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Old 08-05-2008, 11:25 AM   #1
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staceymck HB User
Red face Severe Fatigue not improving!! On depression meds & Hypo-thyroid

Hi there..

I could really use some advice... I am currently awaiting some blood work results from my family doctor, as I have been having EXTREME fatigue for almost a year now... Actually, I have always had fatigue but it is worsening year after year.
I am 26/female.. and overall I would say healthy... I am thin/athletic and always in great shape and played alot of sports....except since my fatigue in the last few years I don't have the energy to exercise anymore.

I was diagnosed with Hypothyroidism about 5 years ago in my early 20's... I tried different medications and nothing made me feel better.. I never gained weight but always felt tired. I have been on natural dessicated thyroid for about 4 years now and it was working amazing!! Until a year ago I hit a VERY stressful/emotional breakdown and rough time in my life... My doctor put me on Celexa for my depression and I have been on it for about 4-5 months now. At first, I felt AMAZING... I had energy again and didn't feel as fatigued as before. About a month later I feel horrible again... I don't feel as many depression symptoms anymore, only the fatigue. Overall, my mood is pretty good I just can't shake this tiredness ALL the time... I sleep 8-10 hrs a day, sometimes less (for fear I may be getting too much?) and I NEVER feel rested... I doze off at work at my desk, in meetings, I NEED coffee or sugar to keep me awake.. and I get sleepy during driving, movies, watching tv. etc. Everyone thinks I party all the time because I can never stay awake at work!
I rarely drink alcohol.. Most nights I am in bed by 10-11pm.. I work dayshift 5 days a week awake at the same time, in bed at the same time. I eat pretty well, although I eat my junk here and there. And I NEVER used to drink coffee until now because I can't function without it at work. I get extreme bouts of sleepiness every morning around 9-11am.. I go for naps in my car on lunch at work its so bad !!

I just can't function I feel like I'm dead all the time, no energy, not alert and always yawning or wanting to sleep anywhere anytime.

Does the sleepiness ever go away with depression? Could my meds just not be working?
My thyroid tests all come back fine and I am not gaining even 5 lbs.. I am still very slim.
I look HORRIBLE though, big black circles, droopy eyes, puffy eyelids, pale skin unless I wear makeup.

Any ideas, or what I can ask my doctor???

Last edited by staceymck; 08-05-2008 at 11:29 AM.

 
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Old 08-05-2008, 11:51 AM   #2
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moejoe39 HB User
Re: Severe Fatigue not improving!! On depression meds & Hypo-thyroid

Hi, have you ever though about getting checked for sleep apnea?

You can have it even if you don't snore. I got tested myself (Sleep study) and was diagnosed with periodic limb movement disorder during sleep. In other words, my leg twitches woke me up 90 times in a three hour period. I didn't even know I was waking up, just had severe fatigue like you.

Good Luck

 
Old 08-05-2008, 12:08 PM   #3
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wangela67 HB User
Re: Severe Fatigue not improving!! On depression meds & Hypo-thyroid

Hi Stacey,
Your post sounds very similiar to my life. I'm also Hypo and take Armour dessicated thyroid in the morning and at lunch. I'm also on 40mg of Paxil. The paxil helps my anxiety and depression but I stay tired (my Starbucks coffee is right beside me now). I do think my fatigue increased when I went to 40 mg of Paxil (I was on 20mg and it didn't seem to help with the depression). I wish if I could go back I would have just asked to be switched to another AD. For now my PDoc wants me to stay on the Paxil. I informed my PDoc about my symptoms - the tiredness, waking up and feeling so sleep and groggy for the longest time, almost falling asleep at my desk during the day. I literally feel like I can shut my door some days and go to sleep and I have had plenty of sleep the night before. Well, I'm better now and let me tell you what I've done. I'm not recommending you do this by the way. My Pdoc has added 20mg of Adderall XR to my med regimen. I take the Adderall after breakfast and it has cured my tiredness during the day. Also, she informed me to take my AD at dinner time instead of at bedtime. Also, I do think that those of us that are on dessicated thyroid are not always optimized. Dessicated thyroid (Armour) will suppress your TSH. Right now, my TSH is .05. Some doctors believe that I'm moving into Hyper because the TSH is so low, however, my Free T3 and T4 levels are in the lower level. I actually take 120mg of Armour in the morning, and 60 in the afternoon.

Here is what I would do if I were you.
1. I don't think you need the Adderall because you stated that you were slim. I've gained 50 lbs since starting Paxil so I would like to loose weight. Adderall does make you not want to eat. This is helping me. Because paxil makes me have awful food cravings.

2. How much Celexa are you on? Try to lower it some and see if this helps. If not, you may want to think about a more stimulating AD like Prozac. I'm considering switching to Lexapro or Prozac if my doctor lets me. This is a risk because we have no idea if the new med will be better or worse. They all have side effects.

3. Are you on Armour? Do you take in the morning and afternoon? If so, I would ask for a copy of your latest blood results. Go to the Thyroid board and post your lab results. There are a lot of knowledgeable people on this board and can give you advice about your lab values. You might need to increase your dosage.

I hope this helps. You are not alone I feel the same way that you do. You are in a better boat than me because your weight is constant. I've gained 50lbs since starting Paxil.

