![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 399 to 423 of 948. Go back in thread:
Posted by BarbaraCat on August 22, 2003, at 21:14:56
In reply to Re: BTW,what the heck of bobbles? » BarbaraCat, posted by katia on August 22, 2003, at 12:42:24
> Barb, where have you heard that lithium and lam. are a match made in heaven for BP depression? (besides your own experience on it).
**I don't have the exact source but it was a professional paper I read on the web. I've heard similar endorsements of it from other web sources and others' personal experiences. If you do a web search on lamictal+lithium you'll get alot of hits. They may not exactly say 'a match made in heaven' but there's alot of impressive research coming in to spark interest.
Posted by BarbaraCat on August 22, 2003, at 22:11:59
In reply to Re: BTW,what the heck of bobbles? » BarbaraCat, posted by katia on August 22, 2003, at 12:42:24
OK, here's some very interesting stuff. I had my naturopath visit today to go over the results of my tests. I did saliva tests of these hormones: estrogen, progesterone, DHEA, testosterone and cortisol. I also did a test for human growth hormone which makes all the others work. I was waaaaaayyyyyyy off on ALL of them, very, very low except for cortisol. This explains alot, my fibromyalgia, mood disorders, anxiety, weight gain, all of it. Don't forget, I'm already taking menopausal hormones (natural progesterone and estrogen) but the dear HMO folks never saw the need to test my levels. I take thyroid but not enough was getting into my cells even tho' the standard TSH blood tests didn't pick this up. I'm also taking the sex hormones orally which apparently doesn't work very well because of the liver's inability to adequately process them. I now have a different prescription for topical cream consisting of DHEA, progesterone, estriol, estradiol and testosterone. Human grown hormone is a whole other chapter of which books have been written but without adequate levels things fall apart, especially around menopause. Suffice it to say, early and ongoing stress disrupts the proper levels. I'll now be taking daily shots of it. The levels were so low that no matter how much I supplemented other hormones, they'd give up the ghost after a while. Human growth hormone is probably not an issue for y'all, but it illustrates the importance of getting to the underlying lynch-pin.
Time will tell if this will make the difference in my moods but according to my naturopath, there's no way I could be this hormonally unbalanced and NOT be one hurtin' unit. My psych meds are holding me together in the meantime and addressing the symptoms, but not the underlying hormonal imbalance. The more I research, the more convinced I am that this whole HPA-axis disregulation affects all our hormones and THIS is the place we should be looking to solve our mental mysteries. After all, hormones are our 'chemical messengers' and this means neurochemical messengers as well! There are SO MANY hormonal disrupters in our environment that it would be amazing if any of us were A-OK in that department.
So, dear friends, I lovingly and strongly suggest to you to get some really good hormonal testing done. Forget your primary care docs unless they're really really unique. They're good mechanics at broken bones and such but lousy at health. Forget endocrinologists, OB/gyn's, or pdocs. They are tunnel-visioned specialists and can't put the pieces together between hormones, moods and lasting wellness. If you know of a very GOOD naturopath, go there (many of them are inept). If you need a suggestion for a holistically oriented physician, try www.acam.org. However you find a good whole body/mind health professional who knows hormones, do yourself a big favor and make it happen.
I'm very relieved that more pieces of the puzzle are fitting together after YEARS of sleuthing but so damned PISSED at the majority of well-intentioned clueless medical professionals who think they're helping us get well. Drug companies fund the research, the scholarships, the symposiums, the education. No wonder we're taking more drugs and not getting much better.
BTW, this hormonal testing applies to men as well. We all have the same hormones, only in different ratios. - BarbaraCat
Posted by SUMMER2002 on August 22, 2003, at 23:09:48
In reply to Re: BTW,what the heck ARE bobbles?, posted by fluffy on August 22, 2003, at 11:04:57
> Hey Katia--
>
> I refer to my little swings as "bobbles". I remember hearing the word a lot as a gymnast and a dancer--when you don't stick a landing and you lose your balance, maybe step out and then step back. The coach or tv announcer says--"ooop--there was a little bobble in her landing--that's gonna cost her some points." (anyway--that's my little analogy)
>
> Welcome summer2002. Glad to have you in our club. I was wondering (like you) last night if my troubles are not so much med related as they are depression related. As much as I thought I was improving, I think the season is catching up with me, and alas, I'm falling back into the blues. I'm feeling low or no motivation (and I've got things to do!--I just lay on the couch watching tv), lack of appetite, tiredness, heavyness, apathy, sadness. jeez--sounds like depression to me. But it's in its mild to moderate stages right now, and I hope to not fall into severe depression.
>
> After talking to my doctor about these new developments, he wants to try Lithium on me. I'm kinda scared--but I think if I respond to it, then it's good. I do feel that I have pretty classic symptoms--at first extreme optomism, energy, lots of ideas, racing thoughts--then I crash into typical depression--slowness, trouble sleeping at night--wanting to sleep all day, no appetite, no interest in pleasure. However, I do seem to have an atypical trait--esp. the rejection sensitivity. Whatever. I just hope i respond.
>
> I also had the bad reaction to Lexapro--I had a doozy of a mixed state--I became obsessed with suicide, I was knashing my teeth, pacing, crying, my thoughts were all layered, I felt like I would explode. That's also when I got my lovely BPII diagnosis. Sometimes I wonder if I'm closer to a BPI.
