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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Fivefires on October 3, 2007, at 17:09:36
What's up w/ this? Any1 have a theory?
tks, 5f
Posted by Fivefires on October 3, 2007, at 18:19:34
In reply to Abilify 7.5mg causing fatigue, posted by Fivefires on October 3, 2007, at 17:09:36
Are all you guys havin' tea or what?
Okay. I'll go back to my nap.
5f
Posted by stargazer2 on October 3, 2007, at 21:42:31
In reply to Re: Abilify 7.5mg causing fatigue, posted by Fivefires on October 3, 2007, at 18:19:34
FF, Abilify did nothing for me, no fatigue, no energy, absolutely nothing. How's that for a medication response. I took between 2.5 and 10 mg and refused to go higher. I'm not a fan of atypicals. Have tried them all and the response I've gotten has been poor.
Stargazer (see I'm awake but no one else is)
Posted by Phillipa on October 3, 2007, at 22:47:54
In reply to Re: Abilify 7.5mg causing fatigue, posted by stargazer2 on October 3, 2007, at 21:42:31
I am just got home. Love Phillipa ps though abilify was activating? See spelled it right!!!
Posted by stargazer2 on October 4, 2007, at 8:28:10
In reply to Re: Abilify 7.5mg causing fatigue » stargazer2, posted by Phillipa on October 3, 2007, at 22:47:54
Phillipa, you should know that one med works differently for each person that is why you cannot take everyone's experience and apply it directly to your own. That is the dilemma with psych meds and the most obvious deficiency in treatment in a standard way.
So Abilify for 50% might be energizing, 25% may have no response (me) and 25% may have solmnolence. No way to know who will have what effect so trial and error is the norm for many of us with depression, anxiety or whatever your Dx is.
The treatment for these conditions is very random.
It doesn't matter who treats you either. The Yale expert said "I don't know what to try next with you"...is my situation so different than others with depression? I don't really think so but docs don't know where to begin when someone has tried just about everything.Oh well, that is why I have to offer suggestions to them and thank God this time it worked! They do not have all of the answers and a good pdoc will admit this, like mine.
Stargazer
Posted by Fivefires on October 4, 2007, at 12:59:28
In reply to Re: Abilify 7.5mg causing fatigue » stargazer2, posted by Phillipa on October 3, 2007, at 22:47:54
U guys wanna' come over and we'll all just flush these damn meds down the can, and smm ... whoops can't say that.
I don't know what to think about this. I guess I feel as stargazer re: increasing. If there isn't a hint 'hinting' .. dunno .. no pdoc appt until Dec or Jan .. almost funny? ..
I'll get by here somehow.
tks, 5f
Posted by Fivefires on October 4, 2007, at 13:39:36
In reply to Re: Abilify 7.5mg causing fatigue/Phillipa, posted by stargazer2 on October 4, 2007, at 8:28:10
I did have a little activation at first w/ Abilify. Felt a little in feeling of well-being. Seems to have waned some, like many others. I'd wanted to keep a dosage of atyp antipsych or neuroleptic, whichever word we prefer, looowwwwww. That was the deal and this may be a deal breaker.
Wish could get a good pdoc would see me more often and actually 'see me'. I recall the time I took my daughter w/ me and my pdoc turned to her and said 'how are you feeling today'? Ha! (We thought 'Well sh*t!')
While you're here, have another prob'. Live above a girl and her school age son. Her bedr, not his, is below mine. Guess my late night music/TV in my bedr are pissing her off (Maybe she wants to trade w*r stories!) and she's gotten an attorney. And, the kicker is, she's in cahoots w/ an 'ex' of mine. 'Which one' I asked? The 'guy' who lives in same condo complex as I, who did me the favor of letting me know, described some1 unfamiliar.(?) Hmmm. Who to trust?
Just another 'kick in the a*s'. Everywhere I go seems someone's gotta' get a kick in. Looked up city code and not sure how 'reasonable noise' is defined.
I used to live below a guy that worked nights. I wore ear plugs; no prob'.
Maybe time to 'turn the page' has come again. I hope so. Just too quiet for me here.
Wonder if I should do anything differently? Could 'knock myself out w/ sleep med @ 8-9p'. Don't think so.
tks4help, 5f
and: Will leave pdoc message phone call about being 'unAbilifyed' on 7.5mg. Until hear from him will stay in holding pattern w/ it guess. May try titrate down my levothyroxine just a tad and observe.
and: Gotta' make phone calls so log off for a bit.
