Fatigue, Depression & ADHD: Hi All, I was... - Thyroid UK

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Fatigue, Depression & ADHD

NowYouKnow profile image
36 Replies

Hi All,

I was diagnosed with Hashimotos (hypothyroid) about three months ago. I began taking Liothyronine at 10mcg/day but it did cause some anxiety so have since cut down to 5mcg/day.

I was really hoping that regulating the thyroid would help with my debilitating fatigue, which I think is caused by a combo of anxiety, depression, ADHD.

I wake up every day feeling pretty good, ready to tackle the day. I have a little coffee, a really healthy breakfast (I don’t eat any flour or sugar). And then about an hour later, I am so tired. Sometimes I feel anxiety when I think about the things I have to do. However those tasks feel more overwhelming than they actually are.

Often I feel a mixed state of being anxious but also physically drained.

My life is busy, yes, but not busy enough to warrant this stupid fatigue. It is overwhelming.

Right now I take Lamotrigine for episodic mood disorder (bipolar) and that has leveled me out which is good. And I take lyrica for fibro because my body hurts. However i suspect the aches may he caused by the hypothyroidism.

I have been prescribed stimulants for ADHD, which give me focus and energy for a couple hours and then stop working really quickly. That’s like a roller coaster which I don’t like.

So, my question to you all is ~ when you manage your hypothyroidism, does your energy increase, are you more motivated?

Mostly I just want to hide and stay in bed because life is overwhelming to me. And I have a really good life, so whatever is happening is way out of proportion to my situation.

Anyone experienced this and found a way out? I want to have some joy and energy for life.

PS. I exercise 3-4 times a week, eat super healthy, have been sober for 8 years, am a Christian with a really great community, and have good friends and family. There is just no rational reason I should feel this way :/

Thanks all

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NowYouKnow
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36 Replies
NowYouKnow profile image
NowYouKnow

Just added the results 😊

NowYouKnow profile image
NowYouKnow

T3 Reverse = 16 (ref range 8-25)

T4, Free = 1.1 (ref range 0.8-1.8)

TSH = 1.57 (ref range .40-4.50)

T3, Free = 2.8 (ref range 2.3-4.2)

Vitamin D = 40 (ref range not established)

greygoose profile image
greygoose

Why did you start on T3, and not levo?

NowYouKnow profile image
NowYouKnow in reply togreygoose

It’s what the doctor prescribed. I have another post in this forum where there was some discussion on which med I should have started. I don’t know how to link to it, but it’s my only other post in this forum.

greygoose profile image
greygoose in reply toNowYouKnow

OK, so just read your other post and the consensus was that you should have been started on levo, not T3. And I agree. That could be part of your problem, the T3 is too much too soon for you. Have you spoken to your doctor about going onto levo since then? I think you should. You should at least try. You need an increase in dose, but it would not be wise to increase the T3 at this point, given the reaction you had to 10 mcg before. :)

greygoose profile image
greygoose in reply togreygoose

To find your other post, just click on your username, and it will take you to your profile:

healthunlocked.com/user/now...

All your posts are listed there. :)

NowYouKnow profile image
NowYouKnow in reply togreygoose

Thank you. Do you think the levo would help with the fatigue, etc? That’s really the part that is making everything so difficult. I mean, even small tasks are daunting.

greygoose profile image
greygoose in reply toNowYouKnow

Once you get on the right dose, yes, it should help with the fatigue. But, you should have your nutrients tested: vit D, vit B12, folate, ferritin. Low nutrients can also cause fatigue.

NowYouKnow profile image
NowYouKnow in reply togreygoose

D was ok, not sure about B12, folate, ferritin

greygoose profile image
greygoose in reply toNowYouKnow

Very important to get them tested. And, just OK probably isn't good enough. You need optimal. :)

NowYouKnow profile image
NowYouKnow in reply togreygoose

Vitamin D 25-OH Total was at 40 (ref range 30-100)

Is that low?

greygoose profile image
greygoose in reply toNowYouKnow

Yes, that is low.

Marz profile image
Marz

I have a feeling the drugs you are taking could be affecting your thyroid meds as your T3 level is quite low in range. Your ferritin - B12 - Folate are better at optimal levels to help your thyroid meds work better. ...

Greekchick profile image
Greekchick

I looked up drug interactions for you for the drugs you list. For your Lamictal and Lyrica, there is no interaction. I don’t know what you are taking for ADHD, so I can’t advise on that.

One thing you should know about Synthroid and Cytomel - Synthroid (T4) accumulates in your body’s tissues, so the effect takes longer to show but lasts much longer. Cytomel (T3) is a shorter acting medication which is usually used to supplement the T4 because some people do not convert the T4 to T3 naturally. It acts more quickly and effects can be seen sooner.

I agree with Greygoose and others - you should have been started on Synthroid and then Cytomel added. Many people do well on Synthroid alone - and others need additional help. You might actually do well with a trial of Synthroid alone first and then see if you need Cytomel after. Speak to your doctor. Dosing for all thyroid conditions is a trial and error business and it will take some time before you find the right “cocktail” that balances your condition. I’m not there yet myself but getting closer.

