![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 25 of 35. This is the beginning of the thread.
Posted by nmk on July 2, 2003, at 12:40:49
After a pretty successful few months on 1200 Trileptal, it started to poop-out and the depression/anxiety/agitation have returned. I tried titrating up to 1500mg of the trileptal but I was extremely nauseous. My doctor suggested throwing 15 mg of abilify in the mix for the anxiety so I filled the prescription, hopped on the web, and what I read scared me out of my mind. It is known to cause increased anxiety, hand tremors, and severe insomnia in some and I decided not to take it. I am taking 25 mg of seroquel at night and feel that I am adding too many atypical's to the mix.
The only med that is getting me through each day is 1 mg of ativan. It helps with the anxiety and depression more than any other med. My pdoc suggested i switch to the new xanax xr but it did not provide near the AD qualities as the ativan.
Also, I went to see an MD yesterday who specializes in holistic meds and natural hormone therapy. Since my moods correspond with my monthly cycle, I thought I would give this a shot. He took a ton of blood and now I need to wait three weeks for the results. He "promised" I would feel better on a natural regimine of progesterone, estrogen, and thyroid hormones.
Sorry to go on about all of this but I don't know what to think at this point. Do I try another AED? Do I try another AD? Do I scrap it all and stick with the ativan? Do I trust this new doc who claims that I will feel better?
I am so desperate that I have left two messages with a pdoc in MA requesting a consult (I live in MI). She is an expert in the area of reproductive hormones and the effects on mood. I will fly across the world if I have to.
Thanks for listening:)
Nicole
Posted by Ritch on July 2, 2003, at 13:27:16
In reply to My pdoc suggests abilify, I am so confused, posted by nmk on July 2, 2003, at 12:40:49
> After a pretty successful few months on 1200 Trileptal, it started to poop-out and the depression/anxiety/agitation have returned. I tried titrating up to 1500mg of the trileptal but I was extremely nauseous. My doctor suggested throwing 15 mg of abilify in the mix for the anxiety so I filled the prescription, hopped on the web, and what I read scared me out of my mind. It is known to cause increased anxiety, hand tremors, and severe insomnia in some and I decided not to take it. I am taking 25 mg of seroquel at night and feel that I am adding too many atypical's to the mix.
>
> The only med that is getting me through each day is 1 mg of ativan. It helps with the anxiety and depression more than any other med. My pdoc suggested i switch to the new xanax xr but it did not provide near the AD qualities as the ativan.
>
> Also, I went to see an MD yesterday who specializes in holistic meds and natural hormone therapy. Since my moods correspond with my monthly cycle, I thought I would give this a shot. He took a ton of blood and now I need to wait three weeks for the results. He "promised" I would feel better on a natural regimine of progesterone, estrogen, and thyroid hormones.
>
> Sorry to go on about all of this but I don't know what to think at this point. Do I try another AED? Do I try another AD? Do I scrap it all and stick with the ativan? Do I trust this new doc who claims that I will feel better?
>
> I am so desperate that I have left two messages with a pdoc in MA requesting a consult (I live in MI). She is an expert in the area of reproductive hormones and the effects on mood. I will fly across the world if I have to.
>
> Thanks for listening:)
> NicoleJust an opinion here, but... If you are scared to take the Abilify-don't. Even if it doesn't cause much trouble you will be vigilant about the side effects and that's a hassle in itself. You mentioned Ativan helping more than anything else. Maybe you just need to take Ativan twice-thrice daily (keep your money from the Xanax XR people)-lorazepam is pretty damn cheap. I'd go with the pdoc that is a specialist in hormones before I would mess with the holistic stuff-esp. if you are bipolar. If you go that route-you will be in conflict with your current pdoc-have to hide stuff-thyroid hormones-what a mess-just an opinion.
Posted by neverendingcycle on July 2, 2003, at 14:59:06
In reply to Re: My pdoc suggests abilify, I am so confused » nmk, posted by Ritch on July 2, 2003, at 13:27:16
> > After a pretty successful few months on 1200 Trileptal, it started to poop-out and the depression/anxiety/agitation have returned. I tried titrating up to 1500mg of the trileptal but I was extremely nauseous. My doctor suggested throwing 15 mg of abilify in the mix for the anxiety so I filled the prescription, hopped on the web, and what I read scared me out of my mind. It is known to cause increased anxiety, hand tremors, and severe insomnia in some and I decided not to take it. I am taking 25 mg of seroquel at night and feel that I am adding too many atypical's to the mix.
> >
> > The only med that is getting me through each day is 1 mg of ativan. It helps with the anxiety and depression more than any other med. My pdoc suggested i switch to the new xanax xr but it did not provide near the AD qualities as the ativan.
> >
> > Also, I went to see an MD yesterday who specializes in holistic meds and natural hormone therapy. Since my moods correspond with my monthly cycle, I thought I would give this a shot. He took a ton of blood and now I need to wait three weeks for the results. He "promised" I would feel better on a natural regimine of progesterone, estrogen, and thyroid hormones.
> >
> > Sorry to go on about all of this but I don't know what to think at this point. Do I try another AED? Do I try another AD? Do I scrap it all and stick with the ativan? Do I trust this new doc who claims that I will feel better?
> >
> > I am so desperate that I have left two messages with a pdoc in MA requesting a consult (I live in MI). She is an expert in the area of reproductive hormones and the effects on mood. I will fly across the world if I have to.
