Re: Need advice re Ovcon, Synthroid, and Wellbutrin
From: anonymous (anonymous@obgyn.net)
Mon, 7 Jan 2002 17:57:58 -0600 (CST)
Kimberly
Thanks again for the info ... I certainly hope you are right that
depression can be cured. Part of me is embarrassed to be diagnosed with
dysthymia (mild depression), but part of me thinks it could be accurate.
Aside from low iron, my blood tests are normal, but iron supplements
never helped my energy (I stopped taking them), so by process of
elimination, depression seems a reasonable explanation for my blah/moody
feeling and lack of energy. It wasn't until my RE checked thyroid
antibodies, that the idea of lack of energy due to hypothyroidism came
into play.
I agree with you ... I am starting to think the the headaches are due
to the Ovcon. If and when I drop the Wellbutrin, I'll know more.
I do get confused by all of the research I read. I consider my PCOS
mild because I definitely have headaches, cysts and irregular periods,
but I'm only about 10-15 pounds more than I'd like, I've never had
problems with excessive hair, and acne has not been a big problem. My
goal is simply to feel 100%. I've taken bcps for so long because not
taking any medication and therefore not getting a period seems dangerous
to me. I reasoned that it least bcps tried to keep things in some sort
of cycle, even it's not a cure.. The bcps that I avoid are the
tri-phasics. I was on them for several years. Then, I read on one of
these PCOS discussion boards that tri-phasic bcps are bad for PCOS, and
that is what really prompted me to switch doctors. My old gyn took it
as a personal insult to his medical knowledge that I didn't think I was
on the right medication. So, I concluded that he didn't care about my
needs. The RE that I am going to now at least seems to be more
scientific. Right away, she agreed that tri-phasic bcps were wrong for
me. But taking no bcps for awhile and then taking OrthoCylen for awhile
caused my cysts to come back and caused breakthrough bleeding. So, now
she prescribed the Ovcon 50, which is alleviating the cysts, but I don't
like how I feel otherwise. In retrospect, it was a bad idea to start
the Ovcon and Synthroid at the same time ... not that there is a
conflict, but it was two new things for me to get used to.
Anyway, I tend to ramble. As far as I know, my blood sugar levels are
normal. So, I haven't paid much attention to Glucophage or a low carb
diet. But, your points are well taken and I need to motivate myself to
really give the low-carb/exercise a try at least until I see the RE
again at the end of February. How many carbs do you limit yourself to
each day? Over the last couple of days, I've been shocked how many carbs
are in everday foods. Do you emphasize proteins instead? How many?
Again, thanks for your help. Take care.
Karin
At Sun, 6 Jan 2002, Kimberly wrote:
>
>Karin - I'm glad I gave you a few things to think about - but it's all
>more clear now that you've clarified a bit.
>
>If you've been on the WEllbutrin for 8 months, I see no reason to not
>stop whenever you want (although find out if you need to taper off of
>course! :). My dr. said 6 months was the treatment for depression. I
>was suprised to discover that a 6 month treatment can actually CURE some
>people's depression and it is not necessary to take it all their lives.
>Anyway, it sounds as if you weren't even sure if you WERE depressed, so
>it would most cetainly be interesting to find out how you feel without
>it.
>
>I would not attribute the headaches to have anything to do with the
>Wellbutrin. I also have never seen any indication that synthroid causes
>headaches. but i may be wrong. The Ovcon seems highly suspect, but
>then again it could simply be stress from the holidays! Or an ongoing
>low-grade sinus infection, or...
>
>Well, it you've been on the synthroid for four weeks and just started
>getting energy it sounds as if it really could be responsible. And
>that's so great! Hypothyroidism can affect such a huge amount of body
>functions that it's amazing. I think it WOULD be a good idea to go off
>the Wellbutrin and see what happens with your energy level and emotions.
>It would probably be a good idea to write down exactly how you are
>feeling every now and then because sometimes things change with
>medication so subtly it is hard to remember how we used to feel. It
>really sounds to me like you probably are not too depressed, because if
>you would have been you would have been likely to know it. The thyroid
>problem slows down every function to the point that even if you are not
>depressed, you wouldn't feel the OPPOSITE of depressed, whatever that
>is! :)
>I wouldn't really worry about it too much and would just focus on the
>synthroid for now. If you feel bad or low on energy in the future, go
>ahead and deal with it then.
