AboutAlan Auerbach Expertise Taught psychology for 30 years, authored four textbooks. Specialize in introductory and industrial/organizational psychology, but will tackle wider range of areas.
I'm a 32 year old female. I was diagnosed with inattentive type ADHD this spring after bringing up my memory problems to my doctor. She thought I might have ADHD and suggested I get evaluated, which I did. I started on Adderall (20 mg) in June and am currently taking 60mg. I have all six of the inattentive-type symptoms.
I recently noticed in my medical records that (ironically enough, on the same spring doctor visit) I was given a routine TSH test and that the result was 5.91. I asked my doctor about it, and she said that it's not necessary to do any further follow up unless it gets above 10; although they'll test each year to keep an eye on it.
Well, I've always had sort of low blood pressure (ranging from 90/60 to my record high of 118/90; norm is 90/70) and frequently feel lightheaded if I get up too quickly. Lately it has gotten *severe* - to the point where I have to stop and hold on to the wall and everything starts to get dark. After about 10-15 seconds I can stand again, but feel tired/groggy for another minute or so. I have small kids, and am frequently squatting down to help zip up jackets, pick up toys etc. and it has become a miserable experience.
So I looked into it and started reading about orthostatic hypotension and that it's sometimes related to hypothyroidism. Then I read up on hypothyroidism and nearly fell off my chair when I read that symptoms include impaired memory and impaired cognitive function (brain fog). I've often compared my ADHD symptoms to being in a fog.
I also have or have had these symptoms:
- migraines
- increased sensitivity to heat and cold
- hair loss, especially thinning of the outer third of the eyebrows
- depression
- fatigue
- anxiety
- shortness of breath with shallow & slow respiratory pattern
- abnormal menstrual cycles
Thinning of the outer third of the eyebrows?! That happened to me sort of suddenly when I was a teenager and never went away. Around the same time I had three day-long migraine headaches in the space of about a year (none since). At the time, I lived in Kuwait. I'm not sure whether my diet was deficient in iodine at the time, but it certainly may have been – and I understand that iodine deficiency, common in developing countries, is a cause of hypothyroidism.
I am definitely abnormally sensitive to heat and cold. My hands are freezing when everyone else is normal. I have a space heater in my office, and everyone else remarks on how I keep it like a sauna - but I get so cold I can't think. But when it's warm, I *have* to keep my feet cool. I have to stand barefoot on a cold floor, moving my feet every 1/2 minute or so to a cooler spot. I stick my feet out from under the covers all night to keep them cool.
Abnormal menstrual cycles - they change all the time. Six weeks apart, three weeks apart, a week earlier than expected, extremely light one month and very heavy the next.
I've had these symptoms since I lived in Kuwait. During my testing for ADHD, I saw a social worker and two psychiatrists. All three diagnosed me with ADHD, the 2 psychiatrists basically by reading the list of ADHD symptoms out of the DSM IV. The social worker did a more thorough (sort of) review of my background. My mother is deceased and my father is on the other side of the planet, and I have no early school records - so the question of whether this existed prior to 7 years of age is based on my vague memory of "possibly, but I really don't remember."
I've had a few bouts of depression and anxiety over the past month or so, but I think they're stress related.
I understand that there may be some connection between ADHD and hypothyroidism - one causes the other, or they sometimes/often occur together, or one is mistaken for the other.
I'm frustrated that my regular doctor didn't notice this when she suggested ADHD and then saw the TSH results one day later. My regular doctor and my current psychiatrist are both part of the same health care system, and can see all of my labs/tests etc.
I'm also upset that none of the mental health professionals I've spent my time and money on asked me a single question about my physical health. He did ask me if I ever feel depressed. Well, really, I have no idea. If I want to figure out whether I’ve ever felt depressed, I’d have to go look up the symptoms - which I’ve done recently, but hadn’t beforehand. I told him no, because I had no idea whether I had and he didn’t explain. I think I probably have.
I don't want to continue to be on an addictive stimulant that sort of helps but has irritating side effects if I don't have ADHD at all. Is this worth pursuing? What is the most reliable, accurate, respected source that I can go to for the most recent research on this subject?
I’m an attorney, mother of a preschooler and 1st grader, and my husband travels regularly. He was also recently diagnosed with diabetes. I’m overstressed and too tired – I cannot seem to make myself go to sleep at a decent time (even now it’s 12:30am) – and I just need to know for sure what exactly is going on.
Thanks -
Abigail
Answer Abigail, someone read your query to us and wants to conact you. I just now told her that if she wanted to give me her email address and the reason, I'd pass them on to you, and it would be up to you. Just to let you know. Alan
Abigail, as neither a physician nor a clinical psychologist, I should take the "SORRY, THIS IS NOT MY FIELD" response option, but you put so much effort and skill into wording your query that I'll provide the little I can. The following paragraphs will seem more disjointed than your inquiry, being my disorganized thoughts.
Not every symptom or combination of them have an explanation or a cure. Multiple symptoms might be related, partly related, or unconnected. So the wish to know for sure exactly ... is sometimes futile.
Though migraines are understood physiologically, we don't know why they happen, and it could be some odd combination of a stress-senstitive personality and the barometric pressure! Most professionals with child-related stress and fatigue get relief by hiring the right kind of help. Depression is always asked about because it's so common (and generally easily treated). I'd immediately ask for a referral to an endocrinologist.
Stimulants have become pretty standard for ADHD, but in your case they could interfere with sleep. There are various approaches to psychopharmaceuticals, and the best person to assess their efficacy is you, after consulting with a clinical (or any) pharmacist about dose ranges and interactions.
Extremity coldness could just be related to your hypotension and/or medications. Everyone experiences stress and anxiety on occasion, and you don't have to worry about their effects on your BP. Some people, especially slight ones, do seem to constitutionally have a temp comfort range of half a degree.
You could contact one of the many excellent holistically-oriented (and I don't use that word in the "new-age medicine" sense) clinics to see if they feel their personnel have the expertise to diagnose and treat you. You can continue to search the net, but it's often hard to differentiate the solid from the quackery. The WebMD site is authoritative, as are those run by reputable universities. Mental health workers are sometimes reluctant to ask about areas that may be seen as intruding into other specialties. Did nobody suggest a mild exercise or physical conditioning regimen?
Hope some of the above will be of some use to you; sorry I'm not in a position to be more definitive. Good luck with finding the right help for this, and thanks for asking us.
