# really frustrated... (thyroid & anti-dep. probs?)



## Enigma (Jun 13, 2011)

I need to vent and get some honest feedback here, please. I am really frustrated right now and not sure if it is warranted or not.

My doc upped me from 50 mcg generic Levo to 75 mcg Levoxyl (TSH was down from 15.4 to 6.8 at the 50 mcg). At the same time I decided (with my doc's help) to wean off of Effexor. I have tried it before (before getting Dx'ed with thyroid probs) and had horrendous withdrawal symptoms. He offered to put my on the lowest dose prozac (fluoxetine) to help with the side effects, and then wean off of that in a month. I took him up on this since I was not able to function for almost 3 weeks the last time I tried to stop Effexor.

I have been taking Prozac for 2 weeks, and off of Effexor for the last week. I started Prozac and the increased Levoxyl dose the same day.

The last few days I have been very anxious... a PHYSICAL feeling of anxiety, not mental. Felt as if I had 10 cups of coffee and became jittery. I have learned how to differentiate between my thoughts causing me to feel anxious and my body itself feeling anxious, and this is definitely my body. Almost a jittery feeling right in the center of my chest. I called the docs office to run this by them, thinking that with the Effexor out of my system I might actually have TOO much thyroid med, thus causing hyperthyroid symptoms. Well, my doc is on vacation, and the other doc covering told me to take a double dose of Prozac... said that it wasn't thyroid meds causing this and that doing a blood test now wouldn't show anything anyway. I got kind of ****y with the nurse telling her that I know my body and this is NOT the effexor feeling, and that I would like to have a blood test to make sure I am not being overmedicated. I told her that it was counter-productive to up my dose of a type of med that I am trying to wean off of- and that if it IS effexor side effects, I would like it confirmed by ruling out thyroid med probs, and then I would work through the side effects without upping the prozac. Well, that didn't matter to her (or the doc either). And now, tonight, I have INCREDIBLE dry mouth (which was a MAJOR problem for me until I was Dx'ed and treated for hypo, and hasn't been a prob for the last 6 weeks) and am dizzy just sitting on the couch, like I am going to fall over. Dizziness was also a huge symptom for me, to the point i thought i was going to fall over at work. None of these things were side effects of stopping effexor the last time, and the dizziness I did get from it was not at all the same kind...

I am just really frustrated. Obviously, the doc won't do anything except tell me to take more Prozac. But I am having these strong symptoms from SOMETHING, and my body is telling me it is at the bodily, physical level, not mind-based.

What should I do??? I do have a first appointment with an acupuncturist tomorrow, and she is also a practicing pharmacist... I am going to ask her opinion on these drug issues and see if she can recommend anything until my doc gets back.

Anything you guys can say it VERY MUCH APPRECIATED!!


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## Andros (Aug 26, 2009)

Enigma said:


> I need to vent and get some honest feedback here, please. I am really frustrated right now and not sure if it is warranted or not.
> 
> My doc upped me from 50 mcg generic Levo to 75 mcg Levoxyl (TSH was down from 15.4 to 6.8 at the 50 mcg). At the same time I decided (with my doc's help) to wean off of Effexor. I have tried it before (before getting Dx'ed with thyroid probs) and had horrendous withdrawal symptoms. He offered to put my on the lowest dose prozac (fluoxetine) to help with the side effects, and then wean off of that in a month. I took him up on this since I was not able to function for almost 3 weeks the last time I tried to stop Effexor.
> 
> ...


Just bumping this up. Unfortunately this is not my field of expertise.


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## Enigma (Jun 13, 2011)

Thank you... I went to the acupuncturist today, so we'll see how that goes. I will go back next week as well. She did not seem to think the Prozac was causing my side effects.

The dry mouth and dry skin are HORRENDOUS today. As as bad as they were at their worst before being treated for thyroid. I called my doctor's office again, and asked for an appt. with my doc next week when he gets back. I am seriously considering not taking the Prozac tomorrow because all of my side effects seem to get worse after I take it.

The acupuncturist/pharmacist also recommended taking the Prozac at a different time in the day and see if I still get the same side effects... thus narrowing the window of what could be causing it.

I think there is something out of whack with my body... I feel like I did before I got treated. It might be the switch from the generic to brand name meds? But I did go up from 50 to 75 mcg, so I wouldn't think there would be a huge difference in the effectiveness... or at least, the brand name at 75 should be just as effective as generic at 50?


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## bigfoot (May 13, 2011)

Enigma said:


> My doc upped me from 50 mcg generic Levo to 75 mcg Levoxyl (TSH was down from 15.4 to 6.8 at the 50 mcg).


So, at this moment, your latest TSH test showed as 6.8, right? If so, that might have a lot to do with how you're feeling. Not to mention your body purging the other medicine (Effexor), getting used to a new one (Prozac), and the drug interactions between everything. Your pharmacist has a good idea about spreading the doses of different medications apart. Plus, I think when your TSH drops further over time, you should be feeling waaay better.

I know my TSH last year was close to your level and I experienced the dizziness, depression/anxiety, fatigue, brain fog, et al. Then I was diagnosed hypo and started on 50 MCG of generic Levothyroxine and it helped tremendously. TSH dropped down to 1.79. More recently my TSH has been climbing and they bumped me up to 75 MCG of name-brand Levoxyl. I would think the name brand is going to be more consistent for you. (Could be your body isn't tolerating the fillers, though.)

