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@Downthelanetheycome 2746 wrote:
Its always helpful to hear that something is working. Sometimes lithium and some other psyche meds can mess with thyroid function which can cause weight gain. Once in a while if you can get your thyroid levels checked.
I have been on lithium for over 3 years for bipolar. In that time I haven’t had any major ups or downs and have been through major life changes in that time too. It has worked very well for me. However, within a couple months of starting it I had to start taking levothyroxine since my TSH went doubled from 4 to 8 in just a month. I also started TRT about the same time. I’ve had some hair thinning, flush or redness to my face i didn’t have before. I take an extended release version, 625mg twice per day.
I used it last year for acne, which i’ve only had since starting TRT 3 years ago. I tried a few different oral antibiotics and a few topicals as well with little benefit. Accutane was the last resort. It was a pain, had to follow strict guidelines to get it filled. Monthly bloodwork, monthly check up with derm, had to get script filled within a certain amount of days. However, the guidelines are much more strict for females. Anyway, it worked better than the other things i tried for acne, but it has returned somewhat. My joints and body ached constantly and just felt run down for most of the treatment. However, I am bipolar and did not have problems with depression. I tried to be very aware of how i felt and saw my therapist regularly. I also tried to exercise and eat healthy which probably helped my mood. Physically i felt like shit and couldn’t wait for it to end, but as my face and shoulders became acne free it gave me a psychological boost.
One thing I asked my dr about was back pain. I never really had lower back pain until i used this drug. He said the side effects go way once the drug is discontinued. It didn’t for me. Its not severe, but not something I had before. He was an older doctor and didn’t seem up to date on the most recent studies, said there weren’t any studies using a low dose accutane showing it to be effective. There actually was at least one at the time I asked him. So, I would bring in that study and suggest it your doc. It is supposed to be as effective as higher doses with less sides.
Cut my plan short. A day after i finished avelox, 21 days, my chills/fever feeling returned. I went back to my primary care doc, as recommended by the ENT, for blood work and stuff.
I’m having labs done for CBC, CMP, TSH, T4, ESR. And getting in to see an allergy specialist. My doc really isn’t sure what it can be but is trying to help figure it out. Doesn’t think it is still a sinus infection because of the amount of antibiotics ive taken.
One thing occurred to me or suggested by my wife rather. Is to look at new medicines i’ve started in the last 3 months. The only new or different one has been switching to synthroid from generic levo. One of the inactive ingredients is acacia which some people are allergic too and report similar symptoms to what im experiencing. Im don’t generally have allergies, but i figure it can’t hurt to switch back to my generic levo for a while. And i have nothing else to investigate at the moment.
Anyone have any ideas, suggestions, or other avenues to investigate with my doc? HAN? Dr. M?
I have been on T4 exclusively for almost 3 years. I can’t recall my exact numbers without digging for labs…but free T3 has always tested at the top of the range, around 4. And free T4 has been slightly above midpoint on the range. TSH very low, under 1. My dose started at 88mcg, down to 75mcg a day and 150mcg on sunday, then currently at 100mcg day.
However, my hypothyroidism is largely due to the lithium i take for bipolar. I suspect i was probably hypo or borderline hypothyroid before i started lithium, just never had extensive lab work done. A month into lithium treatment my TSH doubled from 4.xx to 8.xx. That was when i started T4.
My wife takes T4 and T3. 125mcg and 5mcg, respectively. Her numbers aren’t as optimal as mine. Don’t remember exactly what they are though.
@MetalMX 2375 wrote:
Sinus issues are correlated with adrenal issues as well as allergies. I would try anti-histamines to see if that helps whatsoever. Maybe checking your adrenal functioning might also not be such a bad idea.
Yeah i forgot to mention ive also been using flonase nasal spray for the last month. Didn’t notice much.
I came up with a plan. Im off school for the next two weeks and am going to exercise, eat better, sleep better and see how that goes. Back to the basics type of thing. Since this started ive used all my energy for school and work and haven’t exercised hoping the rest would help me recover. And ate for taste/comfort not nutrition. It didn’t work. So I will re-engage in health behaviors, stop the pseudo ephedrine(and other sinus meds) and if no improvement in two weeks go in for blood work.