> >
> > Thanks for listening:)
> > Nicole
>
> Just an opinion here, but... If you are scared to take the Abilify-don't. Even if it doesn't cause much trouble you will be vigilant about the side effects and that's a hassle in itself. You mentioned Ativan helping more than anything else. Maybe you just need to take Ativan twice-thrice daily (keep your money from the Xanax XR people)-lorazepam is pretty damn cheap. I'd go with the pdoc that is a specialist in hormones before I would mess with the holistic stuff-esp. if you are bipolar. If you go that route-you will be in conflict with your current pdoc-have to hide stuff-thyroid hormones-what a mess-just an opinion.My son is 14 and has been on every medication you can think of since the age of 4. He was put on Abilify last week along with another medication for anxiety that he only had to take for two weeks for the side effects that "go away" after a few weeks. After two days I had a totally different child. He is happy and it has made all his auditory and visual hallucinations go away. I"m just crossing my fingers that it continues to help. It's the first medication that has really helped without all the side effects. Try it - maybe it will be the change that will help.
Posted by Barbara Cat on July 2, 2003, at 15:35:03
In reply to My pdoc suggests abilify, I am so confused, posted by nmk on July 2, 2003, at 12:40:49
Nicole,
I have some pretty strong opinions about this subject. I've been in this mood disorder merry go round for almost 30 years and one thing is certain. Most pdocs do not even consider the area below the head. Few ever suggest a thorough blood workup and instead try excessive polypharmacy to treat each new symptom that emerges from a mind AND body that are ill. If you look at your physical and mood symptoms, even though they may look like separate issues, you begin to realize that they are ALL CONNECTED! OF COURSE there is a hormonal connection! First and formost, hormones are the chemical messenger systems THROUGHOUT the body and brain. For example, primary neurohormone receptors critically need the right amount of estrogen and progesterone to be 'primed'. The wrong amount of estrogen causes thyroid problems. Too low testosterone, even in women, cause loss of libido, fatigue, loss of muscle mass. Low human growth hormone causes muscle aches, disregulation of the pituitary. These are key systems that regulate everything, among which is mood. You might temporarily alleviate mood disorder symptoms through psychopharmacology, but down the line, especially during menopause, those hormonal issues will emerge with a vengeance! You really can't fool Mother Nature.Why the decline in hormones? Stress, which damages the limbic system's ability to regulate hormones. That's really where the source lies, but it's not so easy treating a brain center that is so deeply protected. Treating with supplementary natural bioidentical hormones is a good idea IF testing is done first to measure levels. Run from any doc who foists hormones on you 'just to see if you feel better'. Run from any doc who says they don't use tests because most won't order them because truth be known, THEY CAN'T READ THEM! I ended up with precancerous uterine hyperplasia from one clueless HMO doc's guessing because he 'didn't know what to do with the blood test results'. I later find out that many holistic and naturopathic docs routinely monitor hormone levels with blood and/or saliva testing because it is so important. My current naturopath is incredibly hip to all of this stuff that I've been suspecting for some time now. I have great hope that we're on to something.
My very strong opinion is both systems have to work together. You can add layer after layer of this or that med and it's like beating a dead horse if your depleted of endocrine hormones or other biophysical necessities. What happens is these numerous meds interact, poop out, get confused. Their receptors eventually get clogged or reduce in number, creating a vicious cycle of yet more/different meds. At the same time, you can't just go off meds hoping your physical tune up will do the trick. It takes time to fine tune hormones and you need neurological support until your body systems are attended to, stable, and you can start supplementing with nutrient that support neuro functioning. I think it is a travesty the way we depend upon our pdocs to make us better, but they don't get it that it's not just our heads that are unhappy. I'm sorry you're having these med problems. Me too, but if you trust this doctor, insist he tests you first. If not, find another holistic doc who will work with you. - Barbara
> After a pretty successful few months on 1200 Trileptal, it started to poop-out and the depression/anxiety/agitation have returned. I tried titrating up to 1500mg of the trileptal but I was extremely nauseous. My doctor suggested throwing 15 mg of abilify in the mix for the anxiety so I filled the prescription, hopped on the web, and what I read scared me out of my mind. It is known to cause increased anxiety, hand tremors, and severe insomnia in some and I decided not to take it. I am taking 25 mg of seroquel at night and feel that I am adding too many atypical's to the mix.
>
> The only med that is getting me through each day is 1 mg of ativan. It helps with the anxiety and depression more than any other med. My pdoc suggested i switch to the new xanax xr but it did not provide near the AD qualities as the ativan.
>
> Also, I went to see an MD yesterday who specializes in holistic meds and natural hormone therapy. Since my moods correspond with my monthly cycle, I thought I would give this a shot. He took a ton of blood and now I need to wait three weeks for the results. He "promised" I would feel better on a natural regimine of progesterone, estrogen, and thyroid hormones.
>
> Sorry to go on about all of this but I don't know what to think at this point. Do I try another AED? Do I try another AD? Do I scrap it all and stick with the ativan? Do I trust this new doc who claims that I will feel better?
>
> I am so desperate that I have left two messages with a pdoc in MA requesting a consult (I live in MI). She is an expert in the area of reproductive hormones and the effects on mood. I will fly across the world if I have to.
>
> Thanks for listening:)
> Nicole
Posted by nmk on July 4, 2003, at 14:21:03
In reply to Re: My pdoc suggests abilify, I am so confused » nmk, posted by Ritch on July 2, 2003, at 13:27:16
> > >
> Just an opinion here, but... If you are scared to take the Abilify-don't. Even if it doesn't cause much trouble you will be vigilant about the side effects and that's a hassle in itself. You mentioned Ativan helping more than anything else. Maybe you just need to take Ativan twice-thrice daily (keep your money from the Xanax XR people)-lorazepam is pretty damn cheap. I'd go with the pdoc that is a specialist in hormones before I would mess with the holistic stuff-esp. if you are bipolar. If you go that route-you will be in conflict with your current pdoc-have to hide stuff-thyroid hormones-what a mess-just an opinion.