>
> Miss Summer2002--I sincerely hope your depression doesn't snag you too hard this time around. September can be a rough month on us BP folks. I'm just holding my breath and trying my best.
>
> All I could manage as exercise this morning was 25 jumping jacks. As a former gymnast and dancer, I liked Barb-cat's idea of a trampoline.
>
> best to all of you,
> Katy
Katy,Wow! That is exactly what happened to me on Lexipro. I had to see a dentist and get a mouth guard to sleep at night. Ditto with the suicidal thoughts, high anxiety and pacing. Needless to say it wasn't a pleasant time.
As far as the hormones go - I wonder if it has caused some of this behavior although I have a history back to college days. We have early menopause in the family and my sisters have been on my case to get hormone levels checked. Only person to go to is ob.
Patricia
Posted by lputn333 on August 22, 2003, at 23:18:07
In reply to Naturopath visit results, please read, posted by BarbaraCat on August 22, 2003, at 22:11:59
Hi, I am new to this, I found this by looking up info. on Lexapro. I had a hysterectomy a year ago and was really doing well until a few months ago. I suddenly started getting constant headaches, had trouble breathing, trouble sleeping and mood swings. My doctor said it was stress and prescribed Lexapro to calm me down. It had been working really well but lately I just feel so depressed all the time. It's almost like I'm stuck in this black hole and I can't get out. I'm 42 have been married for 16 years and have 2 daughters. I just need other people I can relate to and discuss this with. Thanks
Posted by katia on August 23, 2003, at 0:29:58
In reply to Naturopath visit results, please read, posted by BarbaraCat on August 22, 2003, at 22:11:59
Hi Barb,
Wow. I'm glad you are finding more pieces to the puzzle. I actually asked my pdoc about testing my hormones, but he said that my "problem" was mood related, probably not hormonal. I wonder if they do affect one another and/or if they are just two individual pieces (to make the whole!)that need sorting out? Maybe you need both?Have you ever done kundalini yoga? I did a class last year for three months (partially academic, partially meditative for my M.A.) and just went to a local meditation tonight (different teacher). It's pretty intense and I'm wondering if it's too much right now while I'm trying to sort out the meds? My therapist seems to think it might "stir" up too much at the moment. The "teacher" of the yoga said it can only support all life areas. who knows. My therapist is very transpersonal oriented too BTW, so she's not just saying that out of ignorance.
anyway!
take care,
Katia
Posted by Ima on August 23, 2003, at 11:10:47
In reply to Re: Naturopath visit results, please read, posted by lputn333 on August 22, 2003, at 23:18:07
> Hi, I am new to this, I found this by looking up info. on Lexapro. I had a hysterectomy a year ago and was really doing well until a few months ago.
Hi Lputn
I have no problem with ADs if their needed. But womens health issues are sometimes more complicated and with a little more investigation, you can find aproaches that are more comprehensive, treat the whole person.
I havent had a hysterectymy but Im peri-mena pausal at 42 (my mom was through her change by the time she was 45) So Our situations are similar.
I was fortunate to find a general Practictioner who believes in natural hormone therapy (actually does reasearch in hormone therapy). These are not the scary hormones we've all heard so much about in the news lately. Those hormones are derived from the urinine of pregnant female horses, bad stuff , very harsh on the body. The ones Im on are a synthetic type, modeled after plants, much easier on the body. They have saved my sanity on more than one occasion.. Please look into it.We all have to face the change at some point but it can be especially hard when you still have children at home. I take progesterone (PROMETRIUM 100 & 200 mg ) during day 14 - 28 of my cycle. By 40 most womens stores of progsterone are completely depleated. It really helps during the last week. I usually have to take 100 mg in the morning and 200 at night to sleep. The progesterone has a calming effect on my nerves. When I start screaming at the kids for really stupid reasons, I know I need to take or increase my progesterone.
I also take ESTRIOL/ESTRADIOL 20/20 mg in a cream form. I apply to my skin. Estriol gives me more energy and lifts my spirts a bit. I take this during day 1-14. The lack of either of these hormones can have a tremendous effect on your mood.
Having said all that, you may not want to go throught the effects of having a monthly cycle agian. And the estriol will probably impact that. Progesterone most likely wouldnt.
It had been working really well but lately I just feel so depressed all the time. It's almost like I'm stuck in this black hole and I can't get out. I'm 42 have been married for 16 years and have 2 daughters. I just need other people I can relate to and discuss this with. Thanks
Talk with your doc about ALL your options. The lexpro may just need more time.
Every one here knows about the black hole. Have you seen the movie "A Gathering Storm"? Winston Churchill called his black times "black dog days".
Blessings to you.
Peace
Ima
Posted by jota on August 23, 2003, at 11:29:50
In reply to Re: Naturopath visit results, please read, posted by Ima on August 23, 2003, at 11:10:47
A lot of evidence has been accumulating that men with treatment-resistant depression have very low levels of testosterone. When we finally checked it, mine turned out to be off the charts low. I would definitely urge men reading this forum to get theirs checked.
Jordan
Posted by BarbaraCat on August 23, 2003, at 12:22:16
In reply to Re: Naturopath visit results, please read » BarbaraCat, posted by katia on August 23, 2003, at 0:29:58
>>I actually asked my pdoc about testing my hormones, but he said that my "problem" was mood related, probably not hormonal. I wonder if they do affect one another and/or if they are just two individual pieces (to make the whole!)that need sorting out? Maybe you need both?
