# Depression Meds and Hyperthyroid



## msbookwormgeek (Apr 29, 2011)

Hello, all-

I am extremely new to this, so I apologize if these questions have been answered elsewhere on these boards. I did do a search, but I quickly got overwhelmed.

I went to my doctor asking her to adjust my depression meds. I take 20mg of Lexapro a day. I went it complaining of being tired all of the time. She wanted to do thyroid tests. So, I had the labs done. The results came back saying that I am possibly hyperthyroid.

After reading all of the symptoms, I'm a bit confused. I don't understand why I can't lose weight if one of the symptoms is weight loss. But, I am on lexapro. I have gained 50 pounds since I started the antidepressant.

So, I'm wondering if my problem hasn't been depression all of this time...and, instead, it's been my thyroid? I'm wondering if I can quit taking my antidepressant over time b/c i'm not depressed?

I've always suspected that I could go off the meds at some point, but docs don't want me to. But, I hate being heavy.

Anyway, she ordered more tests and an ultrasound for my thyroid, which I had done today.

Thanks, in advance, for any info/help anyone can provide!


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## CA-Lynn (Apr 29, 2010)

It will really helpful to have the results of your tests.

In the interim, you should know that typically HYPO thyroidism goes hand in hand with lethargy, and subsequent weight gain. HYPERthyroidism is the reverse. But again, this is typical.....and not always true in all patients.

I'm wondering what kind of doctor prescribed the Lexapro for you and diagnosed you with depression.

It is no secret to others on the board that I'm a big believer in that no one except a psychiatrist or neurologist should ever diagnose depression or prescribe medication to treat. Other doctors are not well trained in the effects of the drugs [as much as they like to think they are].

One of the side effects of Lexapro is indeed weight gain.

That said, do NOT wean off Lexapro without physician supervision.

Why not check in with a licensed psychologist who can assess whether or not you have genuine depression. The psychologist won't be able to address the drugs, but can make a recommendation to your physician about the necessity of using the drug.

While on the topic of Lexapro, I recently found out that it has been approved by the FDA for use by menopausal women for hot flashes. I am not a physician but frankly, I wouldn't fool around with drugs that affect the neurolimbic system unless I genuinely needed them.


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## msbookwormgeek (Apr 29, 2011)

Yes, I was thinking that I need to go back up to my doctor's office and ask for a copy of the lab results.

My history of being diagnosed with depression is somewhat complex. I grew up with a father that was severely depressed and agoraphobic. Then, when I started college, around the time I turned 21, I went into what everyone thought was a depression. I slept a lot and was tired all of the time. My mom took me to see a doctor. She and my father thought I was depressed, so I think my mother said that to the doctor. The first doc I was diagnosed by was a D.O. He put me on Wellbutrin, which made my mouth severely dry and I couldn't stand it; so, he put me on Zoloft after that.

Other members of my extended family and friends were telling me that they didn't think I needed to be on an antidepressant, so I slowly weaned myself off (I know you aren't supposed to, but I did) and I was fine for years. I mean, I have always been a somewhat anxious and sensitive person, but I did fine without the meds.

Then, about 5 years ago (I'm 37 now), I went to my mother's wedding. We have a complex history and have had periods of estrangement. But, we are doing okay now. However, after I went to her wedding, I started feeling extremely tired, anxious, my hand was shaking, etc. So, I went to a doctor (an MD) to see what was wrong. The doctor said I was depressed and put me back on Zoloft. I remember being somewhat surprised by the diagnosis b/c I didn't feel depressed...just tired, anxious, and hand shaking.

Then, I switched doctors due to insurance reasons and found an awesome doctor. I was on Zoloft and he refilled it when I first started seeing him. Then, a few years later, I wasn't feeling so hot and he thought we needed to change my anti-depressant, so onto Lexapro I went.

Now, I've put on 50 pounds since starting all of these meds. And, I did tell my doc at one time that my goal was to go off the meds. He said, "no, don't do that." So, I didn't. But, now, I'm wondering if I should one day. He hired a new doc and I've been seeing her. She is the first one that wanted to do extensive thyroid testing. I had been asked by the other two physician assistants in his office if I had ever had my thyroid tested and I said no.

They went and checked the annual blood work I had done and said my thyroid was fine. But, now, I don't think annual blood work includes all of those thyroid tests that this new doc ordered. I had never heard of them before.

Anyway -- more about my history -- I have had like 1 and 1/2 years of therapy to deal with my childhood issues, my parents divorce, my anxiety and depression, etc. I would complain to them of being tired all of the time and say I felt fine, other than being tired.

