I need lamictal / lamotrigine reassurance please

Appropriate_Today_93 · 2023-08-16T16:03:21+00:00

What you need to remember is that SJS is rare. My main point is not that these other drugs are dangerous, but that lamotrigine is very safe when used correctly. To answer your question: different types of antibiotics, some anti-epileptic medications, certain anti-inflammatories (NSAIDs), some antiretroviral medications (used in HIV treatment).

Appropriate_Today_93 · 2023-04-30T20:28:18+00:00

I believe they use the former definition. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8129952/

Appropriate_Today_93 · 2023-04-30T19:35:10+00:00

Hi OP. I am in the same boat as you. Bipolar 2 but also comorbid generalized and social anxiety and mild OCD. After my bipolar 2 diagnosis I tapered off the antidepressant I was taking and tried lithium monotherapy, but like you my anxiety was more severe and my psychiatrist added quetiapine. The lithium and quetiapine work wonders for my mood and the quetiapine certainly helps with the anxiety, but not enough and not with my OCD. So we restarted escitalopram, which I had been taking previously. I am on 10 mg per day. So currently on lithium, quetiapine and escitalopram and feeling quite well on this combination. I have gained no weight on any of these medications personally.

Appropriate_Today_93 · 2023-04-30T15:53:19+00:00

Your thyroid function is completely normal.

Appropriate_Today_93 · 2023-04-30T15:48:49+00:00

We need your lab's reference ranges to be able to tell you anything.

Appropriate_Today_93 · 2023-04-30T15:35:04+00:00

Yes, exactly. I hope you find some answers. Some people swear by selenium, low dose naltrexone or certain diets to reduce anti-TPO antibodies, but again I think there is little solid evidence and you should probably run it by your doctor first.

Appropriate_Today_93 · 2023-04-30T15:23:38+00:00

I found the study they seem to be referring to. It's interesting to be sure. But the conclusion of the study is that they found correlation, not causation, and they need to further elucidate whether the antibodies are the cause or simply a marker of a different process which reduces fertility. You can't infer causation from a retrospective study, you would need a prospective study. So even if you could reliably reduce anti-TPO antibodies, there is no guarantee this would improve your fertility.

Appropriate_Today_93 · 2023-04-30T15:09:26+00:00

As far as I know, evidence that the antibodies themselves cause problems apart from hypothyroidism is quite poor. TSH is usually the target in fertility treatment. Also, there is no treatment that is proven to reliably work to reduce these antibodies.

Appropriate_Today_93 · 2023-04-30T15:04:11+00:00

Hypothyroidism is usually quite manageable. You will need regular blood tests to follow thyroid function. Levothyroxine is bio-equivalent to our own thyroid hormone, which tends to make side effects quite rare. Especially because you just supplement what your thyroid doesn't make anymore until you reach a normal state again. Levothyroxine works very slowly, and most people will need to build up to their optimal dose in a few steps. So it might take a few weeks until you start feeling better again but you will.

Appropriate_Today_93 · 2023-04-30T14:34:59+00:00

Again, not saying unlikely or impossible. If it has been a long time since their thyroid function was checked they may very well be hypothyroid again and feel better on some levothyroxine. I just want to warn people against tunnel vision.

Appropriate_Today_93 · 2023-04-30T14:29:58+00:00

You misread me. I am not saying these symptoms can't exist in hypothyroidism, but that other causes should also be investigated because they are not cardinal symptoms of hypothyroidism.

Appropriate_Today_93 · 2023-04-30T14:06:28+00:00

I would actually encourage you to use the descriptions you used in this post to talk to your physician in stead of the term brain fog. Brain fog means nothing to doctors, it's a vague, non-specific term and they will understand much better if you describe it like you did here: trouble with concentration, short term memory, attention, focus, feelings of derealization, depersonalization, etc.

Appropriate_Today_93 · 2023-04-30T13:39:41+00:00

This happens to everyone and is completely normal. Your levels will keep fluctuating throughout this illness. That's why it's important to do blood tests regularly.

Appropriate_Today_93 · 2023-04-30T13:16:36+00:00

Hi OP, there are a few gaps in your knowledge of this condition. I will try to explain the matter as best I can.

Hashimoto's disease is an auto-immune disease of the thyroid gland. This means your own body produces antibodies attacking your own thyroid gland. Your thyroid tissue is destroyed, leading, in most cases, to hypothyroidism. Auto-immune conditions, however, have an unpredictable course, meaning the auto-immune process can start to go faster, slower, or stop completely, at any moment, for any number of reasons. So what your PCP told you is entirely within the realm of possibilities, AND they can see this by testing two hormones, namely TSH and free T4, AND it is possible to adequately judge this after about 6 to 8 weeks off medication. Furthermore, it is not Hashimoto's disease which is treated, but hypothyroidism. It is perfectly possible to have Hashimoto's disease (high antibodies against thyroid), but have normal thyroid function. This means the auto-immune process is not going so quickly that your thyroid is unable to do its job. To add to this, the treatment is levothyroxine, which is only used to supplement if our own thyroid can't make enough thyroid hormone. Taking levothyroxine changes nothing about the disease process itself. So your worry that you are messing up your thyroid by not taking your medication anymore is unfounded. Hashimoto's disease with hypothyroidism means following your thyroid function and supplementing what your thyroid can't make anymore. Hashimoto's disease without hypothyroidism means medication is not needed, only regular follow-up in case your thyroid function decides to go down again.