**Your pdoc is not the one to ask about hormonal testing. He/she likely knows nothing about how to decipher them or how the numbers might relate to mood. I asked my gynocologist to please test me and he, who should know about female hormones, said most doctors don't use hormonal testing because they don't know what to do with the numbers!! And yes, of course hormones affect mood and vice versa. The function of hormones is to prodvide communication between bio- and neuro-chemicals. If one system is out of whack it will affect the whole. The brain has a huge number of estrogen receptors, so this should suggest how important supposedly 'unrelated' physical hormones are to neuro systems. There are no separate physical/mental pieces. They all relate to the whole. This is why you'd be best talking to someone who is holistically oriented, who recognizes that all body systems are interrelated and knows what to do with this information. Reproductive hormones may not be your entire problem and granted, mood and stress affects hormone levels. But if you're hormonally unbalanced, you're swimming against the tide to try to get your moods balanced.
>
> Have you ever done kundalini yoga? I did a class last year for three months (partially academic, partially meditative for my M.A.) and just went to a local meditation tonight (different teacher). It's pretty intense and I'm wondering if it's too much right now while I'm trying to sort out the meds?**Yes, I've done kundalini and there are different types. You say that this one is intense. I'd agree with your therapist on this one and wait until you're stabilized. If you go too fast raising energy before you're in a very grounded state, it would be like shooting a huge zap of electricity through a frayed wire. There's a psychiatric condition known as 'kundalini psychosis', believe it or not. Yoga is wonderful for depression and anxiety but again, there are so many different kinds. I'd opt for the more calming and centering kinds, like Kripalu, Anusara, even Iyengar, and be cautious about the really activating ones like Kriya, Kundalini, Ashtanga (Bikram). However, if you get a good gut reaction to this class and teacher and it would be a good community, good exercise and good philosphy then it could be a real gift during this time. Whatever, you can keep a cool head and body as well as taking with a grain of salt anything any teacher tells you.
Posted by fluffy on August 23, 2003, at 13:17:23
In reply to Re: Naturopath visit results, please read » katia, posted by BarbaraCat on August 23, 2003, at 12:22:16
Hey Katia and Patricia--
Aside from all of this Psycho-babble stuff, I've found that one book in particular was extremely helpful to me when I was first diagnosed. And I have finally bought a copy instead of getting it from the library. When I feel like I am questioning what's going on with my moods/diagnosis, it straightens me out and gives good treatment options. It's called "The Bipolar Disorder Survival Guide". I highly recommend it, even though it doesn't dwell on the particularities of bipolar II. All of the information can be applied.Just a thought--take it or leave it.
I hope you guys are well. I've cycled out once again, and feeling normal. However, the Li is coming soon--I have an appt. on monday with my pdoc.Katy
Posted by Ima on August 23, 2003, at 14:46:36
In reply to Re: Naturopath visit results, please read » katia, posted by BarbaraCat on August 23, 2003, at 12:22:16
Its okay for me to respond to responses, right?(Im still new at this :)
> >>I actually asked my pdoc about testing my hormones, but he said that my "problem" was mood related, probably not hormonal. I wonder if they do affect one another and/or if they are just two individual pieces (to make the whole!)that need sorting out? Maybe you need both?
Hormone balance no problem after a hysterectemy? Pleeease!
Of course they affect each other, but your right , the depression problem may exist in some people from childhood, even before puberty.
>
> **Your pdoc is not the one to ask about hormonal testing.Definately.
** said most doctors don't use hormonal testing because they don't know what to do with the numbers!!As my GP told me the numbers are not the best indicator of a womans hormonal needs. You & I may test in the normal range for estrogen levels but not feel the same. I may need more than you to feel normal.
The question is do you want to open the hormonal can of worms? It will take alot energy to get it balanced and then youll have to deal with cycles again. If you feel in your gut that this may be a piece of the puzzle, it wont hurt to start. There are little side effects to Natural hormone therapy.
** But if you're hormonally unbalanced, you're swimming against the tide to try to get your moods balanced.
I agree. But the change of menopause (in this case, pre mature) is inevitable. At some point we (woman)all will have to live with diminshed hormone capacity. That was one of the factors that figured into the national study. Women were taking Premarin long after the change because they "felt better". But the 1 - 2% increase in cancer is a serious consideration.
**It's pretty intense and I'm wondering if it's too much right now while I'm trying to sort out the meds?Youll get lots of helpful suggestions and ideas to look into on this site. You know what you need. Follow your gut and keep investigating.
A great book on Hormones is "Natural Hormone Balace for Woman" by Uzzi Reiss
Peace
Ima
Posted by katia on August 23, 2003, at 15:23:04
In reply to Re: Naturopath visit results, please read » katia, posted by BarbaraCat on August 23, 2003, at 12:22:16
>There's a psychiatric condition known as 'kundalini psychosis', believe it or not.
Yes, I've known about this.
>>Yoga is wonderful for depression and anxiety but again, there are so many different kinds. I'd opt for the more calming and centering kinds, like Kripalu, Anusara, even Iyengar, and be cautious about the really activating ones like Kriya, Kundalini, Ashtanga (Bikram).
