Meds to Lower TSH Level? & Update
[Home] [Bipolar News] [Bipolar Disorder] [Medications] [Treatments] [Bipolar Disorder/Job/School] [Disabilities] [Ask the Doctor] [Ask David] [Self-Injury] [Personal Stories] [Graham's Column] [Steven's Column] [Storm's Column] [Columnist Archives] [Suicide] [Community Support] [Family Members] [Expressions] [Greeting Cards] [Books] [Awards] [Links & Rings] [About Us] [Contact Us]

 


Q:  Meds to Lower TSH Level? & Update


Hi Dr. Phelps,
My 21 year old sons' TSH level was 3.719 at his last lithium blood draw/Thyroid test and his lithium level was .9. He has been on Lithium( lithobid) now about 1 year.  I was wondering what Thyroid medications you would use to bring the TSH level down to below 2? His T4 was 7.4 and T3 uptake 35 and Free Thyroid index 2.6 and T3ria was 122. How are your patients on the Thyroid medications doing this year? I really appreciate the work you are doing. Best Regards..


Dear Ms. B

Most of the patients who demonstrated improvement on thyroid  still look to me to be improved.  However, my enthusiasm has tempered just a little, as many of those folks have gone on to require yet more medication adjustments.  On the other hand, some are still doing so well, of people who had previously had T4 alone, that I am still routinely using T3/T4 combinations instead of T4 alone.  There have been a few folks who have clearly had their symptoms worsened  by T3/T4, about two more than appear in the table, out of another 20 or 30 patients I've been able to follow, so it's not without some risk compared to T4 alone, as best I can now tell.   

One way to approach your son's situation would be to start with T4, as that's the usual routine; then switch later when T4 alone was understood and not working well enough.  I would go ahead and start though, as I think we have enough data to show that a TSH up there is associated with more depressive symptoms, or at least with not responding as well to antidepressant efforts.  I.e. I wouldn't wait for a TSH of 6 or higher.  I especially wouldn't wait if his TSH used to be 1.5 before lithium. 

Of course, all that's just for review with your son and his doctor.  Good luck with that. 

Dr. Phelps


Published August, 2002

 

Bipolar World   1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014
Owners: 
Allie Bloom, David Schafer, M.Ed. (Blackdog)
Partners:  John Haeckel, Judith (Duff) 
Founder:  Colleen Sullivan
 

Email Us at Bipolar World

 

About Us  Add a Link  Advance Directives  Alternative Treatments  Ask the Doctor   Ask Dr. Plyler about Bipolar Disorder   Ask The Doctor/ Topic Archives  Awards  Benny the Bipolar Puppy  Bipolar Chat  Bipolar Children  Bipolar Disorder News  Bipolar Help Contract  Bipolar World Forums  Book Reviews  Bookstore  BP & Other mental Illness   Clinical Research Trials & FDA Drug Approval   Community Support   Contact Us  The Continuum of Mania and Depression   Coping   Criteria    Criteria and Diagnosis  Criteria-World Health Disabilities,  DSMV-IV   Dual Diagnosis  eGroups  Expressions (Poetry, Inspiration, Humor, Art Gallery, Memorials  Family Members   Getting Help for a Loved One who Refuses Treatment  Greeting Cards  History of Mental Illness  Indigo  Job and School  Links  Manage Your Medications  Medications   Medication and Weight Gain    News of the Day  Parent Chat  Pay for Meds  Personal Stories  Self Help  Self Injury  Significant Others  Stigma and Mental Health Law  Storm's Column  Suicide!!!  The Suicide Wall  Table of Contents   Treatments  Treatment Compliance  US Disability  Veteran's Chat  What's New?