga throughout the time of being ill and went back to running when my levels were normal, so I was pretty healthy even before going into surgery. I have lately been seeing a reproductive endocrinologist to work on getting pregnant (though I am doing that *not* because I have Graves, but because my husband and I do not live in the same place, which makes everything–especially at the age of 39–a bit more challenging, to say the least; I’ve also gotten linked up with a high-risk ob-gyn just to cover all the bases). For me–and I’m repeating myself from earlier postings–I wanted to try to speed up the time to when I could try again, and I also wanted to not blame myself if I had another miscarriage (always a sad possibility) with thinking that it had happened because I didn’t wait long enough after RAI (doctors used to say a year, now it’s 6 months, and that discrepancy alone suggested to me that maybe no one really quite knows how long is long enough, and I knew that at exactly 6 months I’d want to start trying again, and then if something went wrong….I’d blame myself and wonder if it was the RAI…etc. As I said above, my decision was a highly personal one keyed to what I know of my psyche!).

Trust me, I know just how saddening and frustrating it is to have to put off trying to have a child when you’re in your mid (or in my case, late) thirties. But it definitely is so important to get healthy first, whichever way you choose to go.

Best,
lhc11

[lhc11]

in reply to: kinda personal…but going to ask anyway #1064397

This question made me laugh! There is no question that while I was sick I had NO interest in sex, and no question that since I’ve felt better I have felt more…so inclined. ” title=”Wink” /> Of course, we are also trying to conceive, so that complicates knowing what it is exactly that one "wants" at any given moment….

All of which is to say: don’t worry about it.

lhc11

[lhc11]

in reply to: Confused… in need of advise #1064386

I’m so sorry you are having these difficulties. I too am trying to conceive at the moment and hoping for success soon after months of no success that was almost definitely due to my being so hyper. (We are actually seeing a reproductive endocrinologist, but that is largely because I turn 39 tomorrow and we, ahem, have no time to lose; you are lucky to have time on your side in this regard). It is not true that surgery is only done for pregnant women who become hyper; more and more people are turning to surgery IF it is available to them and IF they are good candidates for it (which depends on factors only your doctor can really discuss with you). I am someone who chose surgery because I didn’t want to wait 6 months or more with the RAI before trying again to conceive and because I had access to (and insurance permission for) an excellent thyroid surgeon at a university hospital. I did briefly contemplate switching to PTU and trying to get pregnant without surgery or RAI, which some people on this board have in fact done. I didn’t want to do this because I have already had one miscarriage, and if something went wrong and I hadn’t done what I considered the safest thing for a child (that is, surgery), I would blame myself. (It was a very personal decision and I am not judging anyone else’s choices). My endo was also supportive of my choice and was the one who set up my original surgical consult. You can read about my struggle to decide what to do by searching for my posts with my username (lhc11) or just with the word "surgery" in the search box.

At any rate: my understanding is that ob-gyns and reproductive endocrinologists do not worry about the antibodies as a barrier to getting pregnant; the time they check the level of antibodies (after they’ve checked to verify that you have Graves’ disease) is sometime in your third trimester, because there is a very small chance (something like 3%) that the antibodies can cross the placental barrier to the fetus (this, too, is treatable, so there is no point in worrying about it–I have a good friend with Graves, who had RAI ten years ago and a beautiful healthy baby girl 2 and 1/2 years ago with no problems at all).

It sounds like you might need to force the issue and be really firm with your endo about what you want. But you also might want to ask why he is turning you away from surgery–it could be that there isn’t a good enough thyroid surgeon in your area, for example.

Good luck!

lhc11

[lhc11]

in reply to: after surgery #1064355

Hi Cynthia — I’m very glad to hear your surgery went well. I can’t speak to chest pains, but I was certainly tired during the week after surgery and took a lot of long naps. I don’t think you can expect anything else of yourself. I wouldn’t think the Synthroid would be causing you problems at this early point. But of course, as I’m sure others will say as well: with these symptoms or anything else you are concerned about, you should definitely call your doctor.

best,
lhc11

[lhc11]

in reply to: RAI vs. thyroidectomy #1064420

Hi pinkphone — sorry to hear you’re having to struggle with this decision, but glad you’ve found this board. I spent a long time using the very good search engine on this site (see the "search" box on every page) typing in "RAI" and "thyroidectomy" and "surgery" and reading all I could when I was trying to come to grips with what I wanted to do only a few months ago. Rather than repeat everything I wrote and have written about the decision to have surgery over RAI (just one person’s personal experience, not a recommendation for you), I’ll just say you can also search for "lhc11" in the search box and you’ll pull up my many posts on the matter. Many here will speak up for the virtues (and negatives) of both methods, but I can tell you that surgery (which I had only two months ago, on June 9th) was absolutely the right choice for me, was nowhere near what I was dreading, and that I don’t regret it for a minute. As I say in other posts, though, how one feels about surgery depends too on the surgical resources that are available where you live or what your insurance will cover.

Good luck!

lhc11

[lhc11]

in reply to: Normal labs but feeling a little hyper? #1064456

See, that’s the thing–I *haven’t* had a dosage change, unless we count my starting the Synthroid on June 10th the day after my surgery as one, which in a sense I guess it is, a change from my body providing some previously unmeasured level to the pill providing it. So I’ve been on 100 mcg for two months, never on any other (synthetic) dosage, with two blood tests–one after five weeks (these hyperish symptoms hadn’t started at that point, even though the TSH was still in the hyper range), the second after another four weeks (this past Monday). So it’s hard to gauge how long I should now wait on this same dosage before asking her to lower it (and *then* waiting for 6-8 weeks to see what happens) or asking for another blood test (another month?). My hope is that my body is *still* adjusting to this initial dose and that the symptoms will in fact decrease, but it hasn’t seemed like that is happening…yet. It’s really annoying to be feeling anxious/hyped up when I *don’t* feel anxious or hyped up, if you know what I mean! (Side note: I wonder how many endos have themselves experienced thyroid problems, and if they’re really able to understand what their patients are experiencing when it’s described to them. Then again, I guess one could ask that about any medical specialist. I always thought it it was cool that an orthopedic surgeon my mother once met had himself had his leg amputated….).

