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My name is Tara. I was diagnosed with an anxiety disorder in my early 20's and then after testing with TSH levels of 352 when I was 35, hypothyroidism. It's only last year that I realized the two were linked when I was required to go off my synthroid to have a radiation scan. My anxiety went crazy.

2 months later my 16 year old daughter who has always been the most independent, capable and self driven kid began to spiral into a nasty severe depression. My first thought was to check her thyroid. Her results showed the presence of antibodies (Anti Thyroid Peroxidase). Because her depression included suicidal ideation she was put on effexor xr but it doesn't seem to be very effective. She was taking 25mg of synthroid until her last set of tests came slightly low T4 so is now on 37.5mg synthroid.

She cycles through every three days an emotional crash where she sobs and says she can't go on like this. We live in remote B.C. Canada and have an endo appointment in Vancouver mid April.

I will post her pending results here and ask for advice. It was one thing for me to suffer at the hand of this but it's quite another to watch my amazing kid unravel like this. I'm beside myself with worry. I hope I can lean on some of you more knowledgeable that I regarding my daughter's struggle.

Thanks

19 Replies

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  • It may or may not be related to the thyroid. Given the seriousness of her situation it is a good idea to let the endocrinologist know the details if you haven't already done so. They may just be scheduling her as any other patient when in fact there is good reason to give her a preferential appointment.

    Sometimes patients are 'refractory' to anti-depressants until given a little dose of a thyroid hormone called liothyronine, also known as 'T3'. Doctors do not know why this works but it does. Once she has seen the endocrinologist I would make sure the doctors communicate with each other. In a case like this there should be shared care.

    Try to get her to appreciate that this is a temporary biochemical problem and she will get better. I think it helps if you know that it's the brain chemistry that has gone a bit haywire and not you. Good luck.

    Jim.

  • Thanks Jim,

    I jumped up and down to get the appointment brought forward a month telling them everything. I have read that T3 seems to be more effective when depression is involved and I have spoken about this with the doctor. He wanted to see if elevating T4 because it was low would make a difference first. But I made him promise that T3 was our next move if we didn't see any results.

    I really do think the depression has been triggered by this presence of antibodies and low T4. It was like someone flicked a switch in her. She was never a kid to get easily upset and was always very mature. This is at complete odds with her personality. I can't believe the thyroid issues are coincidental at least I hope they aren't. I have been reading a lot about thyroid issues presenting as mental illness. There seems to be quite the link.

    I really appreciate your response. Feeling very alone with this. πŸ˜•

  • If her fT4 was low, below the lower limit of the reference interval, 37.5mcg levothyroxine will not be enough. Perhaps ask the doctor to raise it to 75 mcg now and reassess when she has her appointment. The risk of a little too much in a young patient is negliglable and the consequences of too little are much greater. It is not unusual to start patients with a low fT4 on 100 mcg and then to titrate after a month or so. I wouldn't try T3 until they have got her fT4 up around the 18 mark (UK ranges).

  • The doctor said something about a heart risk of over medicated on T4? I thought the dose was low too. I'll ask for a copy of her results this time and post them here. I simply don't know enough about this at this stage. Hopefully you and others can weigh in on her results. Thanks again.

  • Heart risk is for elderly patients. If your daughter has no cardiac problems, then raising the dose faster is not a problem.

  • Why don't doctors know this?! I will bring this up at her next appointment! You guys are being so helpful already! Thanks gabkad. 😊

  • Some doctors do. Some don't. Usually they'd start someone like your daughter on 50 mcg and increase by 25 mcg initially. Then fine tune.

    Synthroid has the increments that are not available in the UK. (I'm in Toronto.)

  • So if there are antibodies present that means she has Hashimotos? Does that also mean her levels and mood are fluctuating wildly because of the degradation of the thyroid and the imflammatory response? Could she be swinging between hypo and hyper? I remember in my early 20's going through this horrific anxiety ridden, non sleeping and weight loss phase. I'm wondering if she is following suit but with depression instead of anxiety.

  • If her thyroid levels are low, which they are, then she'll have 'days of desperation'. She's young. It's hard to cope when there's a sudden reduction in quality of life.

    There's some hypothesis that Hashimoto and other autoimmune diseases begins in the gut. 80% of our immune system is in the GI tract. There are people who go gluten free and their antibodies go down. Some people's doesn't.

    Dr. Allesio Fasano (dr. gluten/coeliac) is, last time I read, neutral about Hashi antibodies and going gluten free. He says 'try it, can't hurt, might help'.

    Probably in northern B.C. it's difficult and super expensive (hey groceries have gotten expensive here too so I can't imagine what you guys are paying!) to go on a 'real foods' diet. Potatoes are still cheap and they are very good for the GI tract. Pulses (not soybeans which are considered differently) are also good.

    Sometimes some viral infections can start up (temporarily) a thyroid problem. Like infectious mono, for example. There's others. Also just plain old school stress can adversely affect those of us who are susceptible.