That is always a dilemma for me. Whenever I seek a 2nd opinion, I feel as though I am betraying my pdoc but it has reached the point where I don't care anymore. As Barbara stated in her response, what these docs don't realize, especially with women, is that our reproductive hormones play a critical role in our mood states, which fluctuate throughout the month and with every reproductive event in our lives (in my case, childbirth). To continue to throw psychotropic drugs at every symptom is not addressing the root of the problem.I am always honest about what I am doing and although he has his own opinions about what is right for me, I must trust my intuition. Yes, I will pitch the abilify (although I hear they are 14 bucks a pill...what a shame!!) and stick with the ativan for now.
I will let you know what happens in three weeks when all of the bloodwork comes back and I meet with the doc. For now, I will stay on my current cocktail of meds and take it day by day.
Again, thank you for your understanding, support, and advice.
Sincerely,
Nicole
Posted by nmk on July 4, 2003, at 15:05:47
In reply to Re: My pdoc suggests abilify, I am so confused » nmk, posted by Barbara Cat on July 2, 2003, at 15:35:03
> Nicole,
> I have some pretty strong opinions about this subject. I've been in this mood disorder merry go round for almost 30 years and one thing is certain. Most pdocs do not even consider the area below the head. Few ever suggest a thorough blood workup and instead try excessive polypharmacy to treat each new symptom that emerges from a mind AND body that are ill. If you look at your physical and mood symptoms, even though they may look like separate issues, you begin to realize that they are ALL CONNECTED! OF COURSE there is a hormonal connection! First and formost, hormones are the chemical messenger systems THROUGHOUT the body and brain. For example, primary neurohormone receptors critically need the right amount of estrogen and progesterone to be 'primed'. The wrong amount of estrogen causes thyroid problems. Too low testosterone, even in women, cause loss of libido, fatigue, loss of muscle mass. Low human growth hormone causes muscle aches, disregulation of the pituitary. These are key systems that regulate everything, among which is mood. You might temporarily alleviate mood disorder symptoms through psychopharmacology, but down the line, especially during menopause, those hormonal issues will emerge with a vengeance! You really can't fool Mother Nature.
>
> Why the decline in hormones? Stress, which damages the limbic system's ability to regulate hormones. That's really where the source lies, but it's not so easy treating a brain center that is so deeply protected. Treating with supplementary natural bioidentical hormones is a good idea IF testing is done first to measure levels. Run from any doc who foists hormones on you 'just to see if you feel better'. Run from any doc who says they don't use tests because most won't order them because truth be known, THEY CAN'T READ THEM! I ended up with precancerous uterine hyperplasia from one clueless HMO doc's guessing because he 'didn't know what to do with the blood test results'. I later find out that many holistic and naturopathic docs routinely monitor hormone levels with blood and/or saliva testing because it is so important. My current naturopath is incredibly hip to all of this stuff that I've been suspecting for some time now. I have great hope that we're on to something.
>
> My very strong opinion is both systems have to work together. You can add layer after layer of this or that med and it's like beating a dead horse if your depleted of endocrine hormones or other biophysical necessities. What happens is these numerous meds interact, poop out, get confused. Their receptors eventually get clogged or reduce in number, creating a vicious cycle of yet more/different meds. At the same time, you can't just go off meds hoping your physical tune up will do the trick. It takes time to fine tune hormones and you need neurological support until your body systems are attended to, stable, and you can start supplementing with nutrient that support neuro functioning. I think it is a travesty the way we depend upon our pdocs to make us better, but they don't get it that it's not just our heads that are unhappy. I'm sorry you're having these med problems. Me too, but if you trust this doctor, insist he tests you first. If not, find another holistic doc who will work with you. - Barbara
>
>Barbara,
Thank you for so eloquently stating what I have been suspecting for the last few years. For a doctor to deny that every psychiatric event in my life had no connection whatsoever to the reproductive events in my life is beyond belief. My two bouts with major depression were both followed by the births of my children. My monthly mood cycling almost always corresponds to the luteal phase of my cycle. For a pdoc to continue to treat the symptoms by throwing the latest and greatest meds at the problem only compounds matters and never addresses the core issue. Medical models and treatment modalities are based on male physiology, blatantly ignoring the uniqueness of the female body.
Dr. Deborah Sichel's book, Women's Moods, should be read by all women who are being treated for clinical depression, etc. More importantly, it should be read by pdoc's who prescribe these meds without understanding how these meds can be enhanced-or even replaced- by adding estrogen, progesterone, and testosterone.
The holistic MD that I consulted with last week took half of my blood out of my body and is testing for everything. He will then prescribe natural Tri-estrogen, progesterone, and testosterone that will change in response to monthly blood levels. Also, all prescriptions are made by a compounding pharmacist.
I figure at this point it can't hurt to try this approach since I am convinced my erratic hormones are the cause of my cycling from month to month.
Thank for your support Barbara. I appreciate the time you have taken to listen and respond with such insight and clarity. I will keep you posted.
Sincerely,
Nicole
Posted by Dr. Bob on July 5, 2003, at 13:25:14
In reply to Re: My pdoc suggests abilify, I am so confused » Barbara Cat, posted by nmk on July 4, 2003, at 15:05:47
> Dr. Deborah Sichel's book, Women's Moods, should be read by all women who are being treated for clinical depression, etc. More importantly, it should be read by pdoc's who prescribe these meds without understanding how these meds can be enhanced-or even replaced- by adding estrogen, progesterone, and testosterone.
