Mental health or thyroid issues?

[lauracp]

Hi all - apologies for the length but I hope you can help.

I was diagnosed in August 2013 with an underactive thyroid following the birth of my son. I had put on 4 stone in my pregnancy that I just couldn't shift no matter what I did and was incredibly anxious/down and lethargic with a lot of head fuzz and hair loss. I also have a long history of general anxiety disorder and have had depression in the past (10 years ago), but haven't suffered from depression recently until my underactive thyroid diagnosis (the anxiety is ongoing).

I was put on 50mg levithyroxine and pushed for a higher dosage as I didn't feel any better after 3 months on the medication. I'm now on 100mg and have been advised by my GP surgery that I'm 'within normal range' but still don't feel right (I'm not sure I even remember what right actually feels like!).

My current symptoms are inability to lose weight, hair loss, low moods, brain fog, high levels of stress/anxiety, quick to anger, constipation and lethargy (I fall asleep on the sofa nearly every night at around 8pm)

I've been back a number of times complaining about lethargy and low moods and not being able to lose weight but the various GPs have all blamed it on my history of anxiety/depression and one GP even told me that I couldn't lose weight because my body "had changed" following the birth of my son and that I was "blaming my thyroid". Her advice to me was to accept my weight gain and quit my job and become a stay at home mother and I'd feel better. She also accused me of 'eating takeaways' due to being tired because of my job/commute/being a mum which is why I couldn't lose weight(!!!!)

Following this appointment back in April, I went on a strictly calorie controlled diet (1200 calories a day) and I've managed to lose 8lbs in 3 months but the weight loss seems to have reached a plateau. I asked for another blood test as my partner and I want to try for another baby - this was done last week and was for TSH, Iron and vitamin D as I was deficient in these in 2013.

Serum TSH Level - 0.99 miu/L (0.38 - 5.5)

Serum vitamin D level - 65.3 nmol/L (>50 nmol/L may be adequate)

Iron Profile 12 umol/L (9.0 - 30.0)

Transferrin saturation index 19% (15.0 - 50.0)

Serum ferritin level 45 ng/mL (22.0 - 322.0)

Yesterday I had a follow up appointment with the one GP at my surgery who I actually think is good and she told me that I was at the low end of the normal range for my TSH and my Iron/Vit D looked fine so wouldn't look to do any further testing due to this despite me explaining my symptoms. I raised the question of taking T3 and/or a referral to an Endo but she said that because my TSH was fine that she wouldn't look to do this. I was also told she'd never heard of T3. I tried to explain to her about the research I'd done and the things I'd been reading about from the various charities/support and this website, but she seemed pretty skeptical and basically told me that I'd have to go private if I wanted more help or more tests. She did promise however to speak to the surgery partners about T3 and would let me know.

I didn't have much hope of hearing back from her but had a call this morning and they're testing my T3 and T4 levels for me and I'll find out tomorrow about those results.

If they come back 'within normal range again' should I go for a private blood test? I really don't think it's mental health issues that are causing these symptoms but my GP surgery thinks I'm in denial. I'm happy to be proven wrong, but I'd rather not take medication that will make my brain even foggier and tried than I feel now.

PS. In addition to the levithyroxine am taking Iron, Vitamin D3, B12, Selenium, Folic Acid and Cod Liver Oil supplements.

[rosetrees]

The most important of all those tests is the FT3 test. So post back when you get the next set of results. Your iron and ferritin are too low, so it's good that you are supplementing. Have they raised at all? If not, you might consider taking more iron to boost your levels even more.

The GP who accused you of eating takeaways and told you to accept your weight gain is worthy of a formal complaint, but I can understand that you probably wouldn't want to do this if other doctors at the practice are more helpful.

[yenool in reply to rosetrees]

I wouldn't recommend complaining about anything within the NHS. I know from personal experience (x3) that it doesn't get you anywhere. They will just cover their arse and offer a pathetic insincere apology without actually acknowledging they did anything wrong.

[lauracp in reply to yenool]

It was several months ago now so I think my opportunity to complain has passed by. But I definitely won't be cowed into agreeing any more. I knew in the session that was she was saying was wrong, but I think the belief that Drs are more knowledgeable than us is so engrained I didn't feel at the time I could actually challenge back.

Now because of this group I don't have to agree with what they say and that I know my body/symptoms and what feels right for me.

[shaws Administrator]

Hi Laura

I am sorry you are still unwell. The first thing is we have to dismiss the phrase 'normal' because what's normal for me may not be for you. Many doctors only go by the blood tests but ignore our clinical symptoms which should really be the priority. It will be interesting to know your T4 and T3 levels and when you post put the ranges too as it makes it easier to comment.

It's good you are supplementing because Vit D3 should not be lower than 70.

Levothyroxine doesn't suit many patients as they have continuing symptoms and never feel well.

Let's see what their decision is re adding T3 to your T4 as we have an article by Dr Toft of the British Thyroid Association who says that some of us need a suppressed TSH or the addition of 10mcg of t3 for a reduced 50mcg levo.

So many people have been diagnosed with mental health issues because their TSH doesn't fall within a range and they have so many clinical symptoms which are ignored (or doctors don't know them).

[cazz]

Hi i am hypo and struggled with my weight tried all sorts of mad diets but in jan this year joined slimming world with my daughter as she wanted to loose baby weight they were very understanding of my condition and although my weight came off a lot slower than other peoples the group were very supportive and i am 2lb of my target weight which is my pre hypo weight 2stone 3lbs off and they help you to maintain your weight loss

[lauracp in reply to cazz]

Hi Cazz, I did slimmingworld before I was diagnosed and it worked really well for me. Since my diagnosis I've tried 3 different groups and extra easy and red days only but it didn't seem to be working any more. It might be worth looking at again now that my thyroid levels have stabilised. Thanks for the reply.

[eeng]

Ironically they may prescribe you T3 to help with the depression rather than for the hypothyroidism!

[lauracp]

Thank you so much for all of your supportive replies. I had to have two blood tests last week as the first one they just tested the TSH level again. Here are the results:

Serum TSH level - 1.27 (0.38 - 5.5)

Serum Free T4 level - 14.0 (10.0 - 18.7)

Serum Free Triiodothytonine Level 4.1 (3.5 - 6.5)

Can anyone help me decipher these? On first look everything seems fine which leaves me at a loss. I'm starting to wonder whether it is all in my head But then I don't understand why I can't seem to lose weight.

Can anyone advise on next steps? Should I be looking to do some private testing for my adrenals for example?

Any help you can give would be greatly appreciated.