Actually Ashtanga and Bikram are two different types. I do Bikram sometimes/often and it helps. But I don't consider it yoga so much.
>However, if you get a good gut reaction to this class and teacher and it would be a good community, good exercise and good philosphy then it could be a real gift during this time. Whatever, you can keep a cool head and body as well as taking with a grain of salt anything any teacher tells you.
yes, I agree. This is not a movement yoga. It's sitted meditation working actively with the charkas. I'm going to go to a few different kinds of meditations and see what feels best.As you probably know from the previous posts, I contacted my pdoc and told him about my reaction (initial) to Depakote. He told me to ramp it up and see what happens. I did and am at 500mg now for three days. I didn't need the Seroquel for sleep last night and slept well. I'm starting to feel a bit more stable, which is great. But I'm still not quite there.
thanks for your input.
Katia
Posted by katia on August 23, 2003, at 15:26:37
In reply to Katia and Patricia--a good book, posted by fluffy on August 23, 2003, at 13:17:23
> Hey Katia and Patricia--
>
> Aside from all of this Psycho-babble stuff, I've found that one book in particular was extremely helpful to me when I was first diagnosed. And I have finally bought a copy instead of getting it from the library. When I feel like I am questioning what's going on with my moods/diagnosis, it straightens me out and gives good treatment options. It's called "The Bipolar Disorder Survival Guide". I highly recommend it, even though it doesn't dwell on the particularities of bipolar II. All of the information can be applied.
>
> Just a thought--take it or leave it.
> I hope you guys are well. I've cycled out once again, and feeling normal. However, the Li is coming soon--I have an appt. on monday with my pdoc.
>
> KatyThanks Katy,
I'll check it out. I've read one called "Bipolar Disorder" A guide for patients and families.it helped some.
k.
Posted by BarbaraCat on August 23, 2003, at 21:15:13
In reply to Re: Naturopath visit results, please read, posted by jota on August 23, 2003, at 11:29:50
> A lot of evidence has been accumulating that men with treatment-resistant depression have very low levels of testosterone. When we finally checked it, mine turned out to be off the charts low. I would definitely urge men reading this forum to get theirs checked.
**And women as well! My testosterone was barely squeaking down there and testosterone has so much to do with mood and energy of all kinds. What kind of supplementing are you using? My husband was on the Androderm patch for a while but it gave him headaches. His levels were excrutiatingly low and now that he's not on anything he's slowly turning into a lass before my horrified eyes. I'm using a topical cream containing testosterone along with other hormones.
Posted by Ponder on August 24, 2003, at 11:42:21
In reply to Re: Katia and Patricia--a good book » fluffy, posted by katia on August 23, 2003, at 15:26:37
>
> Thanks Katy,
> I'll check it out. I've read one called "Bipolar Disorder" A guide for patients and families.
>
> it helped some.
> k.I, too, found Bipolar Disorder: A Guide for Patients and Familes to be an excellent book, but was frustrated with the authors failing to list weight gain as a side effect of medications that are notorious for it. Weight gain poses a grave threat to anyone's health, and yet the propensity for it that psych drugs endow is rarely discussed openly by professionals. There is stuff in the medical journals on it, but in a book like this one--both credible, fairly comprehensive, and well-written--you'd expect to see the issue addressed.
With Depakote, he mentioned that he had heard of some weight gain with the drug, but had not seen it in his practice. Is there anyone on this board who did NOT gain weight with Depakote?
Posted by Ponder on August 24, 2003, at 11:56:13
In reply to Naturopath visit results, please read, posted by BarbaraCat on August 22, 2003, at 22:11:59
B-Cat, you are so right about the difficulty in getting coordinated care on the hormonal piece of the puzzle. My psych-doc doesn't know what to do with estrogen/progestin, my family practice doc doesn't know beans about psychiatric issues, my gyn doesn't want to deal with anything but the HRT. I've never seen an endocrinologist, but understand they have a beef with anything but the most conservative thyroid supplementation (partly because of the osteoporosis risk).
The HRT thing is confusing. I've heard that these hormones play a huge role in mood disorders, but the effects are unpredictable. So, I guess it's another one of those try-it-and-see kinds of things. I've been reluctant to discontinue for fear of destabilizing.
Truth is, I'm pretty much afraid of everything these days. I've lost hope for feeling any better than marginal. I have a few days of euthymia a month and they are wonderful, but the rest of the time I'm just grateful that I'm able to get out of bed in the morning. So I keep taking my usual meds and call it good. It's so hard to evaluate treatment efficacy with rapid-cycling BP that the try-it-and-see method is stressful. I can't always tell what is helping vs. just cycling out of the depression for a while. I fear I may be spending my money and subjecting my body to drugs/supplements that are not really helping at all.
Well, there, I've talked about several issues, I guess, and in not too organized a way. But there it is.
Thanks, B. for your lucid and helpful posts.
Posted by fluffy on August 24, 2003, at 15:04:42
In reply to Re: Katia and Patricia--a good book » katia, posted by Ponder on August 24, 2003, at 11:42:21
Hi Ponder-
I think there are two books with similar names. I'm not sure, but the Bipolar Survival Guide addressed weight gain. But all in all, I know what you mean. It's kind of a problem with the psychitrists. I was just telling my boyfriend last night that I wish psychiatrists were more blunt about the course of bipolar disorder and the side effects of drugs. For most doctors, it's a trade off--health problems in the long run, or the patient running the risk of having consecutive and more severe episodes. Weight gain or suicide? ALSO--Not EVERYONE gains weight on Depakote--it's a POSSIBLE side effect.
