Study from holtorfmed.com/depression-s...
With an understanding of thyroid physiology and associated dysfunction that is present in depressed patients, it is clear that timed-released T3 supplementation should be considered in all depressed and bipolar patients despite “normal” serum thyroid levels. Additionally, straight T4 should be considered inappropriate and suboptimal therapy for replacement in such patients.
This has been posted before I think but is relevant to this thread :
Subject: When Thyroid Disease Masquerades As Psychiatric Disorder
Hi good psychiatrists have known this for years and test the thyroid but unfortunately not well known.
Jackie
The joke is that psychiatrists are allowed to prescribe T3 to augment anti-depressants but not for hypothyroidism. I think T3 was originally prescribed for depression/psychosis when it was first formulated.
Hi Stupid doctors! they also do prescribe T4.,have for years. However, not good on the record to be under psyches, definitely most docs do treat you differently. I have always considered it just any illness, but medics not so professional . A lot of people in top stressful occupations have to keep quiet. as it is held against them,
best wishes,
Jackie
I don't feel that I've been discriminated against because of bipolar. GP visits were for anti-depressants (not the best therapy for bipolar) and incontrovertible ailments like wonky smears, UTI etc. and I didn't see GP about thyroid until the lump presented and discussed all symptoms I'd kept to myself for a year.
She was excellent and I like to think would have drilled down the problem on symptoms alone without the lump and normal TSH. Shame she's moved on.
Endonobs have never suggested anything's 'in my head' either. Just the brick wall "we're happy with your thyroid" which I take to be endonob speak for TSH as I no longer have a thyroid
My bipolar is currently in remission and I stopped ADs in October so I have to try and be aware of recurrence. I do wonder whether T3+T4 combi might be of help there.
Hi Glad you are doing better. bipolar can be dreadful, although I think it is more understood now. It is the hospitals , especially when admitted for other things, that are so dreadful about any mental illness, as if you are mad.Seen this often. I had a lovely consultant, who this happened to you. he told me but would not tell any colleagues because of the predigest
Best wishes,
jackie.
NHS GPs get no additional funding for prescribing t3/t4 but they DO for prescribing anti-depressants. It is financially beneficial for them to put yuou down as a mental patient. See how it works?
Yes. I have an appointment to see my MP on Friday. This is one of the pieces of evidence I will be presenting him with.
Good luck and do keep us updated!
This might be of interest too nahypothyroidism.org/deiodi...
Some of us were mental patients prior to becoming hypothyroid but that doesn't seem to make any difference. Psychiatrists tend to brain and endos to glands and never the twain shall overlap, despite the study suggesting T3 is beneficial and T4 monotherapy inappropriate. 
Ok. Is it daft to think that this gives us a glimmer of hope for a way forward. That study also states " timed-released T3 is significantly more beneficial than T4 or T4/T3 combination supplementation"
Should all those thyroid patients who do better on NDT or T3 make a BIG THING (apologies for capitals) of how depressed they are and how these therapies have proved more effective.
Do you see what this could, potentially, do? Get appropriate treatment for patients AND allow GPs to claim the maximum funding for diagnosing these patients as depressed?
Too obvious, or too daft, too work I guess.
Until there is a more holistic crossover and NHS purchasing of T3 improves I fear not. I remain convinced that the primary objection to T3 prescribing is cost based.
Don't forget, the study is based on undiagonised hypothyroidism in depressed patients. Just an excuse for more studies I imagine. Royal College of Psychiatrists will need to tackle Royal College of Physicians, how long will that take?
Am I the only one who did not feel very well on T3, I had read the enthusiasm and persuaded my Doctor to refer me to an Endo, who in due course agreed a trial of T3, sadly it did not agree with me, I did not feel right at all. I have now resorted back to my original T4 dosage only and feel better once again. My primary aim was to reduce my joint/muscle pains but sadly could not continue with the T3 to find out if that would have helped. I do not feel ill but I am back to square one with my diagnosis of fibromyalgia and cervical spondylitis. Needless to say after all the hype I felt disappointed.
Yes I was on a trial of 100 T4 and 10 T3
Maybe 75mcg T4 + 20mcg T3 worth a go? Split T3 twice daily until you're sure you can tolerate it. I took 100mcg T4 + 25mcg T3 in one dose at night.
Maybe, we need a list of shrinks who would be willing to prescribe T3/T4 then?
Obviously, this will help many seriously depressed patients without going through ECT etc. I personally think many psychotropic medications are hazardous and unrecommended if I'm honest.
I have read that psychiatrists (in UK) need to prescribe a number of antidepressants before concluding the patient has a form of drug resistant depression before T3 can be prescribed. This doesn't fit the recommendations of the article, of course, because it is for treating depression in undiagnosed hypothyroid px.
Luckily, I've never been prescribed anti-psychotics or anti-convulsantants to manage my bipolar, although I took mood stabilisers, tranqs and ADs for years. I probably wasn't sick enough,for which I'm profoundly grateful.
My GP doled out anti-depressants for over 20 years, and despite my fatigue complaints, never mentioned T3, or let me know I was diagnosed sub-clinical hypothyroid.
I had a very bad crash after a manic episode on an afternoon my GP practice was closed. My mother found a private doctor who ran a battery of tests, sedated me and referred me to a psychiatrist.
The family GP had been useless, advising me to consider what was making me so unhappy. Not the most useful thing to say to someone who loved her job, had no money or other worries but wanted to die
Hi Clutter, Most GP's seem to be quite useless, even missing serious illnesses like cancer for years, by not recognising typical symptoms. Could you let me know what dosage of T3 and T4 / NDT you take please?
Even with patients on T4 supposedly "properly treated", quality of life falls with increasing TSHIn treated patients Free T3 does correlate with quality of life
Clinical Significance of TSH Circadian Variability in Patients with HypothyroidismEvaluation of serum vitamin B12 levels and its correlation with anti-thyroperoxidase antibody in patients with autoimmune thyroid disorders
NICE - patients should be more 'pushy'