>
>I think I used the wrong terminology when I was discussing mild and
>serious PCOS. I used those terms because you said your case was mild -
>and yet I'm not sure if there is really much distinction between mild
>and serious. I think there is only the way one's body responds to the
>'malfunction'. I was talking more about insulin resistance, and that if
>your case is 'mild' or not - you are still most likely insulin resistant
>and therefor need to seek treatment because your chance of diabetes is
>huge - and also your risk of heart disease and stroke goes up quite a
>few notches. But I was not directly speaking of the symptoms of PCOS -
>because I don't honestly know if they get worse with age or lack of
>treatment. My guess is that everyone is different.
>
>Birth control pills are not treatment for PCOS. They do nothing to help
>correct most of the symptoms (except giving you a timely period - and
>the PCOS directed ones that I mentioned can help with acne and hair)-
>and as I also said they often times make the condition worse. Most dr.s
>who focus primarily on PCOS do not suggest BCP's unless the patient
>really wants to prevent pregnancy.
>
>I don't know how much you know about insulin resistance - but quite
>simply over a long period of time of being insulin resistant, the
>pancreas simply cannot work any longer because it has been pumping out
>more than it's fair share of insulin for most of it's life. This is
>what causes diabetes II. BCP's make insulin resistance worse, therefore
>causing the pancreas to work even harder than it would without them.
>That is why it really is a personal decision - but it's nice to know
>what you are deciding about. I was not aware that BCP's made it worse
>until recently - and I was pretty suprised, but all the evidence I've
>found has totally pointed in that direction as well. (such as diabetics
>shouldn't take them!)
>
>If you are not taking them to avoid pregnancy - I would really suggest
>that you consider talking to your dr. about insulin sensitizers
>(Glucophage being the most popular, Actos and Avandia being less popular
>but quite effective when Glucophage side effects cause too much
>trouble). These alone could regulate your periods, control your
>insulin/blood sugar levels therefore giving you more energy, and quite
>possibly help a whole bunch with your cyst discomfort. (Sorry, but I
>know little about the cysts, as I think it is only a small percentage of
>women who actually have trouble or discomfort with the cysts - and I'm
>not one of them, so really I don't know - but you might want to ask some
>women on the PCOS support board if they have had any luck with that when
>they are treated for I.resistance. - I recommend that page because it's
>more active) The meds can also help with whatever other side effects you
>may be having - some of which you might be so used to you're not even
>aware of them.
>
>The other option is the low-carb diet (which forgoes the whole insulin
>process altogether so that the pancreas is never stressed and the
>horomones that are messed up because of it go back to normal) and
>regular excercise (which makes the cells accept the insulin better to
>begin with so that once again the pancreas doesn't have to work so
>hard). When I first found out about my PCOS I went low-carb and had 3
>regular periods for the first time in my life (right off the bat) and
>got pregnant (unexpectedly!) thereafter. My skin cleared up and I felt
>so wonderful I was shocked that I had ever felt so bad. But then after
>I had my baby the low-carb diet did nothing for me at all. But that
>could have been the thyroid problem I developed from the pregnancy. Just
>another one of those things I'm sure I'll never understand! Now that I'm
>on Glucophage (and synthroid)I've lost 40lbs and my skin is almost
>perfect - I have very few cravings and I all around feel better than I
>have in a long time.
>Quite simply, BCP's just can't do much for you when it comes to
>correcting the imbalances in your body. That is why I was suprised when
>you seem to be really looking to feel better but that your dr. hadn't
>put you on anything to help the PCOS. Also, if you really want to be on
>the BCP's I would really recommend asking your dr. about Jasmin. It
>blocks the androgens your body is making and is the only BCP available
>that does so - and it just came out last year, so perhaps your dr. isn't
>too used to thinking about it. At least if you block the androgens it
>helps a little bit more than the average pill.