Anyway, thanks, everyone. I’ll stand firm with my endo when I get back in touch with her. The upside of her being a young doctor is I think she is afraid to make a mistake….

[lhc11]

in reply to: Normal labs but feeling a little hyper? #1064453

Thanks, Bobbi. Since my endo was clearly not about to lower my dosage yet–nor am I entirely sure that she should, at least not yet–I guess I’ll wait at least a couple of weeks to see how I feel, and at that point ask her to lower the dosage if I’m still having hyper symptoms. What bothers me is that she didn’t give me any instructions getting for future labs (i.e., didn’t put an order in), just said to be in touch if I got pregnant (and/or if symptoms persist). So it almost seems as if she was planning on just otherwise letting me go with no further follow-up on her end until whenever (next year?)…which seems odd to me when I’m only 2 months out of surgery. I wish I had *full* confidence in this endo but the thing is, she only just finished her residency and sometimes I wonder if she really knows entirely what she’s doing. Unfortunately, like everywhere else we’re short on endos here and a switch would not be easy.

I definitely don’t have insomnia or tremors or anything truly awful–just the uncomfortable feeling of being slightly off, which again kind of comes and goes. But you’re right, essentially I know what’s going on with my body (which is feeling hyper while I type this….).

lhc11

[lhc11]

in reply to: Normal labs but feeling a little hyper? #1064450

Sorry, Shirley, no cause for alarm! ” title=”Very Happy” /> I meant 19-20 per 15 seconds, i.e. 76-80/minute. And I’m really in good shape–but this has been my pulse rate pretty much ever since everything calmed down, except for when it dipped to 50 on the beta blockers and they had me stop taking them.

cheers,
lhc11

[lhc11]

in reply to: Normal labs but feeling a little hyper? #1064448

Well, I’m nearly positive it’s not caffeine (I generally drink only one cup of coffee per day, in the mornings, and have pretty much since before I was hyperthyroid [as far as I know]), and it’s definitely not perimenopause, and it’s not the Clomid because these symptoms were present before last week, though the Clomid could of course be exacerbating them. So maybe it is the levels being on the rise….or maybe my body is happier at a lower range. I’ll do my best to keep track and see.

lhc11

[lhc11]

in reply to: Newly diagnosed and only the internet for information #1064496

Hi Steph — to answer your question about different countries, yes, from everything I’ve read European doctors prefer to try the ATD route first, whereas American doctors tend to opt (or push) for more aggressive methods earlier on. I was given a much lower level of remission possibility by my doctors–more like 30%, with a chance of the problem returning down the line (but the endocrinologist also, interestingly, said that the percentage rates seem to be different with different populations). I am someone who opted for surgical removal for a number of personal reasons (my doctor would have let me do whatever I insisted upon), and you can learn more about that experience by searching for posts with the word "surgery" (or under my username, lhc11). Lots of people on this board have talked about their past and present experiences with RAI, too.

I was impossible to live with while very hyperthyroid! I, or rather Graves’ disease, put my husband and mother through probably the worst two months of their lives (as my mother is still telling me… ” title=”Wink” /> ).

best,
lhc11

[lhc11]

in reply to: Newly diagnosed and only the internet for information #1064492

Hi Stephster — it’s great that you found this site while you’re still hyperthyroid; I only found it when I was already quite a bit calmed down, and I could really have used the site (the best one as far as I am concerned) at the place you are at right now! I can’t comment on the weight gain you’re currently experiencing, as I lost a ton of weight while hyperthyroid (my issue is now that I’m gaining it back….when I would have liked to stop gaining it back a few pounds ago….). But I just wanted to say that my thyroid levels were about 4-5x normal and when I started on the anti-thyroid drugs I was taking 60 mg (20mg, 3x per day). It then went progressively down from there as my levels improved, until I was taking only 5 mg per day–I forget exactly how fast but I can tell you my levels weren’t in normal range for at least 6 weeks, maybe a little longer (I had my thyroid removed 9 weeks after my initial diagnosis). So you just have to try to be patient and hang in there–as almost everyone on this site will tell you, it DOES get better. I too had the palpitations that kept me from sleeping and the incredibly high pulse rate (in my case, 140!) and was on the beta-blockers…which I was then also able to stop taking.

It took me a long time to be able to accept that it really wasn’t all in my head. And I had doctors giving me anti-anxiety medication too, so I sympathize with your dilemma (I continued to take mine all the way through my surgery, but I had been on it before so didn’t have much of an issue with doing so; I’ve since gone off of it). But on this, as Kimberly says, you do need to consult with your doctor. I was of the opinion that I would take anything that might help while I was in crisis!

Again: it gets better!!!! Fortunately, they really do know how to help with this once they figure out what is actually the problem.

best,
lhc11

[lhc11]

in reply to: Endo dropped me :( #1064560

I just want to say that I am beyond horrified by this! I thought all doctors took the Hippocrate oath–"first, do no harm"–and it sounds like this guy did just the opposite to you, both by his unhelpfulness and his suggestion re: "working itself out." I hope you can quickly set yourself with a GP or internist who can help in the meantime.

Very sorry.

lhc11

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