So, they asked me what I was trying to avoid by not getting up in the morning. I couldn't think of anything. I mean, truly, I have a wonderful life. It's just that I'm tired all of the time; and, I feel anxious more than other people seem to, but I've learned how to deal with that over the years. I've had that since childhood.

So, there's my history in a nutshell. So, I am anxious to find out if my symptoms have been my thyroid all along...and, if so, after thyroid treatment (if needed), go off the antidepressants. Wow, that would be nice.

Thank you for your response. I really appreciate it.


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## Andros (Aug 26, 2009)

msbookwormgeek said:


> Hello, all-
> 
> I am extremely new to this, so I apologize if these questions have been answered elsewhere on these boards. I did do a search, but I quickly got overwhelmed.
> 
> ...


Welcome to the board!










Oh, yes.....................hyperthyroid can cause depression and also weight gain. Symptoms can and do cross over. Many are very depressed and have suicidal ideation as well.

Please read this. It will offer you comfort and validate your sanity.
http://www.ngdf.org/cms/modules/files/uploads/7699.PDF

I hope you will share test results and ranges. We must have the ranges and of course we will be interested in the ultrasound results as well.

When a person is hyper, even at rest the metabolism is going full bore and that makes the patient very very tired. You may think you are getting rest but you in fact are not.

Hope she puts you on a beta blocker if you are having arrhythmia.


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## msbookwormgeek (Apr 29, 2011)

Hello! Thank you! I'm glad I found these boards. Also, thank you for the link with the info. I went by my doctor's office this morning and got a copy of my first lab results. Still waiting on the second lab results and ultrasound results. I will share those when I receive them.

Anyway, I'm not exactly sure how to read the whole lab report, but, my T3 result was 193. The expected result says 71-180.

The other results on the lab report that say out-of-range were:


my Eos (Absolute) -- listed under the heading 5009-CBC With Differential/Platelet. My result was 0.5, expected says 0.0-0.4.

my Glucose, Serum -- listed under the heading 322000-Comp. Metabolic Panel (14). My result was 102, expected says 65-99.

My doc says I'm not severely out of range on anything, but she wanted to do more tests because I have the symptoms of hyperthyroidism. She said if I didn't have the symptoms, she wouldn't worry about it; but, since I have the symptoms, she's worried about it. She also ordered blood sugar tests over the past 3 months to make sure I'm not diabetic, etc.

She said depending on the next lab test results and the ultrasound results, she may send me to an endocrinologist.


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## msbookwormgeek (Apr 29, 2011)

I thought I'd also include my T4 and TSH results, although they say in-range. T4 was 1.01. Expected says 0.82-1.77; TSH was 1.370, expected says 0.450-4.500


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## Andros (Aug 26, 2009)

msbookwormgeek said:


> Hello! Thank you! I'm glad I found these boards. Also, thank you for the link with the info. I went by my doctor's office this morning and got a copy of my first lab results. Still waiting on the second lab results and ultrasound results. I will share those when I receive them.
> 
> Anyway, I'm not exactly sure how to read the whole lab report, but, my T3 result was 193. The expected result says 71-180.
> 
> ...


Okay............I have to explain something to you. I am now pretty certain you are hyper but you need more tests. First the explanation:

T3 is Total 3. This is bound, unbound and rT3 (reverse) hormone. Rarely is this test really useful except in this case, because it is over the top of the range, that was a "red flag" to me.

So..............it is imperative for you to get the FREE T3 test which is the unbound (free)hormone available for cellular uptake.

And, I do very much recommend antibodies tests. These all have to do with the thyroid.

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism. 
http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html

TSI (thyroid stimulating immunoglobulin),TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/

And here is a great place to learn about the difference between the Totals and the Frees plus so much more.
http://www.amarillomed.com/howto/#Thyroid

Was this a fasting blood test on the glucose? If so, you could be borderline diabetic so get a handle on that quickly.

High numbers of eosinophils (eosinophilia) are usually associated with allergic diseases and infections from parasites such as worms. A high eosinophil count may be due to:

Asthma 
Autoimmune diseases hugs2 most likely scenario but talk to your doc about this. 
Eczema 
Hay fever 
Leukemia
A lower-than-normal eosinophil count may be due to:

Alcohol intoxication
Over production of certain steroids in the body (such as cortisol
http://health.nytimes.com/health/guides/test/eosinophil-count-absolute/overview.html

Thank you very much for the ranges. And it would be a good idea for you keep a copy of all your lab tests in a folder. You want to track your improvements or not. Very important.