By the way, I had back issues that I thought were from surgery 20 years ago - not so - it was from my Graves’ (hyperthyroid) disease! Most of my pain went away when my thyroid was removed -3 weeks ago and my medication was adjusted. You may find the same when you are on the right medication.

I hope you will feel better soon. Sending you best wishes and positive thoughts. Good luck!

NowYouKnow profile image
NowYouKnow in reply toGreekchick

Thank you for the response. I’m not taking anything for the ADHD, the stimulants work for a very short time and then I am left with a ton of residual anxiety. I wish my body processed them differently.

My doctor said my problem was that I was not converting T4 into T3 so that’s why he used Cytomel.

So glad your pain is gone, that’s awesome!!

Greekchick profile image
Greekchick in reply toNowYouKnow

Thank you so much for your good wishes! I just started on Cytomel and feel like a different person - my energy is coming back and I hope yours will too once you get the right dose (FYI I am on 2.5 of Cytomel once a day and it was enough to induce significant improvement) . Everyone is different. All the best!

Borja profile image
Borja

I am a Christian and I am the same bar fibro.

JuliaWM profile image
JuliaWM

That is a really low dose. they start you low and increase. They may get you up to 150-200 a day.are you sure the anxiety isn't about the whole condition/ My superviror at oxford just did a telly programme about placebos with dr michael Mosely. just knowing you are taking anything at all can have big effect on your brain. personally I doubt if it will do anything at all until it is up far nearer the levels i say. then not for everyone as some ned T3 too. You are just still feeling ill because of the Hashimotos.At that dose it can't possibly make you better yet. they have to start low and increase. try to relax. lean to meditate or something. when you thyroid levels are up to real therapeutic levels you will feel a whole letter better.at the moment you just have anxiety at finding you have a medical condition. I have had it for 60 years and am still carrying on. slower than other people, not always feeling well, but I have had a full life. For instance, I have been a part time psychotherapist. Now I do part time medical research at Oxford.think what you would really like to do. Then think "I am the tortoise, not the hare, but I will get there".

JuliaWM profile image
JuliaWM in reply toJuliaWM

sorry. My typing is terrible. My supervisor at Oxford, you may need much more and you may in the end need T3 too. learn to meditate or something. don't worry. You will be ok and you are lucky, it is highly unlikely if you take your meds that your life will be any shorter than that of others. just appreciate that you may have to go at a bit of a slower pace. But there is nothing you can't do (well maybe not Olympic athlete.) Go for what you really want, but appreciate you may take longer getting there.

FancyPants54 profile image
FancyPants54 in reply toJuliaWM

He is talking about T3! He is taking T3. I think you think he’s on Levothyroxine. He isn’t.

NowYouKnow profile image
NowYouKnow in reply toJuliaWM

Really? I thought 5-10 was a relatively normal dose. I backed it down because I thought it was causing anxiety.

I have anxiety in general. I’ve been using a meditation program which I am hoping will help. I am also working on cutting back on caffeine, I’m sure that doesn’t help.

JuliaWM profile image
JuliaWM in reply toNowYouKnow

yes. Someone has pointed out I was not reading carefully and mad e an idiot intervention . I take T3 and T4 and I still get tired and achive less. But my brain can't be that bad, I am doing medical research at Oxford. Just super slowly.

JuliaWM profile image
JuliaWM in reply toJuliaWM

oops. I didn't read it carefully enough. as someone pointed out he is talking about T3. How stupid of me I was skimming too fast. Same applies to life with thyroid disease. I have both (T3 and T4), and I still achieve more slowly than others. sorry about the other idiot intervention though.

HowNowWhatNow profile image
HowNowWhatNow

Hello Now You Know, what you are going through doesn’t sound fun at all.

In answer to your question, I don’t feel like the same person I was before my Hashimoto’s diagnosis, no. (In terms of treatment, i am on a high dose of thyroxine, which started low.) My thought patterns feel much more jumbled up, my short term memory is woeful and my blood circulation is very poor, so I am always cold.

I feel better than I was physically before I was initially diagnosed. But the mental symptoms are much harder to negotiate with or treat. I became hypo after having my first child and haven’t been back to work since, partly because I don’t feel I am up to the kind of work (law) I did before. And not being the same intelligent (with hindsight I can say this!) person anymore sends out ripples into my social life. I find social events harder to handle and prefer one on one conversations. I am not the person I used to be, and that stings.

I hope I am the exception on this message board, and not the norm - who can say?

It’s not all doom and gloom - I feel much better in the summer months and I suspect that moving to / spending more time in a warmer climate would really help me. Like you, I remain hopeful that I will find my equilibrium again too. It sounds like you have some good doctors on the case.

I also wonder whether monitoring my blood sugar levels would help me because I feel a huge crash of energy after mealtimes, not just breakfast, whatever I eat.

A few questions:

When in the day do you take your thyroid meds?