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 galkeepinon on July 7, 2003, at 13:55:18
In reply to Re: My pdoc suggests abilify, I am so confused » Barbara Cat, posted by nmk on July 4, 2003, at 15:05:47
hi Nicole, please get back to me on this. I have PCOS and am wondering if all my suffering has been due to this. I have been tested and tested a zillion times, blood, surgeries, etc. it's a long story, but the book you speak of? What is it all about??? I felt 110% better ALWAYS after I had a period and I don't get them anymore at all. Once in a while my doc will give me Progesgterone pills to start my menses-but ohhhhh they make me irritable and depressed. What is a woman to do then? I truly believe with all my heart that not having regular periods has a definite role in ou psychological wellness!!!
Would love to hear back
thanks
Gal
>
> Dr. Deborah Sichel's book, Women's Moods, should be read by all women who are being treated for clinical depression, etc. More importantly, it should be read by pdoc's who prescribe these meds without understanding how these meds can be enhanced-or even replaced- by adding estrogen, progesterone, and testosterone.
>
> The holistic MD that I consulted with last week took half of my blood out of my body and is testing for everything. He will then prescribe natural Tri-estrogen, progesterone, and testosterone that will change in response to monthly blood levels. Also, all prescriptions are made by a compounding pharmacist.
>
> I figure at this point it can't hurt to try this approach since I am convinced my erratic hormones are the cause of my cycling from month to month.
>
> Thank for your support Barbara. I appreciate the time you have taken to listen and respond with such insight and clarity. I will keep you posted.
>
> Sincerely,
>
> Nicole
Posted by nmk on July 9, 2003, at 11:18:15
In reply to please reply-hormonal ? and meds » nmk, posted by galkeepinon on July 7, 2003, at 13:55:18
> hi Nicole, please get back to me on this. I have PCOS and am wondering if all my suffering has been due to this. I have been tested and tested a zillion times, blood, surgeries, etc. it's a long story, but the book you speak of? What is it all about??? I felt 110% better ALWAYS after I had a period and I don't get them anymore at all. Once in a while my doc will give me Progesgterone pills to start my menses-but ohhhhh they make me irritable and depressed. What is a woman to do then? I truly believe with all my heart that not having regular periods has a definite role in ou psychological wellness!!!
>
> Would love to hear back
> thanks
> Gal
>
>
>
>
> >
> Hi Gal,Please look up further in this thread and read the response from BarbaraCat. She discusses the mind/body connection better than I ever could. The book I mentioned discusses how our reproductive hormones play such a critical role in our mood states and how these vary throughout the month with the rise and fall of estrogen, progesterone, and testosterone. Some women, especially BP women, are extremely sensitive to any fluctuation in hormones and as a result, suffer month to month. Like you, I feel ok the first two weeks of my cycle, but then crash into depression and anxiety for the last two weeks.
Your PCOS is most likely affecting your mood states and I would get to a pdoc who specializes in reproductive hormone disorders. I am currently having a complete hormone, thyroid, etc. etc profile done to see where there are any deficiencies. Like you, synthetic progesterone caused depression but hopefully, I will respond better to natural estrogen, progesterone, etc.. It's worth a shot and if that doesn't help, I can always go back to my never-ending search for the right med-combo. Let me know what happens.
Nicole
Posted by Barbara Cat on July 10, 2003, at 1:59:49
In reply to Re: please reply-hormonal ? and meds » galkeepinon, posted by nmk on July 9, 2003, at 11:18:15
Hi Girlfriends,
First of all, Gal, it sure sounds like you've got a hormonal imbalance that is certainly making you feel awful in every way. It may not be the whole story to your moods, but it's definitely not helping. Two weeks before your period, progesterone is on the rise and estrogen is low. Menstruation starts when the rising progesterone sharply drops. A few days into the menses, estrogen starts it's rise again in the relative absence of progesterone. What your moods are wisely telling you is that for now they prefer estrogen and hate progesterone. This may not be what your body actually needs but the emotional body seems to have it's own opinions. These hormones are potent mood regulators. Just ask any man whose been in the line of fire of a woman's PMS.I'm seeing a naturopath who I have great faith in. She's an expert in hormonal imbalances and how it all interrelates. Her impression, and one that I share, is that prolonged stress damages the HPA axis. The pituitary and the hypothalamus have to be talking to each other in order to regulate the endocrine system which is delicate to begin with. Add a mood disorder, menopause, anything to tip it, and the imbalances start to feed off each other. It's appearing that in many cases, both the hormones and the limbic system in the brain have to be adressed simulataneously. Something to keep in mind is that the areas of the brain that manufacture neurotransmitters (which are also hormones) are very dense with estrogen receptors. You'd think this would ring some bells in the psych world, but still they snore.
I'll keep you posted on what I find out because I think it will apply to all of us. One thing I know for sure. Synthetic hormones will not do. Sometimes they're necessary short term to shock the system into action, but definitely not long term. There are no exceptions to this rule. They cause more problems than they're worth and most doctors, including OB/Gyn's are simply clueless on this subject. Unfortunately, all the many books out there can't seem to decide on any protocol either but we still have to do the research. We're on the cutting edge. Great. -- BarbaraCat
> > hi Nicole, please get back to me on this. I have PCOS and am wondering if all my suffering has been due to this. I have been tested and tested a zillion times, blood, surgeries, etc. it's a long story, but the book you speak of? What is it all about??? I felt 110% better ALWAYS after I had a period and I don't get them anymore at all. Once in a while my doc will give me Progesgterone pills to start my menses-but ohhhhh they make me irritable and depressed. What is a woman to do then? I truly believe with all my heart that not having regular periods has a definite role in ou psychological wellness!!!