The psychiatrists who do have expertise with mood disorders have an obligation to inform patients of the risks and possible side effects of medications, as well as the probable future of maybe more episodes. I think they just don't want to bog patients down with too much bad news at once. Could you imagine if your psychiatrist said "you have a disorder that will be with you for the rest of your life. the only way to control it is with medication. And we're not sure which ones with work for you--you might be miserable for years trying new ones. And most of the kinks are not worked out, so you may feel like a zombie and gain 40 lbs." Esp. since most BP patients get treatment only when they feel depressed, it's probably good that they dwell on the positives of treatment. I was too close to suicide to hear all of the negatives at once. I'm kind of glad that things were sugar coated and that I've come to understand the positves and negatives for myself.
Posted by BarbaraCat on August 24, 2003, at 16:10:53
In reply to Re: Naturopath visit results, please read » BarbaraCat, posted by Ponder on August 24, 2003, at 11:56:13
Hey there, it's been a while! Great to hear from you again! Are you taking HRT? What kind? You know that there's the standard formulary crap - Prempro and the like which is derived from mare's urine. That is the most problematic and it's tragic that it's the bulk of what gets prescribed. If this is what you're taking, or Premarin and Norprin or any of the standard generic synthetics, you are not doing yourself any favors. You have to ask for the bio-identical and even then you get the one size fits all dosage. They never test. Why? Because testing isn't cheap! I had been taking Prometrium which is micronized bioidentical progesterone and estrace which is bioidentical estrogen, (but estriol only instead of estradiol also), thinkin I was at least getting the 'natural' kind. No one ever tested me and it turned out that I was getting way too much estrogen and ended up with a buildup in the lining of my uterus, lumpy breasts and a precancerous condition that eventually caused hemorraging. Fun. My thyroid zoomed through the roof because I was on lithium but no one seemed very concerned even though I'm well aware of what normal levels should be and the many problems even miniscule abnormal levels cause. I had to INSIST I be given more thyroid than they were willing to prescribe (the party line being, oh, even though you're a little hypothyroid, it shouldn't cause any problems). BULL SHIT!!!!!
In short, my hormones were all screwed up and even the most basic dumb HMO tests showed this. Do you think my pdoc ever looked at those records, even though all my 'care' providers were in the same building? Did he ever bother to put the obvious pieces together that just maybe my loopy hormones were affecting my mood? Did my primary care doc ever consider that the very obvious unbalanced state of my physical systems had anything to do with the intense psychic suffering I was experiencing? Does anyone remember PMS?? Any woman (or man living with such woman) who's gone through rabid PMS can tell you about the hormone/mood connection.
So yes, you're point regarding concern about all the meds doing much good and maybe doing harm is very relevant. What's interacting negatively? Is there anything beyond hit or miss psych treatment that should be considered and explored? If you have an unusually good MD who knows what the heck they're doing, then thank the Great Spirit every night. Most of them are not the physicians/healers of the past. They don't have time and are dictated by HMO guidelines and drug company funding. We absolutely MUST take charge and learn about our bodies, and ESPECIALLY our hormones. I am on a soap box about this one and if I reach just one person, I can eventually die feeling like I've made a difference. We're putting our psyches in the hands of well-meaning sound-bite technicians who have no idea beyond the basics of what to do with us. We have to go farther than looking at our brain chemistry. WHY is our brain responding the way it is? What is causing the imbalance? What imbalances are our brain chemistry causing? The wholeness of our being isn't divided at our necks. Two books can help:
"Screaming to be Heard", Elizabeth Vliet
"The Wisdom of Menopause", Christiane NorthrupUltimately, it means hoofing around and finding a talented and dedicated health practitioner who knows what the heck they're doing and takes the time to get to know precious you. It probably means paying out of pocket because, I assure you, the only concern managed care and health insurance companies give a rip about concerning your continued good health is if you don't cost them anything. They are out to cut costs and are NOT on your side. I'll keep my woefully inadequate HMO in case I get run over by a truck, but for my health, my naturopath is now my mentor because she is one smart cookie and I trust her wisdom and experience. Sorry to rant, but boy oh boy, am I pissed! The answer was right in front of their bamboozled faces and it was I who had to stamp my feet and do something! - Barbara
Posted by katia on August 24, 2003, at 17:11:37
In reply to Re: Katia and Patricia--a good book » katia, posted by Ponder on August 24, 2003, at 11:42:21
> >
> > Thanks Katy,
> > I'll check it out. I've read one called "Bipolar Disorder" A guide for patients and families.
> >
> > it helped some.
> > k.
>
> I, too, found Bipolar Disorder: A Guide for Patients and Familes to be an excellent book, but was frustrated with the authors failing to list weight gain as a side effect of medications that are notorious for it. Weight gain poses a grave threat to anyone's health, and yet the propensity for it that psych drugs endow is rarely discussed openly by professionals. There is stuff in the medical journals on it, but in a book like this one--both credible, fairly comprehensive, and well-written--you'd expect to see the issue addressed.