Are you happy with the ADHD diagnosis? And are you happier on the stimulants than you were before taking them? And if happier, are you happier because more like yourself or happier because it’s easier to be productive?

Do you have any physical symptoms of hypothyroidism, besides pain?

NowYouKnow profile image
NowYouKnow in reply toHowNowWhatNow

I totally relate to what you say here. I wasn’t the same after getting mono when I was 16. That did something to me that I never fully recovered from.

I take the Liothyronine first thing in the morning and then try to wait 30 min before having coffee.

I don’t take anything for ADHD, stimulants work for a short time and then I’m left with massive anxiety. It’s like my body processes them super fast.

I have fatigue, super cold all the time, pain, depression, etc

MaireB profile image
MaireB

For me I found that walking made me feel better. Gym only made me worse! I fill my plate with lots of veg before I put anything else on at dinner time. I still love my G&Ts but keep them to a minimum on a night out. I found depriving myself did not work as I was always tired. I try not to fight the tiredness so take naps if I need to - and when possible! Magnesium works well for me !

HowNowWhatNow profile image
HowNowWhatNow in reply toMaireB

Hi Maire B, how much magnesium do you take? And which brand do you recommend?

MaireB profile image
MaireB in reply toHowNowWhatNow

I buy Mag365 from Nourish. I only use less than a teaspoon in water. Seems to give me energy

jjyankee profile image
jjyankee in reply toMaireB

Walking is the most helpful to me too but I can’t walk as far or fast as I used to- but being out in the sun and fresh air in a pretty place also lifts my mood, and calms my mind ( along with giving the body some exercise) .

MaireB profile image
MaireB in reply tojjyankee

But we don’t need to move fast! I found that moving slowly and not pushing my body helps me enormously. Took me years to cop on! I was always fighting this condition. Waste of time! Taking it as easy as one can works better for me!

jjyankee profile image
jjyankee

I also have ADHD and depression - I used to take a low dose of adderall for the ADHD but after some research I learned that stimulants are really bad for thyroid so I stopped- also the combo of a stimulant with the T3 (which is stimulating) could definitely make one very anxious- not a good combo in my book.

I also take lamictal and had to lower dose because that also caused anxiety - not a problem at current dose (75mg).

I totally agree with others- to start you on just t3 is crazy. You should start on T4 and add t3 later if needed.

And- at 40 your Vitamin D has is not deficient but not optimal- mine is 40 and I take 50000-70000 iu’s of Vit D a day. ( I started at 25 so it’s gradually going up) .

This is a tricky illness to deal with - just keep reading and researching- at this point I honestly feel much more informed than my doctors ( as so many on this site are) . Hang in there!

soupybp profile image
soupybp

I have read your previous post/replies as well as this post and replies. I am newer to the thyroid front but my husband and his family have had multiple people with bipolar disorder for a very long time.

There is definitely good evidence for hypothyroidism, especially autoimmune type, to be misdiagnosed as bipolar. Something that stands out to me is that you say that you are able to take stimulants for your ADHD, it seems without issue. ADHD medications can be highly destabilizing for bipolar sufferers. In your previous post, you mention taking Welbutrin - can help with bipolar, but it tends to keep people on an edge of hypomania which can feel pretty good at times - but in the long term tends to cause most everyone issues eventually.

There are some psychiatrists that are having very good success in treating bipolar with high dose T3 alone or in combination with T4. A very good read is The Art and Science of Thyroid Supplementation for the Treatment of Bipolar Depression by Dr. Tammas Kelly. He talks about how the working theory is that many instances of bipolar disorder may actually be a cellular level resistance to thyroid hormone that requires high level flooding with T3 to overcome. He also includes a comprehensive guide for other doctors to use when treating bipolar patients with thyroid hormone - so even if not going the high T3 approach, there are good pearls of wisdom to keep mood stable. It is written by a doctor for doctors, so even if it is beyond your understanding, your doctor(s) might be willing to give it a read.

When I look at your T3 level, I know how I felt at that level (which was recently) vs how I feel now with it increased even only slightly...it is definitely worth trying medication to see if you can gain improvements. That said, you may want to try T4, a T4/T3 combo, or even NDT (natural dessicated thyroid). Once you get levels up further, additional T3 may be better tolerated. Definitely need to get your vitamin D level up further.

As an aside, my husband found that lamotrigine was not enough...it smoothed out the ups and downs but didn't bring the overall mood level up enough (which is probably why your doctor had you trying Welbutrin). Hubby found the combo of lamotrigine and Latuda to be almost miraculous for him. Latuda is expensive, but they do have discount/assistance cards available. I would suggest going the thyroid route first, but keep this idea in your back pocket.

Marz profile image
Marz

Wondering how your gut is ?

NowYouKnow profile image
NowYouKnow in reply toMarz

I honestly have no idea.

Marz profile image
Marz in reply toNowYouKnow

Oh Dear ! All the latest buzz is all about the gut microbiome and its health and how it affects the brain too ...

NowYouKnow profile image
NowYouKnow in reply toMarz

Yeah I’ve heard about it but know very littt

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