> >
> > Would love to hear back
> > thanks
> > Gal
> >
> >
> >
> >
> > >
> > Hi Gal,
>
> Please look up further in this thread and read the response from BarbaraCat. She discusses the mind/body connection better than I ever could. The book I mentioned discusses how our reproductive hormones play such a critical role in our mood states and how these vary throughout the month with the rise and fall of estrogen, progesterone, and testosterone. Some women, especially BP women, are extremely sensitive to any fluctuation in hormones and as a result, suffer month to month. Like you, I feel ok the first two weeks of my cycle, but then crash into depression and anxiety for the last two weeks.
>
> Your PCOS is most likely affecting your mood states and I would get to a pdoc who specializes in reproductive hormone disorders. I am currently having a complete hormone, thyroid, etc. etc profile done to see where there are any deficiencies. Like you, synthetic progesterone caused depression but hopefully, I will respond better to natural estrogen, progesterone, etc.. It's worth a shot and if that doesn't help, I can always go back to my never-ending search for the right med-combo. Let me know what happens.
>
> Nicole
>
>
Posted by nmk on July 10, 2003, at 13:37:14
In reply to Re: please reply-hormonal ? and meds, posted by nmk on July 10, 2003, at 13:36:02
> Hi Barbara,
>
> I have a question for you. The holistic MD that I saw last week had me start on a 7% progesterone cream (1/8 teaspoon days 1-13 of my cycle and 1/4 teaspoon x 2 per day from day 14 until menses). He felt this would provide some relief for me until the results of my bloodwork come back in a few weeks. Anyway, I have been on it for 5 days and have noticed that my depression is worse than usual at this point in my cycle. The doc is out of town for two weeks and I am wondering if I should hold off on the cream until I see him in a few weeks. Prior to that appt., I will be meeting with my pdoc and I fear that I will see the eyes rolling when I tell him about this.
>
> I know that synthetic progestins can induce depression but what about natural progesterone? Also, shouldn't progesterone be used in conjunction with estrogen? Are you taking any natural hormone supplements and if so, how does your doc determine how much to administer from month to month since it would vary throughout your cycle? Does she measure hormone levels throughout the month? This is soooooooooo confusing.
>
> Do you have any great books to recommend? I am trying to gather as much information as possible so I don't sound like a babbling idiot when I meet with all these docs.
>
> Thanks again Barbara for everything....you are a sweetheart.
>
> Sincerely,
>
> Nicole
Forgot to forward to you :)
Posted by noa on July 10, 2003, at 18:51:55
In reply to Re: please reply-hormonal ? and meds-BarbaraCat, posted by nmk on July 10, 2003, at 13:37:14
Years ago, for irregular menstrual periods, a doctor put me on progesterone. It did two things: gave me horrible acne and made me very depressed. It didn't even seem to regulate my cycle all that well anyway.
Posted by Barbara Cat on July 10, 2003, at 19:43:08
In reply to Re: please reply-hormonal ? and meds-BarbaraCat, posted by nmk on July 10, 2003, at 13:37:14
Hi Nicole,
This whole topic of hormones is sooooo confusing, I totally agree. First of all, your progesterone question. As I recall, you have suspected PCOS? It's not something I know very much about. I'll look it up, but in the meantime I wonder if your doc is treating you for estrogen excess, which is a very common malady. Many toxins in our environment act as endocrine disruptors, as if we didn't have enough to deal with already.I had a buildup of my endometrium because I wasn't absorbing progesterone and wound up with an estrogen excess condition. You're right, there has to be a balance between estrogen and progesterone. There has to be a balance of testosterone as well. And testing? It's the rare doc who does testing. They claim that none of them are reliable and, as one admitted to me, they don't know what to do with the data(!). This is simply outrageous! There are reliable tests and a good knowledgable health professional will use them until things are stable. I get very frustrated about the one size fits all unless you hemorrage theory.
It sure sounds like you feel better on more estrogen than you're getting. Progesterone 'opposes' estrogen, so the more you get, the less estrogen your cells uptake. I don't know what your doc has in mind about this. It sounds like his idea that you'd feel better on progesterone alone isn't working. As far as should you go off it, that's something only you can decide. If it makes you feel horrible but it's not medically necessary then I'd question whether it's not needless discomfort. Especially while your doc isn't available for guidance. Is there another doc he's referring to for emergencies? Maybe you could discuss it with them.
I'll look up PCOS and get back to you with some book suggestions. There is one I haven't read but heard raves about, Dr. Christiane Northrup "The Wisdom of Menopause" which extensively goes into hormones. Anything by her is a winner.
Posted by galkeepinon on July 10, 2003, at 23:51:48
In reply to Re: please reply-hormonal ? and meds » nmk, posted by Barbara Cat on July 10, 2003, at 1:59:49
Hi Girlfriends,
My problem is I don't get my periods:( I saw the book in the post and I'm going to check that out. This has gone on too long and it's not normal and I think the fact I don't get a period plays a definate part in all this mental stuff.(a very worried/perplexed Gal-who gets no period)
> Hi Girlfriends,
> First of all, Gal, it sure sounds like you've got a hormonal imbalance that is certainly making you feel awful in every way. It may not be the whole story to your moods, but it's definitely not helping. Two weeks before your period, progesterone is on the rise and estrogen is low. Menstruation starts when the rising progesterone sharply drops. A few days into the menses, estrogen starts it's rise again in the relative absence of progesterone. What your moods are wisely telling you is that for now they prefer estrogen and hate progesterone. This may not be what your body actually needs but the emotional body seems to have it's own opinions. These hormones are potent mood regulators. Just ask any man whose been in the line of fire of a woman's PMS.