>
> With Depakote, he mentioned that he had heard of some weight gain with the drug, but had not seen it in his practice. Is there anyone on this board who did NOT gain weight with Depakote?
>Hi,
I actually am on my second week of Depakote at 500mg a day. I definitely have not lost weight and I don't have a scale, but I think I may be gaining weight. I've been really good about not overeating and getting exercise, but my clothes are tight! And so, it's not due to overeating. My period also just started so it could've been that. But I'm defin. not losing weight and I've already maxed out my average range of weight. I feel a bit heavy. I just hope that the weight gain doesn't happen!
How about you? Did you take Dep.? and gain weight? I've heard of a couple of people who took dep. and did not gain weight.katia
Posted by Jota on August 24, 2003, at 21:35:00
In reply to Re: Naturopath visit results, please read » jota, posted by BarbaraCat on August 23, 2003, at 21:15:13
> What kind of supplementing are you using? My husband was on the Androderm patch for a while but it gave him headaches.I'm using AndroGel. At 7.5 g, my testosterone level was still extremely low. Now at 10g and will do another blood test in a week. I haven't noticed any side effects so far. Instead, diminished headaches. And increased sexual desire.
Jordan
Posted by Dr. Bob on August 24, 2003, at 22:22:32
In reply to Re: Naturopath visit results, please read, posted by Ima on August 23, 2003, at 14:46:36
> A great book on Hormones is "Natural Hormone Balace for Woman" by Uzzi Reiss
I'd just like to plug the double double quotes feature at this site:
http://www.dr-bob.org/babble/faq.html#amazon
The first time anyone refers to a book without using this option, I post this to try to make sure he or she at least knows about it. It's just an option, though, and doesn't *have* to be used. If people *choose* not to use it, I'd be interested why not, but I'd like that redirected to Psycho-Babble Administration:
http://www.dr-bob.org/babble/admin/20020918/msgs/7717.html
Thanks!
Bob
Posted by McPac on August 24, 2003, at 22:50:07
In reply to Naturopath visit results, please read, posted by BarbaraCat on August 22, 2003, at 22:11:59
"I did saliva tests of these hormones: estrogen, progesterone, DHEA, testosterone and cortisol. I also did a test for human growth hormone which makes all the others work".
>>>>>>>>>>>>> Barb, would these tests be the standard hormone tests to have done, male or female? Are there add'l tests you'll have done? Is it really expensive?
GOOD FOR YOU BCat......Hope this really helps you a lot! I agree w/ ALL you say about the medical establishment. It's a joke. Keep us posted!!!
Posted by BarbaraCat on August 24, 2003, at 23:55:52
In reply to Barb, Re: Naturopath visit results, please read, posted by McPac on August 24, 2003, at 22:50:07
> >>>>>>>>>>>>> Barb, would these tests be the standard hormone tests to have done, male or female? Are there add'l tests you'll have done? Is it really expensive?
***Hi Mr. Mac,
They were saliva tests done by a company called ZRT Labs in Portland, OR. Check out their website:Saliva tests get bad raps because they're considered inaccurate, but I had blood serum and urine tests done as well and the levels matched. I did this to ease my mind that I was going to be getting accurate test data once I fired my HMO 'health care team' - hah! Saliva tests are used primarily by naturopaths and holistically oriented physicians. When I asked at my HMO if I could get them done, they either didn't know anything about them or blabbed the party line 'we don't have enough scientific data on them' crap. I had to insist I get specific and individual blood and urine tests done to measure the hormones I knew I needed to be looking at. The tests were relatively expensive and not 'formulary' but my HMO did pick up the tab because I literally stamped my foot. So once I had those 'medically acceptable' test values in hand, I went to my naturopath who ordered saliva tests, which are easy to use, less expense, and much more sensitive. We'll be using the saliva tests to monitor my treatment, but if there's a test better served by blood serum testing, we'll go that route. In other words, whatever works the best. I am currently paying for all this out of pocket, but some health insurance companies cover alternative care. But you have to be careful to find the right practitioner. Just because they're 'alternative' doesn't mean they're good!
Saliva tests ran around $150 for measuring reproductive hormones, DHEA, cortisol.
There's a very thorough thyroid test that measures way beyond the standard TSH test. It measures ratios of T3 to T4, reverse T3, free and bound T3 - basically, a more accurate picture of how the cells are really uptaking thyroxine. That one is around $140, but I didn't have it done because my TSH values were so obviously high that my hypothyroidism is a given.
I also did a blood spot test to measure IG-1, or human growth hormone. That one was $75.
My naturopath visits cost about $150 each and I spend 60 minutes with her each time. She would not sell any vitamin supplements to me saying that my body would not use them very well at this time. This is not the usual case with many naturopaths who have walls of exotic pills they're all too happy to sell you. The woman I'm seeing is a rare jewell and I had to kiss alot of frogs before finding her.
My medicines to correct my hormonal imbalances were compounded into a topical cream by a compounding pharmacy. It contains progesterone, estradiol and estriol (the two estrogens women need), DHEA, and testosterone. The amounts of each hormone are individually tailored to me based on values from my saliva tests. I rub a small amount on my skin every morning. A month's supply of this cream is $30. Already I'm feeling a difference in energy and motivation (probably the testosterone of which I tested at near zero). In fact, it's probably fueling my 'I'm pissed as hell and not gonna take it any more!' attitude.