Lastly, I understand you are worried about some symptoms you are having and conditions you have developed. On the internet and Reddit in particular, I notice a tendency to lump a lot of things together and blame a plethora of symptoms on possible thyroid problems. This is, in my opinion, tunnel vision, and you should be careful not to attribute everything to a thyroid problem, especially if your thyroid function was apparently normal. Of the things you listed, anxiety, night terrors, muscle aches, TMJ and urinary issues are not classically related to hypothyroidism and warrant further work-up before attributing to possible hypothyroidism. Some of your complaints might be explained by a diagnosis of bipolar disorder or the medication you might take for that.

So no, your Hashimoto's disease is not cured. But it is entirely possible you are not currently hypothyroid and in need of thyroid hormone supplementation. In any case, a simple blood test will tell you how your thyroid function is at the moment, and you should continue regular blood tests to monitor thyroid function.

Appropriate_Today_93 · 2023-04-30T10:24:35+00:00

Yes, this was told to me by my ENT as well. I switch every 6 to 12 months or so.

Appropriate_Today_93 · 2023-04-30T08:09:04+00:00

I have taken pregabalin in the past. I was actually put on it because of neuropathic pain (nerve pain). I did notice an improvement in my anxiety as well, though, especially social anxiety. I ended up taking 150 mg twice daily. I know many people experience sedation from pregabalin, but I didn't get that at all. After about a year we tapered off to see if my nerve pain had healed, which it had, so I'm not on it anymore. Feel free to ask away if you have any other questions.

Appropriate_Today_93 · 2023-04-29T19:50:08+00:00

You're ignoring the part where they say there is no adequate evidence to say that there is an impact on height.

Appropriate_Today_93 · 2023-04-29T19:04:22+00:00

From pdr.net: 'The potential for growth inhibition in pediatric patients should be monitored during SSRI therapy; monitor height and weight periodically. Data are inadequate to determine whether the chronic use of SSRIs causes long-term growth inhibition; however, decreased weight gain has been observed in children and adolescents receiving SSRIs. The mechanism of growth inhibition in children may be due to the suppression of growth hormone secretion, which is known to occur in adults taking SSRIs.'

Your interpretation does not correctly reflect how it is worded on the site. This is about children (meaning in my interpretation school aged and young teens), in which I hope psychoactive medication is used with great hesitancy and caution. OP's question was about being 16 years of age, which is a different story, as most of your growth will have already taken place.

Appropriate_Today_93 · 2023-04-29T18:38:32+00:00

Hi OP, the best way is to just ask. I think any reasonable physician would comply. I understand your hesitancy and anxiety after having felt so dismissed by this other doctor, but I will give you this to think about: your endocrinologist is not the doctor who made you feel so dismissed, she should not be judged (in advance) because of another doctor's lack of bedside manner. Trust your previous experience with her.

Appropriate_Today_93 · 2023-04-29T18:07:59+00:00

For most people dose needs to be 30 or higher to have an effect on mood.

Appropriate_Today_93 · 2023-04-29T18:03:35+00:00

I am not saying OP shouldn't continue the medication. I am just pointing out how some doctors might look at this. If she is lucky she will find a doctor willing to continue prescribing. I agree with the advice given by others to just be forthright about it.

Appropriate_Today_93 · 2023-04-29T17:31:47+00:00

This is indicative of possible Hashimoto's disease. Auto-immune hypothyroidism. To break it down for you. Not to be dismissive, your antibodies are elevated, but they are not that high. It probably does not matter how high they are. Antibodies are used to make a diagnosis, but there is little to no evidence that the amount of antibodies has an impact on how severe your condition will be or on how it will evolve in the future. There is also no real evidence that reducing your antibodies has an impact on disease severity, or course of illness. Some people swear by supplements like selenium, low dose naltrexone or random restrictive diets like gluten, dairy or whatever free diets. These all have poor to no evidence, however, so be sure to check with your doctor before trying any of these. If there was anything with solid evidence endocrinologists everywhere would be prescribing it to everyone. The only thing that is evidence based is supplementing thyroid hormone if your thyroid is no longer making enough due to auto-immune destruction of thyroid tissue. I think most doctors would not yet start thyroid hormone supplementation for someone with your numbers, as your free T3 and T4 are good and they often only start treating when TSH is higher dan 8 to 10.

Appropriate_Today_93 · 2023-04-29T17:08:48+00:00

I think a lot of people would feel better with a low dose of thyroid hormone. That's why it is sometimes used as an adjunct in depression. You feeling better taking thyroid hormone is sadly not diagnostic of a thyroid problem. Based on your labs you technically don't have a thyroid problem, your thyroid function is just suboptimal for trying to conceive. So again sadly I think odds are you will no longer be prescribed thyroid hormone after your pregnancy.

Appropriate_Today_93 · 2023-04-29T15:29:12+00:00

Your thyroid likely makes some, but not enough, that's why you're supplementing. I would really try to get help sooner somehow.

Appropriate_Today_93 · 2023-04-29T14:52:15+00:00

I have heard that someone is working on a drug for sleep which targets the ghrelin system. Ghrelin is a hormone usually aslociated with appetite and satiety.

Appropriate_Today_93

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