Help for my Mother

[Siddha]

Hello everyone.
Woman 62 years old, height 160 cm, weight 70 kg.
She has had sleep problems since she was young.
At ~29 years of age, Diffuse toxic goiter was diagnosed and a partial strumectomy was performed.

After removing part of the thyroid gland, she experienced symptoms such as obstetrician's fingers, weakness, poor sleep, chills.
She was diagnosed with hypoparathyroidism.

At that time, her treatment consisted of such drugs as calcium chloride, Thyrocomb (Levoteroxin 70 mcg, leothyronine 10 mcg, potassium iodide 150 mcg), as well as the drug Thyroidine (spirulin 180, l-thyrorosine 90, vit. E 45 mg, iodine 0.30 mcg, selenium 0.15 mcg)

She has been treated with T4 monotherapy for the last ~10+ years.

Current diseases:
Osteochondrosis of the cervical vertebrae.
Osteoporosis.
Varicose veins and 2 operations to remove them.
Ovarian cyst.
Polyp of the gallbladder.
A stomach ulcer, now gastritis.
Chronic pancreatitis.
Cholecystitis.
Chronic pyelonephritis
Cardiomyopathy.

Symptoms today:
Recent years have been especially stressful for her, her husband's oncology and many other problems.
Lack of sleep at night, slight lapses in sleep during the day for a couple of minutes.
At night, if she manages to fall asleep, sometimes there are nightmares, sometimes she can scream loudly in her sleep. It was recently.
Anxiety
Depressive mood.
Fear.
Bad memory.
Weakness.
Chills.
Lethargy.
Dizziness.

Medications prescribed by doctors:
Neurologist - recently, after a stronger attack of anxiety than usual, accompanied by a clearer heartbeat, she turned to a neurologist and he prescribed her:
Magnesium sulfate intravenously.
Betamax (Sulpiride)
Adep (Mirtazapine)
She has not started taking these medications yet.

One good person from this forum advised me to try pregnenolone and progesterone.
I bought pregnenolone powder from HealthNature and gave her 100mg daily and also bought Progestin (progesteron) from Haidut and gave her 40mg transdermally at a time, but no effect. Probably should try a dose of 100mg. Ray Peat says that some women do not notice any effects even from 100mg, and that in such cases, thyroid hormone and an improved diet are required to normalize estrogen prolactin and cortisol


I tried to feed her nutritiously, I also ordered pure aspirin from HealthNatura and she took occasionally 100-300mg. For every 300 mg of aspirin, she took 1 mg of K2(Mk4).
I bought from Haydut Vitamins of group B, Magnesium, Estroban (vit. A, D3, K2, E), which she also occasionally took.

Guys please tell me how to get out of this? @lampofred @CLASH @ecstatichamster @tankasnowgod @haidut @youngsinatra @David @Amazoniac @schultz @tara
What steps need to be taken?
The main task is to relieve anxiety and improve sleep.
Remove T4 and add T3? The half-life of T4 is 2 weeks?! How to make this transition? My mom is afraid to stop T4.
Or start taking antipsychotics and antidepressants (Sulpiride, Mirtazapine) on the recommendation of a neurologist?
Thank you all in advance for any help.

 

[Jennifer]

@Siddha, can you tell us what your mom’s diet consists of and does she suffer any digestive issues? I ask because anything that is poorly digested and/or irritating to my intestines will reliably cause night terrors.

For the gastritis, gelatinous broth/bone broth, collagen peptides or bloomed and fully dissolved gelatin taken before meals might help. I had gastritis for years and it healed rapidly when I began supplementing gelatin. Also, an effective thyroid med and proper dose should help with optimizing enzyme production and gut motility/peristalsis to prevent ulcers and gastritis in the future.

Has your mom tried progesterone orally or vaginally? My mum and I found it far more potent when taken internally. If taken orally, she can apply it directly to her gums. This should hopefully lower her cortisol so her sleep improves, as well as addressing the polyps. My mum had chronic insomnia, and vaginal polyps that led to uterine cancer, and high doses of Progest-E not only had her finally sleeping through the night, her surgeon was shocked to find that the cancer that had spread to her uterine wall had “mysteriously” disappeared.