Posted by Phillipa on October 4, 2007, at 19:18:05
In reply to Re: Abilify 7.5mg causing fatigue/Phillipa, posted by stargazer2 on October 4, 2007, at 8:28:10
Stargazer you are very correct. Phillipa
Posted by Phillipa on October 4, 2007, at 19:22:06
In reply to Re: Abilify 7.5mg causing fatigue/Phillipa, posted by Fivefires on October 4, 2007, at 13:39:36
Five Fires are you getting your levels checked first we talked on the-----About this remember? Phillipa
Posted by Fivefires on October 4, 2007, at 19:31:10
In reply to Re: Abilify 7.5mg causing fatigue/Phillipa » Fivefires, posted by Phillipa on October 4, 2007, at 19:22:06
I can't get a redo done as just had those labs done. PCP said everything fine. Gyn said everything not fine. Guess I have to look out for myself.
Need to find a site which shows the particular thyroid tests that should be done and the ranges re levels.
I got out my referral to the endo today and tried to call for an appt but no answer. Set it out to call 2moro.
Can u understand 'the county system' sort of looks at mental health care like they're doing you a favor. Letting me go for 90days w/o followup ... well you can kind of see what this says. W/o $ u are w/o quality and concern. I agree w/ you Phillipa, but not all of us have the same opportunities available to them, ya' know. There is absolutely no one, no one but a child of mine, who cares.
5f
Posted by Phillipa on October 4, 2007, at 21:13:36
In reply to Re: Abilify 7.5mg causing fatigue/Phillipa, posted by Fivefires on October 4, 2007, at 19:31:10
Here's one study. Phillipa
The TSH Thyroid Function Test
When Thyrotropin Isn't The Gold Standard
© Elaine MooreMar 12, 2007
The TSH test result is an excellent tool for screening new patients for thyroid disease. But in some cases of autoimmune thyroid disease, the results can be misleading.
The hormone thyrotropin, which is also known as thyroid stimulating hormone or TSH, is produced by the pituitary gland. The pituitary gland regulates thyroid hormone levels by secreting more or less TSH. Consequently, low levels of TSH are seen in hyperthyroidism, and high levels are seen in hypothyroidism. Usually, blood levels of TSH can detect abnormal thyroid function.The Hypothalamic-Pituitary-Thyroid Axis
The hypothalamus at the base of the skull is considered the true master gland since it controls the other endocrine glands, including the pituitary gland. The hypothalamus monitors all of the body’s hormone levels. When slight abnormalities occurs, the hypothalamus engages other organs to correct matters.Normally, the pituitary gland secretes TSH in small pulses throughout the day. TSH orders follicular thyroid cells to grow and produce thyroid hormone. Without adequate TSH (due to a pituitary or hypothalamic malfunction as is seen in central hypothyroidism) the thyroid gland normally couldn’t produce adequate thyroid hormone.
The hypothalamus secretes a hormone known as thyrotropin-releasing-hormone or TRH. TRH directs the pituitary gland to secrete TSH. When the hypothalamus notes a rise in thyroid hormone levels it secretes less TRH, causing the pituitary to secrete less TSH. When the hypothalamus sees that thyroid hormone levels are falling, it releases more TRH, which raises TSH levels and, in turn, thyroid hormone levels.
The Axis Has Its Limits
In thyroid disease, the axis can’t fully correct thyroid hormone levels. In Graves’ disease, stimulating TSH receptor antibodies (also known as thyroid stimulating immunoglobulins or TSI) stimulate the thyroid receptor to produce more thyroid hormone. Acting in place of TSH, TSI antibodies order thyroid hormone production even when TSH falls to non-detectable levels. In Graves’ disease, thyroid function falls under immune system control rather than hypothalamic regulation.In hypothyroidism, damaged or defective thyroid cells can’t produce adequate thyroid hormone. Even with a steadily rising TSH, thyroid hormone levels remain low.
Benefits of TSH Testing
As soon as the pituitary gland is alerted that thyroid hormone levels are changing, it adjusts secretion of TSH accordingly. Normally, TSH levels rises to abnormally high levels before thyroid hormone (FT4 and FT3) levels fall below the normal range. Similarly, TSH levels fall below the reference range before thyroid hormone levels rise above the normal range.Thus, in screening for thyroid disease, the TSH test is the best early indicator of thyroid dysfunction. If the TSH level is normal, thyroid function and levels of FT4 and FT3 are usually also normal. In screening new patients, the TSH test is considered a cost-effective gold standard for evaluating thyroid function.