I'm also taking a more exotic treatment, Human Growth Hormone, because my very low levels were a red flag indicating that this imbalance could be throwing off everything down line. HGH is a pituitary derived hormone and if the pituitary is off, which is the case in many chronically stressed folks, then this may be the upline source of all the the cascading imbalances downline - the infamous HPA-axis disregulation. I take a very small amount as a shot in the butt 6 days a week. This will cost about $140 a month, which is a major bargoon considering most sources you'll find on the internet quote around $400 a month. The place I'm getting it (prescription from my naturopath) is Women's International Pharmacy, a very reputable mail order compounding pharmacy. If you're interested in pursuing this path, you might contact them and ask for recommendations health professionals in your area who use their services. They serve both men and women. There's some interesting reading material on their site. Check it out at:
http://www.womensinternational.com/about.htmlLater, BarbCat
Posted by McPac on August 25, 2003, at 1:13:04
In reply to Re: Barb, Re: Naturopath visit results, please read » McPac, posted by BarbaraCat on August 24, 2003, at 23:55:52
Thank you for all that info Barb! Much appreciated!
ALSO, I've got a dilemna that I'd LOVE to run by you because I really do value your thoughts and opinions.
Okay, for years I've taken AD's and lithium together....I've always taken a much smaller amount of lithium than most bipolars (I am likely bipolar, though very rarely get even the mini-highs (hypomania), I'm VERY much just the depression part)....anyway, I would, for YEARS, take only 600 mgs/day of Lithium along w/ my anti-dep (and this worked very, very well).......over the last couple of years, I have tried to even DEcrease that small lithium dose, taking only 300 mg/day of lithium w/ my AD...my lithium level is PUNY, something like .016 or .02 last time I checked it...in other words downright microscopic for a bipolar......anyways, over the last couple of years (since lowering my lithium dose to these PUNY levels) I have felt like total crap much of this time--- I have had a lot of AGITATED feelings with ANGER problems....and when I try to switch AD's, as soon as I get to just a moderately high dose, the agitation/anger/irritability gets MUCH worse....for a while I kept thinking that it's just the AD's that are causing the anger....but NOW I'm seriously thinking that it's the PUNY, DEcreased lithium dose, THAT WHEN COMBINED WITH the AD's, that is the problem....in other words, that the AD's are 'destabilizing' me or making me feel agit/angry but it's BECAUSE I'm on TOO LITTLE of a mood stabilizer....Isn't that a signal or tip-off to bipolar in many cases---that if someone is trying different AD's and having really bad effects and no success (and often feel even worse!) that they may be bipolar and need a mood stab. WITH their AD? I think my agitation/anger/irrit on the AD's is telling me that I need to increase my mood stab....(I KNOW that one AD (Prozac) was DEFINITELY a TERRIBLE drug for me, TERRIBLE anger/rage......but now, as more and more seem to cause problems, I think my PUNY lith. dose is a BIG part of the problem.....would most bipolars get totally messed up (agit/anger/irrit) if they were only taking an AD WITHOUT their mood stabilizer? Sorry for that rambling post, lol, what do you think Barb?
Posted by BarbaraCat on August 25, 2003, at 11:58:40
In reply to BARB!, Naturopath visit results, please read, posted by McPac on August 25, 2003, at 1:13:04
**I think your take on the situation is right on. Yes, I do think that taking an AD without an adequate amount of mood stabilizer is a sure recipe for what your describing, if you're bipolar - and some research suggests even if you're not bipolar. However, you state that you 'rarely get the hypomanic highs' which tells me that you equate BP 'manias' as the classic ones, the kind everyone's impressions of mania is (myself included until I found out better). Mania/hypomania is NOT always the bubbly, get things done, madcap high time that we all have associated it with. It's more likely IRRITABILITY and AGITATION. For me, when I have the classic madcap manias, they last only a short time and then disintegrate quickly into frazzled annoyance and rage. Mainly, I don't get the enjoyable stuff at all, but only the trigger fire anger and disorganization on the manic side and the lethargy and life sucks kind on the depressive side. Before lithium I was getting both together in godawful mixed states. I'm not on very much lithium at 600mg because I want to keep my edge so I still have some hypomania of different sorts occasionally, and I still get variations of 'life sucks' (but, really, it does!) depressions. But thank God, no more mixed states. I could live with ANYTHING but not mixed states! Once again, you MUST understand beyond any doubt that your symptoms of anger, irritability, rage are most likely undertreated manic symptoms. Mainly depression with irritability and agitation (also known as hypomania) IS the description for BPII. It's also the description for agigatated depression or depressive GAD, but this is splitting hairs. It sounds like you are BPII to me and if this is true, you absolutely need an effective level of mood stabilizer. If you are getting horrible mixed states, you're more likely BPI (as I now know myself to be), although I don't think this is the case with you, but in any case, you'd STILL need a mood stabilizer. I have my own experiences about too little lithium:
A year and a half ago I ran out of lithium and my mail order pharmacy took about 10 days to get the prescription to me, so I was without for over 2 weeks. I was taking Remeron at the time so I thought I was covered at least until I got my lith in the mail. I started having a very enjoyable hypomania so I didn't start taking the lith once I got it back thinking 'oh boy, I sure feel good so I probably don't need it'. The pleasant hypomania didn't last all that long and quickly turned into disorganization, irritability, snappy quick-trigger anger, sarcasm (my poor husband!), spending money I didn't have, sleeplessness, poor judgement. Once I went back to my 600mg things mellowed out within 1 week. Note that I'm only taking 600mg which is way below my therapeutic window, but it's obviously making a big difference.