In regards to thyroid, women often struggle converting T4 to T3 in the liver so your mom might want to consider talking with her doctor about trying a combination T4/T3 med. My mum and I found NDT to be better tolerated, but some find a synthetic like Cynoplus more effective. When adjusting my dose, I titrate up or down every two weeks and reassess my temps, pulse and symptoms. I find it important to keep an eye on my cholesterol to make sure it doesn’t fall too low as cholesterol is needed for hormone production and without enough, a stress reaction can occur such as anxiety.

 

[mostlylurking]

What steps need to be taken?
The main task is to relieve anxiety and improve sleep.
Remove T4 and add T3? The half-life of T4 is 2 weeks?! How to make this transition? My mom is afraid to stop T4.

@Jennifer has provided excellent advice.

I took T4 without any T3 for many years; it actually makes symptoms worse. T3 is needed by the liver so it can do its job of converting T4 into T3. T3 "primes the pump" to get the cycle going. Suggested reading:

Thyroid: Therapies, Confusion, and Fraud

Ray Peat

raypeat.com

Thyroid, insomnia, and the insanities: Commonalities in disease

Ray Peat

raypeat.com

Or start taking antipsychotics and antidepressants (Sulpiride, Mirtazapine) on the recommendation of a neurologist?

In addition to appropriately addressing your mother's hypothyroidism, some thiamine might prove helpful, also maybe a good B-complex. I'd avoid the pharmaceuticals like the poisons that they are.

13 Signs of Thiamine Deficiency (B1)

Cliff notes: Thiamine deficiency was not solved decades ago by enriching grains and is alive and well. The implications of this have a huge impact on modern day health and disease. It's always been amazing to me that a country with an endless food supply and resources can coexist with so much...

butternutrition.com

Thiamin Deficiency - Disorders of Nutrition - Merck Manual Consumer Version

Thiamin Deficiency - Explore from the Merck Manuals - Medical Consumer Version.

www.merckmanuals.com

@Jennifer

 

[Jennifer]

@mostlylurking, thank you for providing all those useful articles for Siddha to read. I appreciate it. :)

 

[mostlylurking]

@mostlylurking, thank you for providing all those useful articles for Siddha to read. I appreciate it. :)

Glad to try to help. You covered the hormone part and digestion angle very well.

 

[Jennifer]

You covered the hormone part and digestion angle very well.

Thank you. :)

 

[Siddha]

Hello @Jennifer @mostlylurking
Thanks for your time and the information provided.

As for her diet, it is not ideal, but I tried my best to exclude poisons from her diet, such as oils (sunflower), etc. She consumes milk, some cheese, fruits (tangerines), which are hard to find in good ripe quality, especially in winter. I also ask her to eat one carrot a day. Eggs, beef, rice, potatoes. In general, from what I have, I try to make food that is less harmful to her.

Which Cologen Peptides or Gelatin do you recommend? Heard a lot about Green Lakes, but as always there are problems with delivery to my country.
Is regular store-bought table gelatin safe and pure enough?

I bought progesterone from Haidut in the store, based on SFA esters and ethanol. I took it transdermally (navel, sometimes on the temples for a direct effect on the brain). I gave her the maximum dose of 40mg. No effect. In the writings of Ray Peet on progesterone, I found information that sometimes a woman may not notice any effect even at a dose of 100 mg of progesterone, and in such cases, thyroid hormones and improved nutrition are required to normalize estrogen, prolactin and cortisol.
Your idea of vaginal progesta-e is interesting, given that my mother was found to have swollen lymph nodes in this area, the cause of which we do not yet know.
When you talked about the high doses of progest-e used by your mother and you vaginally, how many milligrams did you mean?
I think the first priority is to take it quickly and get the right dose of thyroid hormone.

I read Pete's work that you suggested. I figured everything out, except how to switch to T3 / T4 combo therapy for a person who takes only T4 for a long time? Given the current fact that such a person has a T3 / T4 ratio of 1:50.

