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Dr. David
Dr. David, Doctor (MD)
Category: Oncology
Satisfied Customers: 43480
Experience:  Board Certified Oncologist
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im borderline underactive thyroid my symptoms are feeling cold

Resolved Question:

im borderline underactive thyroid my symptoms are feeling cold and depression but have to wait 3 mnths to be retested im at my wits end as ive had these symptoms 5 months another 3 months fills me with despair as im practally house bound is there any way I could have trial meds before 3 months
Submitted: 2 years ago.
Category: Oncology
Expert:  Dr. David replied 2 years ago.

Dr. David :

This is Dr. David

Dr. David :

I am sorry you are having these symptoms.

Dr. David :

what is your most recent TSH levels?

Dr. David :

you also should be checked for low iron, low B12, low vitamin D, low magnesium, as well

Dr. David :

and possibly low testosterone levels as well.

Dr. David :

mirtazapine is used to treat depression and posttraumatic stress disorder

Dr. David :

it sounds like your depression is also not well controlled as well.

Dr. David :

you might need to try higher doses or mirtazapine or another antidepressant as well.

Dr. David :

what dose of mirtazapine are you on?

Customer:

30 mg

Dr. David :

did you see my full response above?

Dr. David :

maximum dose of mirtazapine is 45mg taking at night before bed time.

Dr. David :

are you taking it before bed time?

Customer:

no

Dr. David :

it sounds like you might need a better antidepressant

Customer:

what kind

Dr. David :

mirtazapine can make you sleepy, so most doctors recommend you take it before bed time.

Dr. David :

I would try taking it before bed time to see if it helps better.

Dr. David :

and also get your iron and B12 and testosterone and vitamin D levels checked as well

Dr. David :

and also get your TSH thyroid hormone levels checked as well.

Customer:

i have everythins fine exept thyroid which is borderline

Dr. David :

I see.

Dr. David :

I would be happy to review your lab work with you if you get a copy of it.

Dr. David :

try taking the mirtazapine before bed.

Dr. David :

if it doesn't work, you should talk to your doctor about tapering off of it and trying something else

Dr. David :

like sertraline

Dr. David :

or paroxetine

Customer:

i take it before bed now would Prozac in the day help

Dr. David :

remember, you should not stop mirtazapine suddently, you have to taper off of it if you want to switch to something else

Dr. David :

I would not mix the two.

Dr. David :

if the mirtazapine doesn't help, then I would taper off of it and start up prozac separately to see if that helps

Dr. David :

you have been on prozac as well before?

Customer:

why do i have to wait 3 months to be retested for my thyroid

Dr. David :

changes in thyroid hormones can take 6-12 weeks to change in your body.

Dr. David :

thyroid hormones are very very slow to change and have a very long 1/2 life in your body.

Dr. David :

so if you have a thyroid hormone oral change of dose, then you have to wait 6-8 weeks before checking the blood levels.

Dr. David :

so you could get it checked in 2 months and not 3

Customer:

ok no ive not been on Prozac before been on mirts for 5 months though

Dr. David :

I see.

Dr. David :

you can talk to your doctors about the option of tapering off of mirts and trying prozac if you still have symptoms of depression and PTSD

Dr. David :

does this help?

Dr. David :

do you have other questions?

Customer:

ithis is my first test for thyroid im not on medicaion

Dr. David :

I see.

Dr. David :

well, I would need your blood work to help you more.

Dr. David :

try to get a copy of your thyroid blood work

Dr. David :

I would be happy to review it with you.

Dr. David :

I am not sure what you mean by boarderline

Dr. David :

you want to make sure your TSH level is between 0.3 and 3.0

Dr. David :

TSH levels above 3.0 can mean you are hypothyroid and don't have enough thyroid hormone in your body.

Customer:

borderline means just in normal but only just

Dr. David :

I need to know what your levels are

Dr. David :

many of the older TSH ranges say normal is between 0.3 and 5.0

Dr. David :

and if your TSH level is between 3.0 and 5.0, you might be somewhat hypothyroid

Dr. David :

so you have gotten your testosterone levels checked and B12 and vitamin D levels checked?

Dr. David :

these are not routine blood tests typically.

Customer:

sorry i don't have them would it benefit me if i had treatment now on a trial basis

Dr. David :

I can't say without your blood test.

Dr. David :

doctors don't tend to give thyroid hormone medication treatments on a trial basis.

Dr. David :

either you need thyroid hormone in your body or don't.

Customer:

yes i have all ok exept thyroid

Dr. David :

it sounds like you might need a better depression medication like prozac or zoloft for the depression.

Dr. David :

the thyroid hormone will not be the answer for depression.

Dr. David :

let me know if you have other questions.

if done for now, please leave positive rating below the chat box so I can get credit for helping you today

you can always reach me with "a question for Dr. David" if you have any other questions

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http://www.justanswer.com/medical/expert-dr-david/

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Dr. David, Doctor (MD)
Category: Oncology
Satisfied Customers: 43480
Experience: Board Certified Oncologist
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