Best Wishes!

 
Old 08-05-2008, 03:50 PM   #4
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staceymck HB User
Re: Severe Fatigue not improving!! On depression meds & Hypo-thyroid

Hi thanks for the responses...

No I have not been tested for sleep apnea... I have never thought about it because I don't snore.. But I guess it is worth checking! I was supposed to do a sleep study years ago, but I never went. I have never had my sleep tested, maybe it's a good idea ...

and wangela67- I also am on the lower end TSH (that I could be considered hyper-thyroid) just by a touch I believe I am -0.05 but my T3 and T4 are in the middle to upper ranges and my doctor is happy with them.
I haven't been showing any signs of hyperthyroidism so my doctor thinks my dosage is sufficient. Oh and I am in Canada so our natural thyroid here is called "Thyroid" made by Erfa (formerly Pfizer).. I am on 90 mg.. which I take twice a day (45mg in the am and 45mg in the pm). Similar to yourself...


What is Adderall used for?

I am only on the lowest dose of Celexa.. 20mg.. I noticed a positive change almost right away.. I don't think lowering of my dose would be a good idea, as I am barely on any.. Is it possible I could need a bit of a higher dose? I guess I still have bad days, I am just overall quite happy with the depression meds considering how I used to feel

 
Old 08-05-2008, 08:41 PM   #5
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wangela67 HB User
Re: Severe Fatigue not improving!! On depression meds & Hypo-thyroid

Your thyroid lab values sound good, better than mine so that is not your problem. I've never taken Celexa, so I can't comment if this drug could be causing your problem. I know that the addition of more Paxil (40mg right now) caused my tiredness. I wish I had switched to Celexa instead of going up to the 40mg of Paxil.

If you have ruled out your thyroid and the depression med as the cause of your tiredness why don't you ask your doctor to do a full blood workup - CBC panel to check your B12 levels and other things that could be causing the fatigue.

At one time I added Wellbutrin to the Paxil for low labido, and fatigue. I did not like the Wellbutrin. You may want to try this combination to see if this might work for you. Wellbutrin affects other brain chemicals (norepinephrine and dopamine) the same way SSRI's affect serotonin. Wellbutrin can cause increased anxiety in some people when starting it so you have to give it time.

When I went to my Pdoc and told her about my symptoms she said she wanted me to try the adderall XR to see if it would help. I had never heard of it either. I did some research and it is actually an ADHD drug. This drug is a stimulant and can increase concentration and focus. Also, Adderall increases dopamine and norepinephrine. It is not a reuptake inhibitor for these chemicals. It actually increases them. Some doctors prescribe this drug off label as an adjunct to an AD.

I've only taken the Adderall XR a short time so I can't comment on the long term benefits (not sure if I want to take long term). So far, this addition has helped tremendously with the tiredness, it has suppressed my appetite, I am more focused and energetic at work. I hope this continues.

Good luck on finding the right solution for you.

 
Old 08-06-2008, 10:46 AM   #6
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staceymck HB User
Re: Severe Fatigue not improving!! On depression meds & Hypo-thyroid

Hi again!

I am currently waiting on some bloodwork results, as my doctor wanted to test my B12, and other things as well ... I have had low B12 and iron in the past, so it is a possibility.

The above poster also mentioned sleep apnea... and you know I always ruled that out because I don't snore... But the more I read about it, I have ALOT of the symptoms.
I had a tonsillectomy in 2006 because my tonsils were permanently enlarged and scarred from frequent strep throat.. I also had many sinus infections and I have been to my ENT and he says my nasal passage is very congested. All he gave me was nasal sprays, but they only work for like 5min!
I always wake up feeling congested and usually whatever side I lay on, my nose is completely clogged.

Maybe I have allergies or obstructive sleep apnea.. I will go to that board and get some information.. I just have a feeling my depression is so mild it shouldn't be causing me this much fatigue.. and my thyroid has been consistent for years..

thanks for the help!!

 
Old 08-06-2008, 03:32 PM   #7
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wangela67 HB User
Re: Severe Fatigue not improving!! On depression meds & Hypo-thyroid

Stacey,
I hope you find a solution to your problem. I would wait for the blood results to come back and see what they say. If they are ok I would get the sleep apnea checked out. Also, you may want to go to an allergist and check and see if you are having allergic reactions that is causing the constant stuffiness. Are you drinking a lot of water? Dehydration can cause low energy levels. I would also go an get a multivitamin, and Bcomplex vitamin and start taking. If your gut tells you something is not right I would keep investigating until you find a solution.

The last time I had my iron checked it was 7 (very low). I asked my doctor for a prescription iron supplement and she told me to just get an over the counter supplement for iron. It takes a while to get your iron level increased even with vitamins.

Let us know the results on your bloodwork when it comes back.

 
Old 08-06-2008, 07:27 PM   #8
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beach4me HB User
Re: Severe Fatigue not improving!! On depression meds & Hypo-thyroid

I sleep alot, and still feel tired when I am depressed. I am now taking Wellbutrin and Provigal. The Provigal gives me the extra energy that I need. I have tried other AD's that made me so sleepy. Don't give up! You will find your answer.

 
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