Is it necessary to abstain for 2 weeks without taking T4 and let it leave the body and only then add conditional 40mcg T4 and 10mcg T3? And if so, is it worth adding T3 to this two-week period of abstinence from T4?
Please tell us about your experience of switching from T4 monotherapy to T3/T4 combination.

My mom is not feeling well and I'm afraid of hurting her even more by switching to combos, plus she's terribly afraid of losing her T4, despite my best attempts to explain to her that he is actually making her worse. .
I'm not sure if Cynoplus can be shipped to my country, but I have access to a Haidut lab that has T3, T3/T4 and NDT.
I'm also thinking of taking literally a couple of tests to track such as TSH, total T3 / T4 and cholesterol.

Thanks in advance for your answers.

 

[mostlylurking]

I gave her the maximum dose of 40mg. No effect. In the writings of Ray Peet on progesterone, I found information that sometimes a woman may not notice any effect even at a dose of 100 mg of progesterone, and in such cases, thyroid hormones and improved nutrition are required to normalize estrogen, prolactin and cortisol.

I agree that you need to also address thyroid hormones and nutrition. However, remember that initially when first taking progesterone it will push the estrogen out of the cells so the estrogen in circulation will get higher. The liver must detox the estrogen to get it out of the system. So liver health is important; a sick liver can't detox the estrogen out.

As for her diet, it is not ideal, but I tried my best to exclude poisons from her diet, such as oils (sunflower), etc.

If she has been eating PUFA (polyunsaturated fatty acids), it will be stored in her fat cells. It takes some years to get it gone. Taking a low dose of niacinamide (Peat suggested 90mg) can help lower the circulating free fatty acids. Niacinamide is water soluble so it doesn't stay in circulation very long, perhaps 2 hours, so taking the niacinamide every few hours might be helpful.
Article: Ray Peat, PhD Quotes on Therapeutic Effects of Niacinamide – Functional Performance Systems (FPS)

Which Cologen Peptides or Gelatin do you recommend? Heard a lot about Green Lakes, but as always there are problems with delivery to my country.
Is regular store-bought table gelatin safe and pure enough?

I like Great Lakes gelatin and hydrolyzed gelatin. There is no way to tell about the quality of the store-bought gelatin, but it might be fine for a short term solution.

When you talked about the high doses of progestin

Please remember that progestin and progesterone are two different things. "Progestin" is a synthetic that can have estrogenic qualities whereas "progesterone" is bio-identical to what the body makes.
I found these radio shows to be enormously helpful:

• Politics & Science: Progesterone Part 1
• Politics & Science: Progesterone Part 2
• Politics & Science: Progesterone Part 3

I think the first priority is to take it quickly and get the right dose of thyroid hormone.

Finding the right dose of thyroid hormone can be very tricky. It would be most helpful if you had a knowledgeable endocrinologist to help you. One way to locate one is to ask local pharmacists which doctors prescribe natural desiccated thyroid (contains both T3 and T4). Understanding the lab results is tricky because the lab tests aren't calibrated correctly.
Here's an article about it: Thyroid: Therapies, Confusion, and Fraud

Too much thyroid medication can interfere with thiamine function. Thiamine deficiency/functional blockage has many of the same symptoms as hypothyroidism. I can certainly see that if taking only T4 and no T3 that one could be taking too much (with no benefit) and mess up thiamine function.

Thyroid function and thiamine are tangled up together and deficiencies in either have similar symptoms.

Thiamine and Hashimoto's thyroiditis: a report of three cases - PubMed

As the administration of thiamine led to a partial or complete regression of the fatigue and related disorders, it is reasonable to infer that the administration of large quantities of thiamine restores thiamine-dependent processes. The mild thiamine deficiency suggested by fatigue and related...

pubmed.ncbi.nlm.nih.gov

also:

Effects of Thiamine on Thyroid Fatigue - ThyroMate

Thiamine is one of the eight B Vitamins otherwise known as the B-Complex Vitamins. Studies have shown that Thiamine can help combat fatigue resulting from an underactive thyroid.

www.thyromate.com

"Since it is vital in converting food into the body’s fuel, low levels of Thiamine can lead to the lack of energy which patients characterize as fatigue.