>
> I'm seeing a naturopath who I have great faith in. She's an expert in hormonal imbalances and how it all interrelates. Her impression, and one that I share, is that prolonged stress damages the HPA axis. The pituitary and the hypothalamus have to be talking to each other in order to regulate the endocrine system which is delicate to begin with. Add a mood disorder, menopause, anything to tip it, and the imbalances start to feed off each other. It's appearing that in many cases, both the hormones and the limbic system in the brain have to be adressed simulataneously. Something to keep in mind is that the areas of the brain that manufacture neurotransmitters (which are also hormones) are very dense with estrogen receptors. You'd think this would ring some bells in the psych world, but still they snore.
>
> I'll keep you posted on what I find out because I think it will apply to all of us. One thing I know for sure. Synthetic hormones will not do. Sometimes they're necessary short term to shock the system into action, but definitely not long term. There are no exceptions to this rule. They cause more problems than they're worth and most doctors, including OB/Gyn's are simply clueless on this subject. Unfortunately, all the many books out there can't seem to decide on any protocol either but we still have to do the research. We're on the cutting edge. Great. -- BarbaraCat
>
>
> > > hi Nicole, please get back to me on this. I have PCOS and am wondering if all my suffering has been due to this. I have been tested and tested a zillion times, blood, surgeries, etc. it's a long story, but the book you speak of? What is it all about??? I felt 110% better ALWAYS after I had a period and I don't get them anymore at all. Once in a while my doc will give me Progesgterone pills to start my menses-but ohhhhh they make me irritable and depressed. What is a woman to do then? I truly believe with all my heart that not having regular periods has a definite role in ou psychological wellness!!!
> > >
> > > Would love to hear back
> > > thanks
> > > Gal
> > >
> > >
> > >
> > >
> > > >
> > > Hi Gal,
> >
> > Please look up further in this thread and read the response from BarbaraCat. She discusses the mind/body connection better than I ever could. The book I mentioned discusses how our reproductive hormones play such a critical role in our mood states and how these vary throughout the month with the rise and fall of estrogen, progesterone, and testosterone. Some women, especially BP women, are extremely sensitive to any fluctuation in hormones and as a result, suffer month to month. Like you, I feel ok the first two weeks of my cycle, but then crash into depression and anxiety for the last two weeks.
> >
> > Your PCOS is most likely affecting your mood states and I would get to a pdoc who specializes in reproductive hormone disorders. I am currently having a complete hormone, thyroid, etc. etc profile done to see where there are any deficiencies. Like you, synthetic progesterone caused depression but hopefully, I will respond better to natural estrogen, progesterone, etc.. It's worth a shot and if that doesn't help, I can always go back to my never-ending search for the right med-combo. Let me know what happens.
> >
> > Nicole
> >
> >
>
>
Posted by galkeepinon on July 10, 2003, at 23:56:57
In reply to Re: please reply-hormonal ? and meds » nmk, posted by Barbara Cat on July 10, 2003, at 1:59:49
BINGO when you say this>>>> Synthetic hormones will not do. Sometimes they're necessary short term to shock the system into action. They cause more problems than they're worth and most doctors, including OB/Gyn's are simply clueless on this subject. Unfortunately, all the many books out there can't seem to decide on any protocol either but we still have to do the research. We're on the cutting edge. Great. -- BarbaraCat.........I so agree with you. My doctor gives me 10 days of progesterone pills to get a period and I do it once in a great while if I want to just to get a period-but I don't usually because it makes depression worse-no doubt about it-there has to be an easier way.
Gal
Hi Girlfriends,
> First of all, Gal, it sure sounds like you've got a hormonal imbalance that is certainly making you feel awful in every way. It may not be the whole story to your moods, but it's definitely not helping. Two weeks before your period, progesterone is on the rise and estrogen is low. Menstruation starts when the rising progesterone sharply drops. A few days into the menses, estrogen starts it's rise again in the relative absence of progesterone. What your moods are wisely telling you is that for now they prefer estrogen and hate progesterone. This may not be what your body actually needs but the emotional body seems to have it's own opinions. These hormones are potent mood regulators. Just ask any man whose been in the line of fire of a woman's PMS.
>
> I'm seeing a naturopath who I have great faith in. She's an expert in hormonal imbalances and how it all interrelates. Her impression, and one that I share, is that prolonged stress damages the HPA axis. The pituitary and the hypothalamus have to be talking to each other in order to regulate the endocrine system which is delicate to begin with. Add a mood disorder, menopause, anything to tip it, and the imbalances start to feed off each other. It's appearing that in many cases, both the hormones and the limbic system in the brain have to be adressed simulataneously. Something to keep in mind is that the areas of the brain that manufacture neurotransmitters (which are also hormones) are very dense with estrogen receptors. You'd think this would ring some bells in the psych world, but still they snore.