I’ve been slightly depressed as well. Seems to happen in the wintertime and when i don’t exercise.
@hardasnails1973 2318 wrote:
RErun lab work again in fasted state and if they are still abnormal then 3 hour glucose tolerance test with insulin. If taking metformin makes your fatigue most likely it could be dropping your sugar too low. Again we only brought it to the attention of your GP, but he should investigated it further which we will do on next blood work. I always have to clean up the mess..
Why do you think some drs don’t investigate health problems fully? Or do they feel they are doing all they can by making treatment decisions from a limited number of labs or consults?
@rglr 2242 wrote:
The short answer to “Can marijuana help treat AF?” looks like a “No.”
Obviously smoking is bad for your lungs but what other ill effects are caused by the use of marijuana? I’ve been researching online but see a lot of conflicting data.
As far as psychological effects, I can tell you that as a former daily user in my teenage and early college years that it made me feel okay with not accomplishing much. I did well in school and worked, but wasn’t working towards any goals or really progressing and living to my potential. However, I slept better those years than i do now after trying almost every sleeping medicine. Even though i no longer use it I have a positive opinion on marijuana.
@dehook 2056 wrote:
What is he writing his book on? Does it focus on any particular area?
I think its about dr stuff. I mean, what else would a dr write about anyway?;)
He is defining the Mind. I cannot possibly summarize it justly. He gave us some sneak peaks a while back on MESORX forum i believe. HAN or Pgamer could be more specific. The concepts he writes about seem like they should be common sense, but they aren’t. Yet. Hope my department makes a course out of it.
@canthavetoomanytoys 1709 wrote:
My humble advice is to seek a doctor who will not use synthetic hormones but only prescribes bio-identical hormone therapy. It just so happens that LEF has a report in their October publication. http://www.lef.org/magazine/index.htm
Another source for finding a doctor is one of several books authored by Suzanne Somers. You may actually be convinced that, as a male, you may want to consider BHT yourself.
What kind of BHT options are available for male HRT? Isn’t injectable testosterone cypionate synthesized from a source that is biologically available?
@hardasnails1973 1712 wrote:
If you wish to seek women specialist Dr O and myself deal with this issues at our clinic in PA.
We have gotten really good at it and have many women coming to see us now as well as men.I would love to see you or Dr. M. We live in Salt Lake City, Utah so flying to the east coast is unaffordable at the current time.
@marsaday 1500 wrote:
have you done a saliva adrenal test to see how you cortisol production works? could be a start
I have not, but have considered it.
To be quite honest i don’t understand the adrenal gland as well as i would like. I have been on testosterone and levothyroxine for 2.5 yrs and feel like i understand those more than the adrenals. Yet the adrenal gland i am lacking knowledge on. I know all three(sex, thyroid, adrenal hormone) systems interact, just cant quite SEE the picture yet. If that makes sense.
I will probably give my endo a call this week. Had a test for hemachromatosis and want to know the result, guessing negative since they haven’t called. So, i will ask about saliva testing. I presume the 4x test is what would make sense in my case. Something to see what my cortisol is at four times throughout the day. 8am, 12pm, 4pm, 8pm.
The only cortisol test i had done was from 3/21/2007, 9am. Just before starting TRT. Don’t have units, these are from my online electronic record the hospital uses. This probably doesn’t help much.
Cortisol 20.8 range(2-23.8)
ACTH 58 no range given.On a side note, fall semester begins tomorrow. Im excited for my Health Psychology course.:D
@DrMariano 1444 wrote:
Many times the answer to a question is right in front of us.
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What is interesting about lab testing is that when one test gives an unusual value, a patient becomes overly focused on that result as the “obvious” reason for their problems. Yet there are numerous other possibilities yet to be considered.
For example, in the case of the lack of libido, many young men would overly focus on a testosterone of 400 ng/dL as THE cause of their lack of libido. And they would go from doctor to doctor trying to get testosterone treatment. Will it work? Maybe. But often it does not work. This is because there are other causes for the lack of libido yet to be considered or assessed with a different lab test.