"Thiamine deficiency can also lead to the development of hypothyroidism, where fatigue is one of the many symptoms.

"Low levels of Thiamine impair the liver’s ability to detoxify estrogen, which can then suppress the thyroid gland and lead to hypothyroidism."

Is it necessary to abstain for 2 weeks without taking T4 and let it leave the body and only then add conditional 40mcg T4 and 10mcg T3? And if so, is it worth adding T3 to this two-week period of abstinence from T4?

Around 1999, I changed doctors and switched from taking a horse dose of Synthroid (T4) over to a lower dose of Armour desiccated thyroid (includes T3 and T4). There was no period of abstaining between the medications. However, blood tests were performed periodically (about every 2 months for a while) because it takes a period of time for the body to acclimate. It is normal to stair step up the dose of thyroid supplement until the body reaches a point of optimum function. This Broda Barnes book explains it.

Please tell us about your experience of switching from T4 monotherapy to T3/T4 combination.

When I made the stitch from Synthroid (T4) to prescription natural desiccated thyroid, I immediately felt better. I was under a doctor's care; blood tests were done about every 6-8 weeks while the new medication was slowly increased up to my optimum dose. This process took several months.

My mom is not feeling well and I'm afraid of hurting her even more by switching to combos, plus she's terribly afraid of losing her T4, despite my best attempts to explain to her that he is actually making her worse.

My personal experience showed to me that T4 alone is terrible stuff and natural desiccated thyroid (with the help of a doctor who knows what they're doing) is like night and day. That said, my personal experience also has taught me that thiamine function also plays a part because the thyroid needs it to do its job of making thyroid hormones. When my thyroid medication was too high it exacerbated my thiamine deficiency so my thyroid medication was lowered to help normalize my thiamine function. I also increased my thiamine supplement.

 

[Jennifer]

You’re welcome, @Siddha. I’m very sorry to learn your mom isn’t feeling well.

When you talked about the high doses of progest-e used by your mother and you vaginally, how many milligrams did you mean?
I think the first priority is to take it quickly and get the right dose of thyroid hormone.

When high dosing Progest-E, my mum took 400 mg a day orally. We used lower doses vaginally. In our experience, the absorption rate is higher when it’s applied to mucus membranes. When I had my mum increase her thyroid dose, her requirement for progesterone decreased significantly so I agree that getting the right dose of thyroid hormone is important and that it could be beneficial to seek the help of a knowledgeable endocrinologist, if your mom hasn’t done so already. It may also help alleviate her fears, as well as your own.

For gelatin, I use both Great Lakes and this brand in my cooking:

Perfect Bovine Gelatin - Collagen Protein Sourced Exclusively From Brazilian Pasture Raised (Grass Fed) Cows

Our Perfect Bovine Gelatin was made for YOU. It was not enough to provide you with the best All Natural, Non-GMO grass-fed, pasture raised source of collagen protein on the market, we also needed to make a product that was fairly traded, lab tested, and furthered our mission to be positive...

www.perfectsupplements.com

Perfect Hydrolyzed Collagen Unflavored - 100% Collagen Sourced From Brazilian Pasture Raised (Grass Fed) Cows

Perfect Hydrolyzed Collagen has such a low molecular weight that it is over 90% Bioavailable and instantly dissolves in any liquid - hot or cold.

www.perfectsupplements.com

 

[Siddha]

Hello @Jennifer @mostlylurking @CLASH
While I was studying Tyronen(T3), TyroMax(NDT), TyroMix (T3/T4) and other information from Peate and Broda, my mom is getting worse every day. She continues to take T4 and Mitrazapine, which does not work at all. I ordered 2 bottles of TyroMix and 2 bottles of Tyronen. But I confess I am confused. She is very sick and there is nothing I can do to help her. Starting to take T3 / T4 in this state is also difficult, she has a terrible appetite. Doing nothing will also lead to nothing.
Look at the package and ask her to take a couple of tests such as a complete blood count, total cholesterol, TSH, total t3 and t4, (free t3 t4?) something else?
Looking at the situation with a sober mind, what would you recommend?
Thanks a lot.