>
> I'll keep you posted on what I find out because I think it will apply to all of us. One thing I know for sure. Synthetic hormones will not do. Sometimes they're necessary short term to shock the system into action, but definitely not long term. There are no exceptions to this rule. They cause more problems than they're worth and most doctors, including OB/Gyn's are simply clueless on this subject. Unfortunately, all the many books out there can't seem to decide on any protocol either but we still have to do the research. We're on the cutting edge. Great. -- BarbaraCat
Posted by galkeepinon on July 11, 2003, at 0:04:55
In reply to Re: please reply-hormonal ? and meds » galkeepinon, posted by nmk on July 9, 2003, at 11:18:15
Hi Nicole, thanks so much. I haven't been online for a few-hitting some depression bumps. Hope you're doing good. I did see BarbaraCats post-thanks. I'm going to check out that book for sure. It sounds very interesting. I have had a full hormonal work up thyroid also and everything always checks out fine except 1 thing........I get no periods!!!! My periods have been so irregular for soooooo long. And that is normal? I see my doc in a few weeeks and I really neeed to talk to her about my options here. That just isn't healthy. I feel so much better-physically and emotionally when I'm regular-I KNOW it is so vital to our moods.
Did you get your profile done yet? Please let me know how it goes with you ok? I tried that progesterone cream-no go-made me sick.
Keep in touch ok please. Hang in there, thinking of you.
Gal
> > Hi Gal,
>
> Please look up further in this thread and read the response from BarbaraCat. She discusses the mind/body connection better than I ever could. The book I mentioned discusses how our reproductive hormones play such a critical role in our mood states and how these vary throughout the month with the rise and fall of estrogen, progesterone, and testosterone. Some women, especially BP women, are extremely sensitive to any fluctuation in hormones and as a result, suffer month to month. Like you, I feel ok the first two weeks of my cycle, but then crash into depression and anxiety for the last two weeks.
>
> Your PCOS is most likely affecting your mood states and I would get to a pdoc who specializes in reproductive hormone disorders. I am currently having a complete hormone, thyroid, etc. etc profile done to see where there are any deficiencies. Like you, synthetic progesterone caused depression but hopefully, I will respond better to natural estrogen, progesterone, etc.. It's worth a shot and if that doesn't help, I can always go back to my never-ending search for the right med-combo. Let me know what happens.
>
> Nicole
>
>
Posted by Barbara Cat on July 11, 2003, at 15:26:19
In reply to Re: please reply-hormonal ? and meds » nmk, posted by galkeepinon on July 11, 2003, at 0:04:55
Here's a link about amennorhhea (no periods). This whole site has a ton of information about everything.
http://www.theberries.ns.ca/archives/amenbk.html
Whether it's erratic periods, PCOS, thyroid problems, the theme that keeps reappearing in all these hormonal problems is a dysfunction in the hypothalamus. It can no longer function as it needs to in order to communicate with the pituitary, the 'Master Gland'. The whole HPA axis disorder is becoming more and more linked to all of our woes - depression, anxiety, hypothyroidism, reproductive problems, fatigue, weight gain. It's all related to malfunctioning hormones.
And what causes the hypothalamus to malfunction? Stress, stress and more stress. The chemicals produced by long term stress act as neurotoxins in the limbic brain center. The hypothalamus and thalamus in people with mood disorders have been shown on brain imaging to be smaller with less electrical activity. Corticotrophin factor, produced by cortisol, literally destroys the receptors at these sites.
With chronic stress the 'fight/flight' hypervigilence chemicals continue to be secreted (even though it's bedtime), the adrenals get thoroughly exhausted, the brain is structually damaged, hormones get confused, the body suffers, more stress is created, on and on. This is the source and this is what must be treated rather than giving us a hormone here and there, or an antidepressant without considering the ramifications of the whole system.
Eventually, all endocrine systems will malfunction if this stress cycle is not stopped. Believe me, I've been there and done that. How to heal it? Good question. It's looking like the adrenals have to be first in line. We also have to take an active role in destressing, exercising, meditation, eating well, healthy breathing - all that stuff we hate to do when we're down. Somehow the stress cycle, which takes on a life of it's own, has to be broken. I'm working with a great naturopath and will keep you posted.
Posted by galkeepinon on July 11, 2003, at 16:15:27
In reply to Hormonal info!!, posted by Barbara Cat on July 11, 2003, at 15:26:19
Posted by McPac on July 11, 2003, at 22:35:36
In reply to Hormonal info!!, posted by Barbara Cat on July 11, 2003, at 15:26:19
Barb, I just got results back from a recent TSH test---it was 2.1
Don't know much about thyroid levels as this was never a problem before (my TSH test 9 months ago was 3.1)
Isn't this 2.1 level LOW? I have felt very, very sluggish this past year...unmotivated, lethargic.
Thanks!
Posted by Barbara Cat on July 12, 2003, at 11:32:38
In reply to Barb, Re: Hormonal info!!, posted by McPac on July 11, 2003, at 22:35:36
TSH of 2.1 is a good level. The lower, the better (.5 - 2.0 being ideal). If your levels are high it means that the pituitary keeps pumping out Thyroid Stimulating Hormone (TSH) to prod the thyroid into action because it doesn't detect enough of the hormone in the blood. Lower levels means that pituitary detects adequate blood levels of thryoxine and doesn't have to keep trying to stimulate the thryoid to produce it.
However, TSH alone does not measure how the thyroxine is getting into your cells or if you have an autoimmune form, thyroiditis or Hashimoto's. A thorough thyroid workup includes free T3 and T4 levels, thyroid antibodies, and reverse T3 tests, but few docs will order these unless you insist.
Are you already taking thyroid pills of T4 only (synthroid, levothroid)? If so, you might want to add T3. It makes a huge difference for some people, myself included, who have problems converting T4 into T3, the active form. If you're not taking thyroid meds then it's best not to start if you don't really need them. Your own thyroid will stop producing in the presence of outside sources.