If the TSH result is abnormal, the FT4 level is tested. If FT4 is normal, the FT3 level is tested. In some thyroid disorders, particularly Graves’ disease and toxic multinodular goiter, T3 is released from thyroid cells at a high rate, and levels of FT3/T3 become elevated before FT4 levels rise. Because T3 is nearly 5 times as potent as T4, even a slight rise in FT3 levels can cause symptoms of hyperthyroidism requiring treatment.
Subclinical Thyroid Disorders
In subclinical hypothyroidism and subclinical hyperthyroidism, thyroid hormone levels remain within the normal range while TSH is abnormal. Presumably, thyroid hormone levels may have changed slightly and been corrected by the pituitary. In subclinical disorders, thyroid function remains normal, but the abnormal TSH level suggests that a problem may be developing.Because TSH only affects thyroid hormone production, an abnormal TSH doesn’t cause physiological changes related to hyperthyroidism or hypothyroidism. Symptoms of thyroid disease are caused by low or high thyroid hormone levels. However, if the levels are within range but too high or low for the individual’s bodily needs, symptoms of hyperthyroidism or hypothyroidism can occur.
Subclinical disorders are difficult to confirm. Changes in temperature, diet, altitude, general health, medications and stress influence TSH secretion. TSH also falls in illness (euthyroid sick syndrome, endogenous depression) and during treatment with corticosteroids or dexamethasone. And, as mentioned, TSH can fall when the pituitary gland or the hypothalamus aren’t functioning properly.
In autoimmune thyroid disease, TSH levels also fall in people with TSH receptor antibodies (TRAb). Both the stimulating TRAb seen in Graves’ disease and Hashitoxicosis, and the blocking TRAb seen in atrophic hypothyroidism are recognized by the pituitary gland as if they were TSH. Erroneously thinking that blood levels of TSH are adequate, the pituitary gland secretes less TSH. For this reason, patients with Graves’ disease may have low TSH levels even after they become euthyroid (normal thyroid function). Patients with Graves’ disease are considered euthyroid as soon as FT4 falls within range.
Reference Ranges:
Controversy surrounds the normal TSH range. Early ranges based on results of female hospital workers were much too high. Since, the range has been lowered several times.The current recommendations are for a TSH reference range of 0.3-3.0 mu/L with levels below 0.3 suggesting hyperthyroidism and levels above 3.0 suggesting hypothyroidism. However, as with any clinical laboratory test, correlation must be made with other laboratory results, clinical signs and symptoms, and a careful medical history.
Resources:
GJ Canaris, NR Manowitz, G Mayor, EC Ridway, The Colorado Thyroid Disease Prevalence Study, Archives of Internal medicine;160: 526-534.
Elaine Moore, Graves’ Disease, A Practical Guide, Jefferson, NC; McFarland and Company Publishers, 2000.
Henry Ogedegbe, Thyroid Function Test: A Clinical Lab Perspective, Continuing Education Course, Medical Laboratory Observer, February, 2007: 10-18.
Posted by Fivefires on October 5, 2007, at 14:58:11
In reply to Re: Abilify 7.5mg causing fatigue/Phillipa » Fivefires, posted by Phillipa on October 4, 2007, at 21:13:36
Made appt w/ endocrinologist this morning.
Thanks for the info. Will be tremendously helpful Phillipa.
5f
Posted by Phillipa on October 5, 2007, at 20:16:52
In reply to Re: Abilify 7.5mg causing fatigue/Phillipa, posted by Fivefires on October 5, 2007, at 14:58:11
Five Fires wait til the bloodwork is in before changing dose of thyroid med. Phillipa
Posted by RVP on October 5, 2007, at 21:45:03
In reply to Abilify 7.5mg causing fatigue, posted by Fivefires on October 3, 2007, at 17:09:36
> What's up w/ this? Any1 have a theory?
>
> tks, 5fI am taking 30 mg and I am feeling very much tired. But I have taken another time and it is just in the beggining, youl'll feel better soon.
Posted by Fivefires on October 5, 2007, at 23:42:18
In reply to Re: Abilify 7.5mg causing fatigue, posted by RVP on October 5, 2007, at 21:45:03
Good to hear RVP .. tks, 5f
This is the end of the thread.
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