I went off Remeron because it really made me feel awful and started lamictal along with lithium. About 6 months ago I started having alarming increases in my thyroid TSH levels which is a problem with taking lithium when one is hypothyroid as I am. So I decided to reduce lithium because I was concerned about permanently damaging my thyroid. I got down to 300mg every other day within a 3 week period and experienced the rage, hot temper stuff pretty dramatically. So again, within 1 week of restarting things smoothed out.
I have a few thoughts on this and your experience will shed light. There's always a withdrawal period where things are shaky. I've wondered whether if I just stayed the course I'd eventually smooth out without the lithium. It sounds like you've been on a substandard dose for a while still have symptoms and so your anger/irritability are not due to withdrawal. The other thing is taking an AD at all when you're BP. What kind are you taking? I had nothing but problems with all the ADs I ever took, even with lithium as an augmentor. The only one that helped was nortriptyline, briefly, when I was suicidally depressed after my Mom's death. But once I emerged from that, I stopped nortrip and eventually felt much better without it. Lamictal 125mg and lithium seem to be doing the trick as far as keeping me from destabilizing. One other thing to consider is, are you really BP? Could it be that you're actually unipolar depressed and not getting high enough a dose of your AD? Even if this is true, my personal opinion is that anyone taking an AD should also take it with a mood stabilizer. Sigh, so many variables. My personal hit is that you're not on enough lithium or whatever mood stabilizer you choose, and you're destabilizing with the AD. One more thought. A high level of testosterone is also associated with anger and aggression. Can you possibly have the mixed blessing of having too much of a good thing? A hormone panel test would tell.
Have you read "Why your depression isn't getting better" by Michael Bartos, MD? He describes what you're going through very well and states without any doubt that BPs most definitely and absolutely require a mood stabilizer, should reconsider using ADs at all, and NEVER use ADs without a mood stabilizer. Here's the website:
Also, here's the recommended book page of a website I like very much. The entire website is great. You might find something that helps:
http://www.mcmanweb.com/book-16.htm
And finally, you've been suffering with this for a long time now, Mac. I can only imagine how hard it must be. Why not just up your lithium and see? If you start feeling better, I'll bet you can start lowering your dose of ADs and you'll get an even better response. But only after the withdrawal subsides. What does your pdoc say in all this? He/she should be very aware and up on this whole AD/mood stabilizer issue. If he/she is not, why not?
BarbaraCat
> Okay, for years I've taken AD's and lithium together....I've always taken a much smaller amount of lithium than most bipolars (I am likely bipolar, though very rarely get even the mini-highs (hypomania), I'm VERY much just the depression part)....anyway, I would, for YEARS, take only 600 mgs/day of Lithium along w/ my anti-dep (and this worked very, very well).......over the last couple of years, I have tried to even DEcrease that small lithium dose, taking only 300 mg/day of lithium w/ my AD...my lithium level is PUNY, something like .016 or .02 last time I checked it...in other words downright microscopic for a bipolar......anyways, over the last couple of years (since lowering my lithium dose to these PUNY levels) I have felt like total crap much of this time--- I have had a lot of AGITATED feelings with ANGER problems....and when I try to switch AD's, as soon as I get to just a moderately high dose, the agitation/anger/irritability gets MUCH worse....for a while I kept thinking that it's just the AD's that are causing the anger....but NOW I'm seriously thinking that it's the PUNY, DEcreased lithium dose, THAT WHEN COMBINED WITH the AD's, that is the problem....in other words, that the AD's are 'destabilizing' me or making me feel agit/angry but it's BECAUSE I'm on TOO LITTLE of a mood stabilizer....Isn't that a signal or tip-off to bipolar in many cases---that if someone is trying different AD's and having really bad effects and no success (and often feel even worse!) that they may be bipolar and need a mood stab. WITH their AD? I think my agitation/anger/irrit on the AD's is telling me that I need to increase my mood stab....(I KNOW that one AD (Prozac) was DEFINITELY a TERRIBLE drug for me, TERRIBLE anger/rage......but now, as more and more seem to cause problems, I think my PUNY lith. dose is a BIG part of the problem.....would most bipolars get totally messed up (agit/anger/irrit) if they were only taking an AD WITHOUT their mood stabilizer? Sorry for that rambling post, lol, what do you think Barb?
Posted by katia on August 25, 2003, at 14:38:09
In reply to BARB!, Naturopath visit results, please read, posted by McPac on August 25, 2003, at 1:13:04
Hi McPac,
ditto on all Barb says.>>dose is a BIG part of the problem.....would most bipolars get totally messed up (agit/anger/irrit) if they were only taking an AD WITHOUT their mood stabilizer? Sorry for that rambling post, lol,
for me, I was on ADs for a year (four different kinds) and they messed me up worse. (didn't help). I've recently been dxed as BP and have begun a new regime of only mood stabilizers - no ADs. we'll see how it goes. But from what I've heard and my pdoc says, ADs are not the best things for BP people.
all the best,
Susan
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