Hi, I have had low mood symptoms for two years and fatigue since March 2015. My results show low T4 and low end TSH. Endos refuse to treat?

Hi, I am brand new to this and quite desperate for help!

I have had low mood, depression on and off for two years and fatigue since March this year.

Because in the past I had post natal depression after my baby in 2011, I feel like the GPs and endocrinologists all think I am imagining a thyroid problem but I am sure something is not right.

I have kept a mood diary throughout all of this.

I used to be full of energy and life and happy and now I feel miserable. They keep saying it is depression but I know that something else is causing it!

My bloods keep showing low T4 and low end of normal TSH.

The endocrinologist said that as my periods are regular and I am not overweight, that this is not hypothyroidism..

However, the private GENOVA tests I did - say I am in a hypothyroidism state.

I also feel cold often and sometimes have aches.

I do not have antibodies but I have read about pitutary problems?

However, they are refusing to do a pitutary scan?

Has anyone else experienced this and what helped?


18 Replies

  • Hi Kell79,

    Welcome to the forum.

    Being low in thyroid hormones can definitely be a cause of low mood and fatigue. Your endocrinologist saying you can't have a problem because you aren't overweight is nonsense. Some people with underactive thyroid are quite thin.

    If you already have some test results that is great. Please type your results in to a reply including the reference ranges (we can't interpret the results without those).

    If you have any test results for vitamins and minerals that would be helpful too. The ones of most interest to thyroid people are :

    Vitamin B12, Ferritin, Vitamin D, Folate, and Iron as well if you have it.

    There are almost certainly things that you can do to improve your health, so don't despair. :)

  • Hi, forgot to say along with my reply that also in my July results - my B12 was measured as 347 (180 - 915) and my folate was 20.1 (4.0 - 20).

    My ferritin was 6 in July but now up to 15 due to Vega iron easily absorable tablets from specialist.


  • Both ferritin and B12 are far too low for your thyroid to work properly. Ferritin needs to be at least 70 and B12 around 900-1000.

  • Thanks Angel, will my thyroid function improve therefore by raising ferritin and B12?

  • It will help with converting T4 to active T3, but I don't know if it will increase t4. However, low B12 symptoms are very similar to low thyroid, so it should help you feel better.

  • Hi humanbean and Flower007, thanks so much for posting. I don't feel so alone with your responses coming in...

    My recent blood results from July 2015 are:

    FREE T4 12.15 (12 - 22)

    Free T3 - 4.5 (3.1 - 6.8)

    tsh 2.140 (0.1 - 5.0)

    Zinc 14.2 (11 - 24)

    Ferritin is 15 (range is 15 - 200 for premenopausal)...was as low as 6 a few weeks back.

    Awaiting more mineral and vit blood results...

    My cortisol (over one day - via saliva specimen - GENOVA)

    sample 1 - 18.76 (7.45 - 32.56)

    sample 2 - 5.79 (2.76 - 11.31)

    sample 3 - 2.21 (1.38 - 7.45)

    sample 4 - 3.03 (0.83 - 3.86)

    Does that help?


  • Hello Kell79,

    Welcome to our forum and sorry to hear you are not feeling well.

    It is true irregular periods and experiencing weight gain can be symptoms of hypothyroidism but it is unacceptable for your doctor to discount this diagnosis with the absence of these symptoms.

    Unbalanced thyroid hormones can make you feel terrible. If you have recent test results, post, complete with ranges (numbers in brackets) and members will comment.

    If you have any other test results such as Vits or cortisol, this will also be useful.

    Hope you feel better soon,


  • Hi humanbean and Flower007, thanks so much for posting. I don't feel so alone with your responses coming in...

    My recent blood results from July 2015 are:

    FREE T4 12.15 (12 - 22)

    Free T3 - 4.5 (3.1 - 6.8)

    tsh 2.140 (0.1 - 5.0)

    Zinc 14.2 (11 - 24)

    Ferritin is 15 (range is 15 - 200 for premenopausal)...was as low as 6 a few weeks back.