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## Andros (Aug 26, 2009)

msbookwormgeek said:


> I thought I'd also include my T4 and TSH results, although they say in-range. T4 was 1.01. Expected says 0.82-1.77; TSH was 1.370, expected says 0.450-4.500


Yes....................looks like there is a high conversion rate as T4 is below the mid-range of1.34 and T3 is above the range. As I said, one of the few times the totals stand out.

Your doc has said what about all of this? Or is she waiting for more tests and the ultrasound? When is the ultrasound scheduled?


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## msbookwormgeek (Apr 29, 2011)

Hello again!

Thank you for all of the info and for your response. I really appreciate the info and the help.

I had the ultrasound done yesterday, and I am supposed to go back to the doc next week to get the results. I had more lab work Wed. She ordered more tests. Probably the ones you are talking about.

No, it wasn't a fasting blood test, but she did order a sugar test over the past three months to check for diabetes.

So, I will know more next week. I will share what I find out then. And, yes, I will keep the results in a folder. That is a good idea.

And, in the meantime, I will read up on the info you have given me. I appreciate that b/c as I've searched on the web, it's easy to get overwhelmed and come across conflicting info. So, I appreciate getting it from someone who knows their stuff


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## Andros (Aug 26, 2009)

msbookwormgeek said:


> Hello again!
> 
> Thank you for all of the info and for your response. I really appreciate the info and the help.
> 
> ...


ROLF!! When I laugh, I snort and you did make me laugh. I "try" but as a friend of mine often says, "The more I learn, the more I learn I don't know!"

Bless your heart! But, I am thrilled to help if I can.

If that was not a fasting test, I would not be overly concerned but I would consider at the very least insulin resistance. Will be interested in the A1C test results. I presume that is the one?

Will be very interested in that US result.

You have been through some tough times. Join the "survivor's club" and do know that we are here for you!


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## lavender (Jul 13, 2010)

Hi, you sound a lot like me. I gained weight and had lots of problems with depression/fatigue when hyperthyroid. Went undiagnosed for years, and tried several unsuccessful rounds of anti-depressants. I eventually ended up severely hyperthyroid, and was basically psychotic from high and low mood swings. I had no idea what was going on. Well, it's a year later. I had my thyroid surgically removed, and have been working with my doc to titrate my thyroid meds, and I actually feel pretty emotionally balanced. It's honestly amazing. No psych meds. I'm really glad you found a doc who knew to check for this, and I hope they can help you get all this straightened out so you can be feeling well again.


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## HeidiBR (Apr 4, 2010)

I was on Prozac for a short time of extreme stress. I had gained weight, and on the Prozac, I gained even more. My endo wanted me to go off the Prozac if I felt I could (I did feel I could) because the Prozac had sent my free T3 in the basement. He prescribed me a small dose of synthetic T3 and more me it has made a world of difference.

SSRI meds like Lexapro and Prozac can slow the metabolism. Have you ever discussed with your doctor taking Wellbutrin, which speeds it up and generally causes weight loss?


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## msbookwormgeek (Apr 29, 2011)

Andros said:


> ROLF!! When I laugh, I snort and you did make me laugh. I "try" but as a friend of mine often says, "The more I learn, the more I learn I don't know!"
> 
> Bless your heart! But, I am thrilled to help if I can.
> 
> ...


Hello again!

I'm glad I made you laugh . And, yeah, me too! The more I learn, the more I learn I don't know as well! But, you do know much more about this than I do. I'm learning now b/c I'm shocked and possibly somewhat relieved that there has been a physiological reason for all of this over the years.

I hope so. Thanks for the info on the survivor's club. Yeah, I will join. I'm not sure the name of the new tests my doc ordered...I was so overwhelmed and shocked the day that I got the results of the first lab work that I could barely think straight. I really didn't think she was going to say I possibly had a thyroid problem. I will post the results of the next labs and ultrasound when I find out.

Thank you again, so very much! :hugs:


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## msbookwormgeek (Apr 29, 2011)

lavender said:


> Hi, you sound a lot like me. I gained weight and had lots of problems with depression/fatigue when hyperthyroid. Went undiagnosed for years, and tried several unsuccessful rounds of anti-depressants. I eventually ended up severely hyperthyroid, and was basically psychotic from high and low mood swings. I had no idea what was going on. Well, it's a year later. I had my thyroid surgically removed, and have been working with my doc to titrate my thyroid meds, and I actually feel pretty emotionally balanced. It's honestly amazing. No psych meds. I'm really glad you found a doc who knew to check for this, and I hope they can help you get all this straightened out so you can be feeling well again.


Hello there!

