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Do EFFEXOR and ELTROXIN enough for major DEPRESSION?

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I am 47 yr old female. In 1999 had hysterectomy and removal of overies due to cervical cancer I have. been on Premarin 1.25mg since. The last year I have suffered with major depression and have been off work currently on Effexor 150mg. Within the last year I have also gained 30 lbs and thought it was due to the depression medication. Just had blood work for first time in a year and HST was 4.88. Just been placed on Eltroxin .50mg.
I have been told that premarin effects thyroid.
What level of TSH would I be at?
After a week of taking Eltroxin i have noticed incresed in energy. Please help as the last year with major depression has been worse than when I had cervical cancer.
PS. I never had chemo..

Are the doses correct, what can you sugguest to help me.

Category: Endocrinologist

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Dr. J Muthukrishnan
Category: Diabetologist
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 26 Doctors Online

Expert:  Dr. J Muthukrishnan
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Hello.
Thank you for your query at DoctorSpring.com.
I understand your concern.
TSH of 4.88 isn't way off-target or abnormal. However, due to your symptoms, you have been started on a low dose of thyroxine. Your dose of 50 mcg is fine, as long as it is helping you.
You need to control on diet and exercise regularly to lose weight as thyroid does not seem to explain your weight gain. You need to repeat TSH after 6-8 weeks of starting Thyroxine. If the TSH is in the range of 0.4-2.5, then continue the same dose. If not, the dose has to be adjusted based on the value. Repeat TSH will suggest if your dose is right.
Regarding conjugated estrogens and Thyroid, women on thyroid replacement therapy may require higher doses of thyroid hormone while receiving estrogens. There is no effect on thyroid as such.
I hope this was helpful. Let me know if you have any queries.
Thank you.

Dr. J Muthukrishnan
Category: Diabetologist
Experience: 
Fellowships/Training: 
1. 10th Asia-Pacific Pediatric Endocrine Society  Fellows meeting, Seoul, Korea, Oct 2008
2. Eighth ICMR Course on Genetics and Genetic Counseling – Jul 2008 – SGPGI, Lucknow
3. Annual Certificate Course on Endocrinological Laboratory Techniques at National Institute of Nutrition (ICMR) Hyderabad,India, ( Aug-Sep 2006) 
Fellowship: Endocrinology, Diplomate of National Board, National Academy of Medical Sciences, New Delhi, 2008, Medwin Hospital, Hyderabad
Senior Residency: Diplomate of National Board (General Medicine), National Academy of Medical Sciences, New Delhi, 2002
Residency: MD, General Medicine, 1997-2000, Armed Forces Medical College, 2nd position in University
Medical School: MBBS, Armed Forces Medical College, 1992
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