One thing I did notice is a prior doc figured I just needed anxiety meds (Celexa/citalopram) instead of investigating the thyroid angle further. This is something I had taken previously during chemo, so I thought it wouldn't hurt to try again. Boy, was I wrong. I could only tolerate about a week and I was stuck to the couch, feeling horribly sick & worse than I had in over a year. Even though they say there shouldn't be an interaction, I call b.s. Your body knows what's up.

More random thoughts: You might investigate the Free T3 & Free T4 lab numbers in case something is skewed there. You could try taking your thyroid medicine at night, as there are studies that the absorption is better at night, helping to drop your TSH further. If you drink coffee or caffeine, you might try reducing that intake. Also, less refined sugars & carbs. If you eat a high fiber diet, this could be affecting your thyroid medicine absorption, too. Same goes for soy products. The full effect of your increase thyroid med dose (despite probably feeling things sooner) should start to peak at 3-4 weeks and beyond, up to 8 weeks' time. You could also try taking Selenium to help reduce antibodies and immune system response. A good daily multivitamin (may wish to avoid iodine-containing ones) is another thing to try. Something else to consider; some days are better than others. I can't figure out why, but it just seems to be the case.

Sorry to hear you're feeling bad -- hopefully that turns around soon! :anim_32:


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## Enigma (Jun 13, 2011)

hi Bigfoot,

Thank you so much for your response. Yes, right now, according to my last blood test 2 weeks ago, my TSH is 6.8 and that was while taking the 50mcg generic. The doc upped me to 75 and levoxyl. Tomorrow will be the 2nd week of taking this dose.

I guess you're right that there could be an interplay of all of the drugs at this point. And you're right that my body is still trying to get back into the normal, comfortable thyroid range... I just keep thinking that since my TSH has dropped 9 points, that I should feel GREAT! I keep forgetting that may people feel horrible at 6.8, and that I may not feel well either at that level (in fact, I had symptoms while at 3.07, 5 years ago, but the docs never treated me for anything). I felt bad the first couple of weeks at the 50, and I just assumed I wouldn't feel any different (except better) at 75, but I guess that I could just as easily feel bad at that level as I did at the beginning.

Can you tell me more about how you felt on the Celexa? I am curious. Thankfully this doc doesn't think I need anxiety meds and was more than happy to wean me off... just the effexor has horrendous withdrawal effects, so he thought the Prozac might with the WDs and be easier to get off of in a month or so. I am seriously considering not taking the prozac anymore though, because I really do feel worse after taking it.

I've cut gluten and all sugars (except for honey) out of my diet for the last week. I only drink one cup of coffee in the AM then strictly water the rest of the day...I've asked my doc for a fT3 test (he already does fT4) but he says I don't need it.. but he'll research it and to ask him the next time I see him. So, I am going to print off a bunch of articles/research for my next appointment on the importance of fT3 and how some bodies can't convert T4 to T3 yada yada yada... but that is a battle I'm putting off, so I can say I've done what he wants, now do what I want... which he will, since he has in the past, when I've backed up my ideas with research and facts. He has been a good doc so far.

Thank you again for your support and help!!!


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## bigfoot (May 13, 2011)

As a fellow newbie, while it's great that your TSH has dropped to 6.8, I agree that you will probably need that far lower to begin feeling good. Granted, the TSH test isn't the best indicator from what I read and learned here and elsewhere, but at least doc's are willing to pay attention to it. It does have some usefulness. If you can get the Free T3 checked out, it might give you an indicator of what's available to your body (or if you're having trouble converting T4 to T3).

My TSH flared up from 2.72 to 3.68 recently and I have been feeling awful. How I ever tolerated 6.8 last year is beyond me. Now, at almost three weeks into the 75 MCG dose, things are getting a little better day by day. Some days feel like one step forward and two steps back. (This is the part most docs don't mention.) It's slow, kind of like watching the dinosaurs evolve, or paint dry, but I'll take it.

As far as the Celexa/citalopram, I was in the same boat as you. I took it originally a couple of years ago, as I was honestly anxious/depressed as I was sick and no docs could figure it out over a year's time (probably was partly thyroid, but that's water under the bridge now). I took a small dose (10mg) and for a short while a larger dose (20mg). After getting everything squared away with chemo, and then sorting out the related thyroid & hormone issues, I worked with my doc to get off the Celexa/citalopram. I definitely noticed a lot more energy after I was off it. After all, it is a medicine meant to more-or-less sedate and calm you.

I can't come up with an explanation of why I couldn't briefly tolerate it recently, though. My body wanted no part of it, mood issues got worse, and I could hardly walk around the house or do anything. Forget running errands or driving anywhere. And this was on a tiny dose of 10mg. All I can figure is it was not playing nicely with my thyroid or adrenal glands. As soon as I stopped taking it (again, under doc's care) the sick feeling diminished, mood improved, and I could actually function. This left me to zero in and focus on the thyroid issues.

Based on all of this, I would make a total guesstimate that once you are off the Prozac and your TSH continues to decline to the 1.0-2.0 range (everyone is different), you will be feeling far, far better. Same goes for getting those various antibodies suppressed, in turn helping from that angle.

hugs6


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