  • I will need to do more reading! Thanks. 😊

  • Hi Tara.

    Both experiences - yours and your daughter's - are familiar to me. I'm about to get in the car to go away for the weekend but when I have time I'll tell you more. You're not alone.

    xx

  • Thank you!

    Enjoy your weekend. I look forward to hearing from you. 😊

  • Hi Tara. Sorry, I discovered I'd left my charger at home so wasn't able to reply.

    I suffered from depression/anxiety from an early age and was eventually tested for thyroid disease in my late teens. I wish I had my test results as I now have no idea what the actual results were, but I do remember being told I was in the middle of the range (what was implied was that the middle was the place to be) so I do wonder if I was showing signs of Hashi's even then. I wasn't medicated for thyroid issues until I was 40ish, and it then took a further few years to get some t3 on script, which has helped. I was always a quiet, bookish child, intellectually sharp but very considered, dreamy and slow-moving and I wonder if even then there was a thyroid issue. My body temp has been low ever since I can remember. I have an early memory of being taken to the doctor when I was ill and my temp being below normal but it didn't prompt any action.

    In my 20s I had great results with antidepressants and felt well for the first time in a long time, but sadly I was one of those folk for whom the relief is short-lived and I never again saw much improvement with subsequent courses of ADs. After years of therapy and various other developments (marriage, stable home life etc) I no longer suffer with crippling depression. I don't want to imply that your daughter is in for half a lifetime of problems due to her thyroid; mental health problems run in my family and I had a rocky home life as a child, so I was already at higher risk. Being a teenager is tough and it isn't uncommon even when physically healthy (ie euthyroid) to go through this kind of turmoil. Maybe one day research will be done on what it means to have these experiences as a youngster and how it relates to thyroid issues and maybe we'll be able to predict and head off some of the suffering.

    Like you, when I've scaled back my levo (a few times when I've had to reduce so I could add in more t3 and the one time I tried to cut levo out to try t3 alone) my anxiety has gone wild. These hormones can have such a profound effect on mood.

    I think it's great that your daughter is being treated for her thyroid problems and I do hope she gets good results. It can take a bit of time to get there. If you are well-informed you can stay on top of developments and supervise her treatment. I think someone else mentioned t3 and depression, which is another great option. I'll look for the test results you plan to post.

  • Hi Punchuredbicycle.

    I don't think it's coincidental at all that she was an emotional rock prior to this massive depressive cycling and the onset of thyroid issues. If my experience is anything to go by mood and thyroid issues are inextricably linked.

    She has has had the happiest of childhoods with lots of travel and parents who have been happily married for 20 years. I used to think my symptoms of anxiety were exacerbated by my turmulteous childhood but now I have my doubts. There's anxiety and there's ANXIETY.. if you know what I mean. I am in the midst of collecting as much data on her and information about this condition as I can. I think there is a very strong link between mood and anti-immune thyroiditus and I going to do my best to get to the bottom of it.

    I will definitely post her results when I get them. I would love for you to weigh in.

    Thanks for your reply

    I hope you had a great weekend away

    😊 Tara

  • I think as mothers we will "take on the world for our children" I like you was in my late 30s when I got a diagnosis, my lovely intelligent bubbly daughter was 17. She went from a sparkling ray of sunshine to a black cloudy day, I think at that age for young ladies the impact it has is on them is magnified by the normal teenage hormones they don't want to deal with the problem, so we have to. the first

    step is getting them medicated I think the harder step is getting them medicated

    correctly, do a bullet point list of all the

    symptoms she still has and take it with you. Arm yourself with as much information as you can so that you can't be baffled by their jargon. I can't offer any technical help but I can offer empathy as a mum who has gone through it. My sparkling Ray of sunshine is now 22 and is half way through her masters degree and applying for PHD funding. The tunnel may seem long but the light is there.

  • Thank you so much! I really needed to hear this!

  • Your daughters dosage dose seem a bit low, my daughter was "borderline" when I insisted they medicate her, they wanted to wait till she was worse, but she already had weight gain hair loss dry skin low mood/ mood swings was tired all the time lost all enjoyment in things, she really did loose her sparkle! She takes 75 mcg of Levo and it took about 6 months for her return to "normal" she went through the gambit of emotions including anger at me for giving her this disease, I watch her like a hawk now and look for the signs that she may need an increas. It happened about a year ago she was home from uni, always moaning she was tired or fed up kept saying her jeans were tight! So I booked in a blood test and they increased her meds by 25mcg. So it's an ongoing thing, I'm trying to teach her to recognise the symptoms herself but she is young ..... Things will get better

  • My poor girl has gone from having a rock solid disposition to horrific depressive mood swings which bottom out every 3 days or so. She was never an emotional person so I think this is extra hard on her. Is your daughter on T4 or T3? I'm looking forward to posting her next set of results here for everyone to check out. It really is very helpful to connect with people that know about all this.

  • She is on levothyroxine T4,

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