Thank you for taking the time to respond to my post. Yeah, I've gained ALOT of weight. I went from 130 to 185 (I'm only 5'1") when I started back on the antidepressants. And, that kinda makes me :aim33:! But, I was told that there was nothing else I could do if I wanted to feel better. So, I thought I'd rather deal with somewhat of a weight problem that to feel like crap all of the time. I feel encouraged that you were able to go off your meds. I want to go off of mine. I'm also very glad I found a doc who knew to check for this...I'm eager to find out what the ultrasound and new labs will say. I will feel so excited and relieved if I can go off psych meds. Don't get me wrong, I'm not happy about having a thyroid problem, if I do, but that would make my entire emotional life since childhood make so much more sense...


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## msbookwormgeek (Apr 29, 2011)

HeidiBR said:


> I was on Prozac for a short time of extreme stress. I had gained weight, and on the Prozac, I gained even more. My endo wanted me to go off the Prozac if I felt I could (I did feel I could) because the Prozac had sent my free T3 in the basement. He prescribed me a small dose of synthetic T3 and more me it has made a world of difference.
> 
> SSRI meds like Lexapro and Prozac can slow the metabolism. Have you ever discussed with your doctor taking Wellbutrin, which speeds it up and generally causes weight loss?


I have taken Wellbutrin - it was the first antidepressant I went on and I had extremely severe side effects -- especially dry mouth. It was so bad it was unbearable. Hmm...well, if I see an endo, and if he/she wants me to go off the lexapro, I will do so happily. I'm glad you are feeling better!


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## msbookwormgeek (Apr 29, 2011)

oh yeah - one more thing that I forgot to mention. My doc asked me if I salt my food with iodized salt. I said no, not really. She told me to start doing that. Is that a normal thing to be advised to do? I'm not really used to the taste of salt b/c I hardly ever salt my food...


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## Andros (Aug 26, 2009)

msbookwormgeek said:


> oh yeah - one more thing that I forgot to mention. My doc asked me if I salt my food with iodized salt. I said no, not really. She told me to start doing that. Is that a normal thing to be advised to do? I'm not really used to the taste of salt b/c I hardly ever salt my food...


Once you have thyroid disease, it usually is a good idea to avoid iodine in any form. I use sea salt sans the iodine and many here do that as well.

And if you do not normally salt, I would not do that. That is my humble opinion.


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## lavender (Jul 13, 2010)

msbookwormgeek said:


> Hello there!
> 
> Thank you for taking the time to respond to my post. Yeah, I've gained ALOT of weight. I went from 130 to 185 (I'm only 5'1") when I started back on the antidepressants. And, that kinda makes me :aim33:! But, I was told that there was nothing else I could do if I wanted to feel better. So, I thought I'd rather deal with somewhat of a weight problem that to feel like crap all of the time. I feel encouraged that you were able to go off your meds. I want to go off of mine. I'm also very glad I found a doc who knew to check for this...I'm eager to find out what the ultrasound and new labs will say. I will feel so excited and relieved if I can go off psych meds. Don't get me wrong, I'm not happy about having a thyroid problem, if I do, but that would make my entire emotional life since childhood make so much more sense...


I can relate. I was actually a bit relieved when I got diagnosed because I felt like 1. there was an explanation for how bad I had been feeling for years and 2. there was something that could be done to help me feel better. As much as it sucks that I had to get so sick to get help, I am grateful for my thyroid illness because it has brought me to a new level of healing and health and it has taught me a lot about standing up for myself with doctors, listening to my gut, and continuing to look for answers, even when my doctors have given up on me.

I will caution you that I still had to fight the doctors to get proper treatment for my thyroid. Because of my history of PTSD and depression, they were quick to dismiss my continued symptoms as psychological rather than work with me to fine tune my thyroid meds. I know my history makes me more prone to depression than most, but my gut kept telling me my symptoms were physical, not psychological, and my therapists supported me. I ended up finding a new doc, not disclosing my PTSD and depression history, but giving her a year's worth of lab work. She looked over it all, and could immediately see that my thyroid meds needed to be changed. I hate feeling like I have to lie to get help, but I couldn't face having to face one more doctor's prejudice/ignorance.

She and I are still fine tuning, and I am getting new pieces of the puzzle. With every new bit of info, I am excited that we are getting closer and closer to me really feeling/functioning my best.


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## CA-Lynn (Apr 29, 2010)

I never use salt. Period. There is plenty of salt naturally in foods.

I've never heard of anyone prescribing the use of salt.