 

[Jennifer]

Hi @Siddha,

I’m very sorry your mom continues to get worse. Keep in mind that I’m not a doctor and don’t know your mom’s medical history beyond what you’ve shared with us so it’s best to work with a professional—I don’t want to give you advice that may worsen your mom’s condition. Would she be willing to monitor her temps and pulse? That will help her in establishing a proper thyroid dose and this will hopefully improve her appetite. I always knew when my mum’s appetite was poor that she needed to increase her thyroid dose, which reliably increased her appetite, so maybe the TyroMix will do the same for your mom?

I believe the safest thing would be for your mom to eat, as this would improve her thyroid function and stimulate her appetite—it’s common for our appetite to wane the less we eat—but this is obviously difficult unless you’re with her to make sure she’s eating. I lived with my mum so I was able to monitor her eating habits and see patterns. It has been a few years since we used TyroMix but if I recall correctly, it has a 2:1 ratio of T4/T3? If so, I would be cautious with using both TyroMix and Tyronene together as that may be too much T3. Maybe she could add some Tyronene to the T4 she is already taking? What has her doctor suggested?

 

[Siddha]

Hi @Siddha,

I’m very sorry your mom continues to get worse. Keep in mind that I’m not a doctor and don’t know your mom’s medical history beyond what you’ve shared with us so it’s best to work with a professional—I don’t want to give you advice that may worsen your mom’s condition. Would she be willing to monitor her temps and pulse? That will help her in establishing a proper thyroid dose and this will hopefully improve her appetite. I always knew when my mum’s appetite was poor that she needed to increase her thyroid dose, which reliably increased her appetite, so maybe the TyroMix will do the same for your mom?

I believe the safest thing would be for your mom to eat, as this would improve her thyroid function and stimulate her appetite—it’s common for our appetite to wane the less we eat—but this is obviously difficult unless you’re with her to make sure she’s eating. I lived with my mum so I was able to monitor her eating habits and see patterns. It has been a few years since we used TyroMix but if I recall correctly, it has a 2:1 ratio of T4/T3? If so, I would be cautious with using both TyroMix and Tyronene together as that may be too much T3. Maybe she could add some Tyronene to the T4 she is already taking? What has her doctor suggested?

I understand that you are not a doctor, and you are afraid of doing harm, all responsibility is on me. Multiple points of view are always better.
Yes, literally from tomorrow I will ask her to keep a diary of temperature and pulse.
I live with her now, and I watch and beg her to eat. She tries to eat as much as possible.
Yes TyroMix has T4/T3 2:1.
I ordered Tyronen and TyroMix because I read that both Haidut and Ray Peat said that it is better for a person with hypothyroidism to take not NDT with a ratio of 4:1 but 2:1, which is in Tyromix. Ray also says that for a person with severe hypo, only T3 during the day and T4 / T3 at night can be suitable.
This is the protocol I would like to try.
Her doctor can only raise or lower her T4 dose. There is no hope for him.
What do you think if you cancel T4?
Can it help in reducing anxiety?

 

[mostlylurking]

Hello @Jennifer @mostlylurking @CLASH
While I was studying Tyronen(T3), TyroMax(NDT), TyroMix (T3/T4) and other information from Peate and Broda, my mom is getting worse every day. She continues to take T4 and Mitrazapine, which does not work at all. I ordered 2 bottles of TyroMix and 2 bottles of Tyronen. But I confess I am confused. She is very sick and there is nothing I can do to help her. Starting to take T3 / T4 in this state is also difficult, she has a terrible appetite. Doing nothing will also lead to nothing.
Look at the package and ask her to take a couple of tests such as a complete blood count, total cholesterol, TSH, total t3 and t4, (free t3 t4?) something else?
Looking at the situation with a sober mind, what would you recommend?
Thanks a lot.

