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Suggest Treatment For Severe Depression When Diagnosed With Hypothyroidism
Question: I was diagnosed with hypothyroid last week, TSH was 14.2 T4 .6 T3 3.2 was given 75mcg of synthroid. Took first dose yesterday morning, second dose this morning. Symptoms prior to taking med included depression, cold tolerance, dry skin, trouble sleeping, on and on... Today felt great up until about 3:00pm and then went down in mood, face flushed, etc. Question is that fluctuation normal? Will I see that long and to what degree? Bad going from feeling great to down again.. Was 75mcg a good starting dose for my level? ( Weight 205 lbs)
Brief Answer:
Thyroid
Detailed Answer:
Sorry to learn about your bothersome symptoms.
Generally after starting synthroid, one does not expect the type of fluctuation that you are experiencing. But it can take several weeks for the medicine to have normalize the thyroid levels and consequently it could take couple months for you to feel better.
When I see someone like you in my practice, I typically start with a lower dose of 50 mcg in older adults, and order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this too checks your thyroid) Thyroid autoantibodies : Anti Thyroid Peroxidase (TPO) antibodies and Anti Thyroglobulin antibodies
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
None of these tests require any fasting and can be done at any time of the day Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Thyroid
Detailed Answer:
Sorry to learn about your bothersome symptoms.
Generally after starting synthroid, one does not expect the type of fluctuation that you are experiencing. But it can take several weeks for the medicine to have normalize the thyroid levels and consequently it could take couple months for you to feel better.
When I see someone like you in my practice, I typically start with a lower dose of 50 mcg in older adults, and order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this too checks your thyroid) Thyroid autoantibodies : Anti Thyroid Peroxidase (TPO) antibodies and Anti Thyroglobulin antibodies
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
None of these tests require any fasting and can be done at any time of the day Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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