Thyroid Issues: A 64-Year-Old Woman's Health Journey

I would like to ask if my issue is related to the thyroid?

I am a 64-year-old female who has been diagnosed with hyperthyroidism and depression.
I have previously taken radioactive iodine, and my depression is currently well-controlled.
However, for the past three months, I have been feeling restless and uncomfortable, experiencing palpitations, poor appetite (with a bitter taste in my mouth and food lacking flavor), and I have lost 7-8 kilograms.
I initially thought this was due to my depression, for which I have been taking an anxiolytic (Kalma) and an antidepressant (Cipram), but I have found them to be ineffective.
After two hours of taking the medication, I start to feel uncomfortable again.
I visited an internist, and on July 21, I had blood tests that showed T3 at 0.76, T4 at 8.87, and TSH at 0.019.
The doctor said it was okay but was hesitant to prescribe medication.
Subsequently, I had another blood test for free T4, which was 1.85, and the physician prescribed me Thiamazole, one tablet daily.
However, after taking it for a week, my condition has not improved.
Could you please advise me on what might be happening? Thank you.

Xiao Bao, 60~69 year old female. Ask Date: 2008/08/08

Dr. Yang Hongzhi reply Internal Medicine

Your thyroid function is on the borderline of hyperthyroidism.
It is not expected to cause significant symptoms, but it is reasonable to use low-dose antithyroid medication to lower thyroid function.
The effects of the medication may not be apparent within a week, as the thyroid issue may not fully explain your symptoms.
A psychiatric evaluation is also needed.

Reply Date: 2008/08/08

More Info

It sounds like you are experiencing a challenging time with your health, particularly concerning your thyroid issues and mental well-being. As a 64-year-old woman with a history of hyperthyroidism and depression, it is understandable that you are feeling anxious and uncomfortable. Let’s break down your situation and explore some potential avenues for improvement.

Understanding Your Thyroid Condition
Hyperthyroidism, or an overactive thyroid, occurs when the thyroid gland produces excessive amounts of thyroid hormones (T3 and T4). This can lead to symptoms such as anxiety, weight loss, increased appetite, and gastrointestinal issues. Your recent lab results indicate a suppressed TSH level (0.019), which suggests that your thyroid is indeed overactive. The T3 and T4 levels, while within a certain range, still indicate that your thyroid function needs careful monitoring and management.

Current Treatment and Its Challenges
You mentioned that you were prescribed Thiamazole, which is a common medication used to treat hyperthyroidism by inhibiting the production of thyroid hormones. However, it can take several weeks to notice significant improvements in symptoms after starting this medication. If you have only been on Thiamazole for a week, it may be too early to assess its effectiveness fully.
Additionally, the fact that you are experiencing persistent symptoms such as anxiety, poor appetite, and weight loss may indicate that your hyperthyroidism is not yet adequately controlled. It’s also possible that your mental health medications (Kalma and Cipram) may not be fully addressing your anxiety and depressive symptoms, especially if they are exacerbated by your thyroid condition.

Recommendations for Management
1. Follow-Up with Your Healthcare Provider: It’s crucial to maintain open communication with your healthcare provider regarding your symptoms and treatment. If you feel that your current treatment is not effective, do not hesitate to express your concerns. You may need a dosage adjustment or a different medication altogether.

2. Regular Monitoring: Regular blood tests to monitor your thyroid hormone levels (T3, T4, and TSH) are essential. This will help your doctor determine how well your treatment is working and whether any adjustments are necessary.

3. Mental Health Support: Given your history of depression and anxiety, consider consulting with a mental health professional who can provide therapy or adjust your medications as needed. Sometimes, a combination of medication and therapy can yield better results.

4. Diet and Nutrition: Pay attention to your diet, especially since you mentioned a poor appetite and weight loss. Eating small, frequent meals that are nutrient-dense can help improve your energy levels and overall well-being. Foods rich in omega-3 fatty acids, antioxidants, and vitamins can support both thyroid health and mental health.

5. Lifestyle Modifications: Incorporate stress-reducing activities into your daily routine. Practices such as yoga, meditation, or gentle exercise can help alleviate anxiety and improve your mood.
6. Consider a Second Opinion: If you continue to feel unwell despite treatment, it may be beneficial to seek a second opinion from an endocrinologist who specializes in thyroid disorders. They can provide additional insights and treatment options.

7. Support System: Engage with family and friends for emotional support. Sharing your feelings and experiences can help alleviate some of the burdens you are carrying.

Conclusion
Your health journey is complex, and it’s important to approach it holistically. By working closely with your healthcare team, monitoring your thyroid levels, and addressing both your physical and mental health needs, you can find a path toward feeling better. Remember, it’s okay to seek help and advocate for your health. You deserve to feel comfortable and supported during this time.

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