    Awaiting more mineral and vit blood results...

    My cortisol (over one day - via saliva specimen - GENOVA)

    sample 1 - 18.76 (7.45 - 32.56)

    sample 2 - 5.79 (2.76 - 11.31)

    sample 3 - 2.21 (1.38 - 7.45)

    sample 4 - 3.03 (0.83 - 3.86)

    Does that help?


  • Hello again, Kell79,

    Sorry about the delay in replying. I wrote a post to you last night then lost it all before I had submitted it when I closed the wrong tab on my browser. Doh! So I'll reply in chunks this time!

    Sadly, the treatment of hypothyroidism in the UK is the most brutal and sadistic in the developed world. Doctors will sometimes treat when TSH is over the reference range but only if thyroid antibodies are positive. If antibodies are negative then they often won't treat until TSH is over 10. And to cap it all when the NHS does test antibodies for someone with suspected hypothyroidism they usually only test one kind - TPOAb. For the full list see the table on this page :


    In autoimmune hypothyroidism/Hashimoto's Disease, either or both of TPOAb and TgAb could be positive, but TgAb rarely gets tested.

    So, since your TSH, FT4, and FT3 are all in range the chances of you getting treatment on the NHS are zero. There are several options open to you.

    1) Put up with how you feel until your TSH rises enough to get treated. The problem with this is that without a crystal ball you can't tell how long this will take. It might happen next month, or your TSH may still be in range in 20 years time.

    2) You could try and improve your thyroid results with changes to diet and using supplements. The things that reduce thyroid function and TSH (which is produced by the pituitary) are things like being low in minerals and vitamins, having high or low cortisol (produced by the adrenal glands), gut problems e.g. inflammation, having untreated coeliac disease, being gluten-intolerant and/or lactose intolerant.

    3) Treat your own thyroid by buying thyroid meds online. This is a scary prospect and shouldn't be attempted without knowing what you are doing, and also you need to get advice from forums like this one on which websites and products are reliable.

    I'm going to ignore option 1, because to my mind it isn't really a viable option for anyone who feels really ill.

    Doing option 2 on its own is well worth it whatever else you decide to do, and it is necessary to deal with such problems anyway, before trying option 3. For example, being low in ferritin (as you are) will prevent your body from making use of any thyroid hormone you give it.

    Doing option 3... My advice (for what its worth, I'm not a doctor) is to delay looking into this in the short term and concentrate on option 2.

  • Thanks very much Human bean, I will go for option 2. I feel I have already started that journey so fingers crossed... I am seeing a nutritionist and have cut out gluten, wheat, yeast and diary for a few weeks now. I have had my stool analysed and it shows no imflammation and candida has now gone. The problems seemed to all start after I was on PPI for 20 months...off it now but maybe that lowered my B12 and Iron etc?

  • Wow! So maybe the PPIs I was on for 20 months caused all my problems?! I came off them in March this year thank goodness.

    Do you know how long it will take for the B12 to build up in my system to a good level?

  • PPIs are for short term use only, but doctors never pay any attention to that.

    They cut absorption of nutrients from food enormously, and are not things to be relied upon - particularly if the original problem is actually too little acid rather than too much.

    Sorry, I don't know how long it will take to get your B12 up. It depends on whether you have an absorption problem in addition to having taken PPIs or not. In your shoes I would supplement to get my level up, just to speed up the whole process. :)

  • Thanks human bean. I think judging by how quickly my Vit D levels have gone up by taking D vits (they were initially low), hopefully that means I am absorbing ok now.

    Doctors really are rubbish aren't they.

    Looking back, I think the PPIs might have been the trigger for all my nutrient deficiencies.

    I recently did the attached Betaine HCL with pepsin test and it indicated that my acid levels are now back to normal...I guess it will just take time for my nutrients to start going up?

    I asked for B12 injections but the doctor said it is not low enough to get those, so I am going to start the supplements now.