If all other tests are normal, especially anemia, then I'd suggest finding a real good naturopath or someone who could work with you closely. Fatigue is a tricky thing to hunt down and most primary care facilities don't have the time or knowledge. - Barbara
> Barb, I just got results back from a recent TSH test---it was 2.1
> Don't know much about thyroid levels as this was never a problem before (my TSH test 9 months ago was 3.1)
> Isn't this 2.1 level LOW? I have felt very, very sluggish this past year...unmotivated, lethargic.
> Thanks!
Posted by Larry Hoover on July 12, 2003, at 12:22:25
In reply to Re: please reply-hormonal ? and meds » Barbara Cat, posted by galkeepinon on July 10, 2003, at 23:51:48
> Hi Girlfriends,
> My problem is I don't get my periods:( I saw the book in the post and I'm going to check that out. This has gone on too long and it's not normal and I think the fact I don't get a period plays a definate part in all this mental stuff.I hope you don't mind if I cross the gender line here......
If I might ask one question, it may lead to an answer for you. Do you have a low total fat intake, when you consider your diet as a whole?
Lar
Posted by galkeepinon on July 12, 2003, at 15:04:14
In reply to Re: please reply-hormonal ? and meds » galkeepinon, posted by Larry Hoover on July 12, 2003, at 12:22:25
No problem Lar........
When I consider my diet as a whole, my fat intake is at a definate norm. Not too high and not too low. If you need to know more, please ask if you think it may lead to an answer for me. Thanks. Why do you ask?
Gal
> > Hi Girlfriends,
> > My problem is I don't get my periods:( I saw the book in the post and I'm going to check that out. This has gone on too long and it's not normal and I think the fact I don't get a period plays a definate part in all this mental stuff.
>
> I hope you don't mind if I cross the gender line here......
>
> If I might ask one question, it may lead to an answer for you. Do you have a low total fat intake, when you consider your diet as a whole?
>
> Lar
Posted by Larry Hoover on July 12, 2003, at 16:15:09
In reply to Re: please reply-hormonal ? and meds » Larry Hoover, posted by galkeepinon on July 12, 2003, at 15:04:14
> No problem Lar........
> When I consider my diet as a whole, my fat intake is at a definate norm. Not too high and not too low. If you need to know more, please ask if you think it may lead to an answer for me. Thanks. Why do you ask?
>
>
> GalWell, I had been about to give you a simplistic answer. But then I got to pondering your response, above, in the celiac/gluten thread. It may be that these concepts are linked.
When I looked at amenorrhea (lack of menses), and the link to HPA dysfunction, what popped out was a disorder known as functional hypothalamic amenorrhea (FHA). It's been described in the past as a neurotic disorder (probably by men, I know), but there are some strong correlations to disordered fat metabolism. Women with FHA tend to have very low fat stores, or a high ratio of lean muscle to fat. They may also appear perfectly normal. The tendency had been to blame subclinical eating disorders (particularly, avoidance of fat), but recently, a link to celiac disorder has been proposed. You see, celiac disorder can prevent uptake of fat in the intestinal lumen, despite adequate sources in the diet. It seems that low fat stores may be a predisposing factor, and with some source of external stress (which need not be ongoing), menstruation may cease. Somehow, that "locks in", and doesn't resolve after the stress decreases.
Interestingly, one of the effective treatments for FHA is an opioid antagonist, e.g. naltrexone. It seems that the normal pulses of hormone release that drive the menstrual cycle are suppressed by hyperactivation of the opioid receptors. But that also ties in nicely with the celiac concept, when you consider the exorphins (opioid-receptor proteins from an external source) that arise from that disorder. You probably recall the mention of opiate agonists arising from the partial digestion of gluten, from the celiac thread.
There are other possible causes of amenorrhea, of course, and I hope you've been adequately screened for those.
Here are a couple links you might want to look at:
http://www.gfmer.ch/Guidelines/obstetrics_gynecology_guidelines.htm
http://www.endotext.org/female/female5/female5.htm#FUNCTIONALHYPOTHALAMICAMENORRHEA
Best,
Lar
Posted by McPac on July 13, 2003, at 23:09:28
In reply to Re: Barb, Re: Hormonal info!! » McPac, posted by Barbara Cat on July 12, 2003, at 11:32:38
TSH of 2.1 is a good level. The lower, the better (.5 - 2.0 being ideal).
>>>>>>>>>Thanks Barb! I didn't know that lower was better.
However, TSH alone does not measure how the thyroxine is getting into your cells or if you have an autoimmune form, thyroiditis or Hashimoto's. A thorough thyroid workup includes free T3 and T4 levels, thyroid antibodies, and reverse T3 tests, but few docs will order these unless you insist.
>>>>>>>>>OK
Are you already taking thyroid pills of T4 only (synthroid, levothroid)?
>>>>>>>>>No, I'm not taking any drug for the thyroid. I have reason to believe that my adrenals may be at least part of the problem....thanks Barb!
Posted by Barbara Cat on July 14, 2003, at 0:11:12
In reply to Barb, Re: Barb, Re: Hormonal info!!, posted by McPac on July 13, 2003, at 23:09:28
> >>>>>>>>>I have reason to believe that my adrenals may be at least part of the problem....!
>
>Yeah, I'm going the adrenal route myself. I'm becoming more and more convinced that adrenal stress is the culprit behind most of the mood and endocrine disorders I've heard of. Have you been to http:/about.thyroid.com? If you do a search on adrenal in that site there's some good info.
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