>
>Gee, I'm probably confusing you now. I'm really sorry if I am - but
>I've been learning about PCOS for so long and watching how dr.s and
>women are slowly but surely learning more and more about it - yet so
>many dr.s really aren't up to date - and the woman patient is really
>suffering because of it. It just frustrates me that women can suffer
>and suffer when there actually IS treatment available (i.e. any
>treatment plan that involves controlling insulin resistance). I would
>love to see your ovarian pain go away - but on your current treatment
>plan I don't see that there is really much hope of getting regular
>periods that are normal or seeing the cysts go away or lessen. I just
>want to share any info I can that will help anyone feel better, so if I
>have just made you confused with your meds even more I'm sorry, but I
>hope in the end maybe you can get treatment that will really help you
>and prevent further disease in the future.
>
>Anyway - the whole point of that tirade is that I don't necessarily
>think your PCOS is getting worse, because I don't know if the condition
>as a rule does get worse per say. And I didn't mean to mislead you -
>but even if your PCOS isn't getting worse, not being treated for insulin
>resistance can only be bad - and that CAN get worse. Quite simply,
>insulin control is the ONLY treatment for PCOS (at the moment) - and if
>your cysts and irregular periods are being caused by the PCOS you might
>want to look into it.
>
>That's all I can think of! :)
>
>--
>Kimberly
>
>At Sat, 5 Jan 2002, Karin wrote:
>>
>>Hi Kimberly -
>>
>>THANK YOU for your reply!!! It certainly sounds like you've done your
>>homework on all of this, and you gave me good things to think about.
>>
>>To clarify things, I started the Wellbutrin in May 2001 and started the
>>Synthroid about 4 weeks ago. I have been on various birth control pills
>>for almost 8 years, but just started the Ovcon-50 4 weeks ago also. I
>>have never been on any insulin sensitizing drugs and try to be careful
>>about when and what I eat, but follow no specific diet.
>>
>>When my PCP put me on Wellbutrin, he recommended that I stay on it for 6
>>to 9 months to get the full effect (I am now at the 8 month mark). I
>>agree with you that the first couple of months were tough on my stomach,
>>but I did lose several pounds (no complaint there). I did feel
>>increased energy after a few weeks, but it was also summertime and I was
>>more active. By the way, I take the Wellbutrin in the morning to
>>prevent insomnia.
>>
>>Being diagnosed with subclinical hypothyroidism is what really has me
>>wondering if I am depressed, have a problem with my thyroid, or both.
>>That why my thinking was to reduce the number of meds I was on to see if
>>Synthroid without Wellbutrin kept my energy level ok. My RE thought
>>this was a reasonable idea, and said that if I still had headaches, she
>>would have me just take the Ovcon to see it that is what is causing the
>>headaches. But, you made an excellent point that if the headaches go
>>away it could also be because I've gotten used to the Ovcon!!! Aargh! A
>>doctor once told me that our bodies are like a big chemistry set, and
>>the goal is to find out the right combination that works; like you said
>>it's a lot of variables.
>>
>>Lastly, could you clarify about mild PCOS turning into serious PCOS? I
>>am 38 and have never had normal periods whatsoever, and random sonograms
>>over the years always showed cysts on my ovaries. The birth control
>>pills sort of helped regulate things, but often my periods seemed more
>>like spotting than periods, and my gyn kept saying this was ok, and he
>>shrugged off my complaints of fatigue (as I mentioned I got frustrated
>>with him, and am seeing a different doc now). Anyway, for the last year
>>or so, the cysts have caused me erratic pain. The RE that I am seeing
>>now, did a laparoscopy (can't say it, can't spell it) last August to
>>drain the cysts. I was on OrthoCyclen from August until December, but
>>painful cysts came back and I had breakthough bleeding; hence, the
>>attempt at the Ovcon with higher estrogen. Could the pain be due to the
>>PCOS worsening???
>>
>>Again, thanks for the info. My PCP will be back in his office on
>>Tuesday, and I will get his advice on whether or not to stop the
>>Wellbutrin. The ability to post to this discussion board makes the wait
>>to talk with him more bearable.
>>
>>Take care,
>>Karin
>>
--
Karin
![[ PCOS Discussion Forums ]](../../images/pcos_at_obgyn.gif)