    Thanks so much for your help. Kel

  • You're welcome.

    You may have to look into adrenal health at some point. Your sample 4 is too high, and the others are probably too low. But there is also a possibility that supplementing nutrients appropriately and giving up the PPIs may be all you need to do. But if not :

    "24-HOUR CORTISOL SALIVA: This is an at-home test to evaluate your circadian and cellular cortisol levels at key times during a 24 hour period. It’s more accurate than blood cortisol, we saw repeatedly, since the latter measures both bound and unbound cortisol, not cellular levels like saliva, and thus gives a false idea.

    We noted repeatedly that those will healthy adrenal function will have the following saliva results:

    8 am: at the literal top of the range.

    11 am-noon: in the upper quarter, and often about a quarter below the top.

    4-5 pm: mid-range

    11 pm to midnight: at the very bottom.

    A DHEA above midrange is good, we saw, but 8 can mean the adrenals are compensating for a problem. For accuracy, patients learned they needed to be off any adrenal support supplement, any medication containing cortisol, any herbs that support adrenal function, or zinc or licorice root for at least two weeks prior to testing…if possible (it may not be possible for some conditions, though–work with your doctor!) Avoid food when spitting into vials. If you wear dentures, remove them to prevent denture adhesives from tainting the spit, says the facilitiies."

    Quote taken from this page :


    In addition to avoiding food when spitting into the tubes, don't get blood in them either - that falsely raises results apparently, although I don't have a link for that piece of info.

  • Minerals and vitamins

    You need to get the following minerals and vitamins up to optimal levels - optimal is not the same as just being in the reference range.

    Vitamin D - this needs to be around 100 nmol/L for most of us to feel at our best. Some people don't tolerate vitamin D supplements and have to put up with much lower levels, and do what they can with sunlight. You haven't given a level for vitamin D. If you don't have a result for this it can be tested on its own relatively cheaply :



    The test involves pricking your finger and then sending blood spots through the post. The kit required is sent to you after ordering. If your levels are too low then you must supplement with vitamin D3 (Cholecalciferol) not vitamin D2 (Ergocalciferol). Please be careful when researching vitamin D - US websites use different units of measurement to the UK - don't get them confused. Please ask about the appropriate dose for you when you know what your result is. A member named Marz is hot stuff on vitamin D and has lots of useful links.

    Vitamin B12 - Vitamin B12 is unique among vitamins and minerals, as far as I know, in being non-toxic. Any excess is excreted in urine. Most of us feel at our best when levels are around 1000 ng/L. The best absorbed supplement is methylcobalamin. The most popular supplements are made by Jarrow's Formula and Solgar, and they can easily be purchased on Amazon :



    Both the above products are available in 5000 mcg doses as well.

    Take one a day, don't swallow, chew, or suck the tablet, it must be put somewhere in the mouth and allowed to dissolve as slowly as possible to maximise absorption.

    Folate - Your folate level is good. But if you are taking B12 it is strongly recommended that you take a good quality B Complex too, to keep all the B vitamins balanced. There are cheap B Complexes and there are methylated B Complexes, and the latter is better. I use this one which I buy from Amazon, and I take one a day :


  • Thanks so much, I will definately be taking high strength B vits and will look into the links you have sent. How long before people notice a difference in their levels? Kel

  • Ferritin - Your ferritin is abysmal, and this will be one of the major causes of your fatigue. Depending on who you read this needs to be at least 70 - 90 ug/L or mid-range.

    There are various types of iron supplement and member helvella has written a good post about it in this thread, and other members have lots of tips too :


    And this search is well worth doing - it searches the thyroid UK community posts for references to ferritin - this subject has really been done to death, so there is lots to read on the subject :


    Whichever iron supplement you choose, remember that taking 500mg - 1000mg vitamin C with each tablet or capsule helps the body to absorb the iron, it helps to reduce constipation caused by the iron, and it is good for the adrenal glands too.

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