Off the top of my head, other causes of a lack of libido yet to be assessed may include low or high estrogen signaling, low thyroid hormone, low cortisol signaling, excessively high norepinephrine signaling, low dopamine signaling, low or high iron, low fat soluble vitamin intake, low selenium, low growth hormone, low serotonin signaling, psychological issues, stress, anxiety, performance anxiety, homosexuality yet the partner is heterosexual, diabetes, drug abuse, alcohol abuse, sleep apnea, atherosclerosis, medication side effects, zinc deficiency, pituitary tumors, relationship problems, excessive intimacy, childhood sexual abuse or past sexual trauma, hypertension, renal disease, stroke, etc. etc. etc.
Addressing and treating some of the alternative causes may raise testosterone, itself, without having to do testosterone replacement.
Thus, it is important to look for other causes of a persons illness since a better target and more appropriate treatment may be found.
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A large area to explore, for example are nutritional deficits. Modern diets are nutritionally deficient. So many patients tell me they eat well. But when I actually monitor their nutritional status, many deficits show up.
When Weston Price DDS studied nutrition in the early 1900s, he found that traditional diets are usually up to 10 times more nutritionally dense than modern diets. This finding boggled my mind when I saw the data. This is particularly true today since the nutritional value of foods has decreased significantly compared to the same foods in the 1930s. For example, it takes many servings more spinach today to get the same iron content as a serving of spinach in the 1930s.
Dr., can you define ‘traditional diet’ and ‘modern diet’?
Thank you.
i just wanted to add i’ve followed your posts at mesorx and i love the structure and content you’ve created here at the definitive mind forums. very inspiring
@DrMariano 1431 wrote:
Bipolar Disorder not only is a disorder with extremes in mood, it is also a disorder with extremes in life accomplishments.
At one extreme, a person with bipolar disorder can be so dysfunctional, they end up in prison.
At the other extreme, a person with bipolar disorder can be fueled by the elevated state of mood and energy during a hypomanic episode that they can be much more successful than most other people.
When one looks at the most creative inventors and artists, one often finds bipolar disorder.
When one looks at our Hollywood stars, one often finds bipolar disorder. Bipolar disorder and Borderline Personality disorder are conditions which allow an actor to have extremes of emotion such as shown on stage and on film. Who can work the long hours without sleep, the 140+ hour work weeks that are common in Hollywood, other than those with bipolar disorder?
When one looks among the ranks of successful businessmen, bipolar disorder is a common condition.
The key is in maintaining control over the manic and depressed state, allowing only the highly productive and creative hypomanic states and normal mood states to be present.
For the lucky few, they can enjoy their hypomanic or manic highs.
Unfortunately, for most people with bipolar disorder, the depressive or irritable state predominates.
The energy demands of a manic or hypomanic state are such that they are difficult to sustain.
Very true. Who doesn’t love to feel ‘on top’?
You echoed what i’ve heard many therapists tell me. That it can fuel some people’s creative and economic pursuits. I can’t help but think at some point they will crash. And during those manic or hypomanic periods i would think poor decisions about health could be detrimental in the long run. I believe i read one of your posts stating that the mentally ill, on average, live substantially shorter lives and have more health problems.
For those who can put their moods to good use, that is very lucky. I have not personally known anyone who falls into that category. As i learn more, i learn anything is possible. I was thinking the part about this illness i don’t enjoy is the medication side effects, disruptions it causes in relationships, work, school, etc while trying to manage it and lead a productive life.
My manic episodes were remarkably similar in feeling to use of stimulats, cocaine particularly. Amazing(confidence, energy, positive outlook, etc) feelings immediately followed by some of the worst feelings(anxiety, depression, paranoia, irritability, etc) i’ve ever felt. There was no way i could put rapid cycling to good use. I used to paint but could never channel my energy into something useful. Van Gogh has always been one of my favorites incidentally.
i have bipolar disorder and take lithium. Two months into treatment with lithium my TSH was over 8.0. Started on levothyroxine and my free T4, T3 are good. mid-upper range on T4, top of range on T3. Lithium is very effective for me.
I haven’t met another bipolar person who told me they liked having the disorder. It is not something i particularly enjoy, nor my wife or father who also have it. Because of this disease and the type of mind I have, I have learned much about myself, emotions, decided to pursue a career in psychology. Fueled a desire to learn as much as possible about the body, mind, and how they are connected. I love to try and find answers. I hope to soon visit Dr. Mariano and learn even more.