I searched for negative effects of Mitrazapine, some alarming side effects of Mitrazapine did show:
quote:

Drug and food interactions​

Moderate

mirtazapine​

food​

Applies to: mirtazapine
GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
-end-
Please note that the medication your mother is taking intended to affect her central nervous system. This is a really big red flag, at least to me.

Mirtazapine Uses, Dosage & Side Effects - Drugs.com

Mirtazapine (Remeron) is an antidepressant used to treat major depressive disorder. Includes mirtazapine side effects, interactions and indications.

www.drugs.com

"What is mirtazapine?​

"Mirtazapine is an antidepressant. The way this medication works is still not fully understood. It is thought to positively affect communication between nerve cells in the central nervous system and/or restore chemical balance in the brain.


"Mirtazapine is used to treat major depressive disorder in adults.


"It is not known if mirtazapine is safe and effective for use to treat MDD in children.

"Warnings​

"You should not take mirtazapine if you are also taking tryptophan (sometimes called L-tryptophan).

Do not use mirtazapine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, tranylcypromine and others." a note from Mostlylurking: this means that the medication mirtazapine affects the clearing of serotonin so there is a possibility of Serotonin Syndrome.

"Some people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using mirtazapine. Your family or other caregivers should also be alert to changes in your mood or symptoms.

"Do not give this medicine to anyone younger than 18 years old without the advice of a doctor. This medicine is not approved for use in children.

"It may take up to several weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve after 4 weeks of treatment.

"Drinking alcohol can increase certain side effects of mirtazapine.

"Mirtazapine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

"Do not stop taking this medicine abruptly. Talk to your doctor before stopping this medicine."

-end-

please consider the information in these articles:
Silent Death – Serotonin Syndrome- Hormones Matter (specifically names Mirtazapine)

Serotonin Syndrome and Thiamine: Is There a Connection? - Hormones Matter

A mild deficiency of thiamine is responsible for the large number of the polysymptomatic illnesses reported.

www.hormonesmatter.com

Please note that if someone has a thiamine deficiency (more common in older people) the tendency to be unable to clear serotonin in the brain is one of the side effects of the deficiency. Adding an SSRI, or MAO inhibitor to the picture could make things worse. The Mirtazapine warnings include this topic (but does NOT mention the issue with thiamine deficiency).

 

[Jennifer]

I understand that you are not a doctor, and you are afraid of doing harm, all responsibility is on me. Multiple points of view are always better.
Yes, literally from tomorrow I will ask her to keep a diary of temperature and pulse.
I live with her now, and I watch and beg her to eat. She tries to eat as much as possible.
Yes TyroMix has T4/T3 2:1.
I ordered Tyronen and TyroMix because I read that both Haidut and Ray Peat said that it is better for a person with hypothyroidism to take not NDT with a ratio of 4:1 but 2:1, which is in Tyromix. Ray also says that for a person with severe hypo, only T3 during the day and T4 / T3 at night can be suitable.
This is the protocol I would like to try.
Her doctor can only raise or lower her T4 dose. There is no hope for him.
What do you think if you cancel T4?
Can it help in reducing anxiety?

Oh, okay. That’s great that you live with her so you can help her monitor things. For foods that aren’t going to fill her up and make it difficult for her to get in enough calories, have you tried having her consume juices, gelatinous broth/bone broth and milk throughout the day? I had my mum drinking these, as well as natural sodas, when her appetite was suppressed.

Since your mom will be taking TyroMix, she will be getting T4 so unless she finds the 2:1 ratio to be too much for her—increasing symptoms of adrenaline such as a racing heart/heart palpitations, sweating and increased anxiety—I would think the extra T4 isn’t needed. My mom found the 2:1 ratio to be too much for her so she went back to a 4:1 ratio. If your mom finds that it has increased her anxiety, not relieved it, the ratio is likely too much for her, too.

 

[Siddha]

@mostlylurking Tomorrow I will ask her to go to the doctor who prescribed Mirtazapine and start smoothly stopping the drug. Also, if I understand correctly, urgently need to start taking thiamine (dose?).
Do I understand correctly that while she will stop Mirtazapine, it is better not to start the experiment with T3 / T4?
Given her anxiety, I just don't know how to get out of this vicious circle.