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## Mandeloo (May 2, 2011)

Hi I'm new here too and I saw your post. I have been on so many types of medications for depression and mood disorder and can tell you from experience that although lexapro may list weight gain as a side effect, it really doesn't cause it. It's one of those that causes the least weight gain. If it does have that effect, it's minimal weight. I know I lost a bunch of weight while I took it and I will gain weight looking at a cake.
A weight increase of 50 lbs makes sense for drugs like Zyprexa and Depakote but not Lexapro. I'm not a doc but I'd look more to your thyroid too!


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## HeidiBR (Apr 4, 2010)

Some people do indeed gain weight on SSRIs like Lexapro. It just depends on the person.


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## CA-Lynn (Apr 29, 2010)

Instead of focusing on the weight now, focus on the thyroid and once you've got that resolved, then see which problems remain and then treat them.


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## lavender (Jul 13, 2010)

I agree Lynn, we can't change everything at once, and trying to throw in too many changes at once just confuses our bodies. I try to make one change at a time, see what happens, and go from there. Dealing with my thyroid has resolved a lot, but has not fixed everything. I was so miserable when I first got diagnosed, and wanted everything to get better immediately. I had no idea how long it would take to sort out the puzzle.


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## msbookwormgeek (Apr 29, 2011)

Hi everyone!

Thank you all for your responses and for your help! :hugs:

Yes, I have heard that about lexapro; but, I have also experienced weight gain. However, it may not be the lexapro. I know some people gain weight on lexapro and others don't.

I promised to post the results of my lab work and ultrasound when I got them. I went to the doc today and got my results. Here's what I found out:

1) My T3 was normal this time. Here are my numbers:
T3 = 174; expected = 71-180.
T4 = 0.97; expected = 0.82-1.77
TSH = 1.280; expected = 0.450-4.500

2) I have 2 nodules on my thyroid...one on each side. I'm supposed to have the ultrasound repeated in 6 months.

3) I have a vitamin D deficiency. My vitamin D was 26.1; expected = 32.0-100.0. So, I'm supposed to take 800 IU of vitamin D for a month, then take 400 IU of vitamin D for 2-3 months in addition to my daily multivitamin. She said vitamin D deficiency makes you tired and achy. I'm tired and achy.

4) My sugars (hemoglobin A1c) was high. My number was 5.7; expected is 4.8-5.6. She said I'm headed toward diabetes. So, she told me to start really watching what I eat. I do watch what I eat, but she told me to start following a low carb/low glycemic diet. I asked her if it's safe to follow a low-carb diet. She said it's good for me because of glucose intolerance, but one diet doesn't fit all. My grandfather is diabetic, so it's definitely something for me to be concerned about.

However, I'm optimisitic because I can definitely do something about my diet/exercise and vitamin D deficiency. I can't do anything about my thyroid; so, I just have to have that monitored for now, I guess.

Just wanted to give you all an update. Thanks to all of you for being so helpful and supportive!


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## Andros (Aug 26, 2009)

msbookwormgeek said:


> Hi everyone!
> 
> Thank you all for your responses and for your help! :hugs:
> 
> ...


Thanks for the labs and ranges. The Total 4 is rather low. It kind of stands out as mid-range of your given lab range is 1.29 Since this is a Total, that would be bound and unbound hormone combined.

You might enjoy reading this.
understanding thyroid labs
http://www.amarillomed.com/howto/#Thyroid

And you are right about the diet; get on top of this as you definitely don't want to have diabetes. No way.

You sound good so I gather that you are feeling pretty good?


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## msbookwormgeek (Apr 29, 2011)

Hi there!

Thanks for the link. I'll definitely read it. Yeah, I'm reading up on low glycemic/low carb diets right now. I definitely don't want diabetes. SCARY!

I'm feeling somewhat relieved and empowered that I can do something about some of this stuff. But, still tired . Will be going to the store tonight to do some grocery shopping, so I'll pick up some vitamins then.

Also, I feel more confident on what I should be eating. .


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## Andros (Aug 26, 2009)

msbookwormgeek said:


> Hi there!
> 
> Thanks for the link. I'll definitely read it. Yeah, I'm reading up on low glycemic/low carb diets right now. I definitely don't want diabetes. SCARY!
> 
> ...


You are the "perfect" bookworm! LOL!! Love it!

Let us know how you do.


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## msbookwormgeek (Apr 29, 2011)

Why thank you...I take that as a compliment  :hugs:

I'll keep you posted and thanks SO much for the help!


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## Andros (Aug 26, 2009)

msbookwormgeek said:


> Why thank you...I take that as a compliment  :hugs:
> 
> I'll keep you posted and thanks SO much for the help!


It is. My nose is forever in a book.


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