 

[mostlylurking]

Поправите

Спасибо вам огромное.
Если

Tomorrow I will ask her to go to the doctor who prescribed Mirtazapine and start smoothly stopping the drug. Also, if I understand correctly, urgently need to start taking thiamine (dose?).
Do I understand correctly that while she will stop Mirtazapine, it is better not to start the experiment with T3 / T4?
Given her anxiety, I just don't know how to get out of this vicious circle.

Thiamine supplementation might help. However, you have a lot of moving parts that interact with each other. Is there more than one doctor involved?

Although I have taken high dose thiamine hcl for two years with excellent results, I cannot tell you if it would help your mother. I'd like to suggest that you explore the possibility. Thiamine is known to improve/resolve depression by improving/normalizing brain energy.

Suggested reading/links:
HIGH-D0SE THIAMINE (HDT) THERAPY for Parkinson's Disease (read the info at Therapy, FAQs, About; watch the patient videos.)

Nutritional Brain Bomb: Thiamine Deficiency

Vitamin B1 is essential for proper brain energetics.

www.psychologytoday.com

Please note that many things can interfere with thiamine function besides alcohol; many pharmaceutical drugs do, along with thiaminase containing foods (including coffee and black tea). see this article:

Causes of thiamine deficiency

"As thiamine is involved in carbohydrate metabolism, the amount of thiamine required depends on caloric intake. The amount of thiamine needed also is dependent on the composition of the diet, with foods containing fats and proteins having a thiamine-sparing effect versus those dominant in carbohydrates.3 In fact, in healthcare settings, thiamine is concurrently administered in hypoglycemic patients receiving high dose glucose to ensure that ramifications associated with high carbohydrates and limited thiamine do not manifest, most notably Wernicke Encephalopathy."
-end-

There is now a sublingual form of thiamine available. It is discussed here. (link to buying it at bottom of article, very inexpensive). As people age, the ability of the small intestine to absorb thiamine diminishes. I'm 73 and I've recently been testing this type of thiamine out. The tablet is easy to break in half or into fourths, but it must be dissolved/absorbed under the tongue. If you have quick access to thiamine hcl, it would probably work too; take it with water only, never anything sweet. When I started taking thiamine hcl, I started with about 250-300mg, 2Xday, with water.

 

[Siddha]

@mostlylurking
I looked through toxinless.com for pure thiamine on lifegivingstore. There I will also order niacinamide and possibly gelatin. TyroMix(T4/T3) already ordered.

There is no hope for doctors, they are not doctors. The neurologist says that Mitrazapit should be continued, and the endocrinologist can only suggest increasing the dose of T4.
But unfortunately I don’t have enough knowledge to figure out how to get out of this situation.

How do you think you can build a strategy to get out of this situation?
If you are tired of me, I understand you.

 

[mostlylurking]

@mostlylurking
I looked through toxinless.com for pure thiamine on lifegivingstore. There I will also order niacinamide and possibly gelatin. TyroMix(T4/T3) already ordered.

There is no hope for doctors, they are not doctors. The neurologist says that Mitrazapit should be continued, and the endocrinologist can only suggest increasing the dose of T4.
But unfortunately I don’t have enough knowledge to figure out how to get out of this situation.

How do you think you can build a strategy to get out of this situation?
If you are tired of me, I understand you.

I am in agreement with you about the state of the medical industry.

The patient always has the option to stop following the doctors' directions.

The information that you need to become informed on the issues so that you can advise your mother is available on the internet. However, your mother is the patient so the power to follow or to decline the doctors' advice is held by her.

 

[Peatress]

If she decides to come off Mirtazapine do it really slowly.

Mirtazapine withdrawal timeline - help!

Hi, just wondering if anyone can give me some guidance of what to expect during withdrawal from Mirtazapine. &...

patient.info

 

[Siddha]

@Jennifer @mostlylurking @Peatress Thank you all very much