Thyroid UK
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Severe Depression with TSH at 4.02

I am so grateful for the posts this week helping with my own hypothyroidism diagnosis.

I have also been caring for my poor dad who has had severe depression/anxiety for almost 2 years now. This followed prostate cancer scares and almost losing him to a hospital bug 3 years ago so he has had a rough ride!

I have checked back through his blood test results over the years and have had his GP check his Thyroid amongst many others and am now asking for advice about his results.

In Nov/2012 TSH was 5.52 with high prostate antibodies 11.2

In Jan/2013 TSH was 4.85 with prostate AB coming down a little to 9.6 (after prostate operation to reduce size and biopsy)

In June/2013 TSH was 3.64 with prostate AB 12.2 (prostate AB increasing again!)

In July/2015 TSH was 2.54 with prostate AB back up to 15.2

The prostate biopsy showed no cancer despite increasing size.

Since all the cancer scare he has not been able to accept that he has been given the all clear. Depression and Anxiety and I think Post Traumatic Stress has culminated in a very low quality of life and now is becoming suicidal after 3 lots of antidepressants have caused his sodium levels to drop so low that he was having speech seizures!

Now, weaned off all drugs he is struggling so badly.

His latest TSH is back up to 4.02 (range 0.3-3.18)

and his T4 is 17 (13-21) and has always been about this level.

My question is, could the stress caused by the anxiety be raising the TSH, or is it possible that the thyroid is causing neurological problems all along giving him such bad depression.

I have checked through his bloods and B12 has always only been mid range around the 400 mark. I asked for it to be done this month but the lab didn't test for it, or folate, vit D, Iron/ferritin as I had asked either.

I am going to have to get BlueHorizon blood test done I think as I did for myself, but if anyone can give any thoughts on depression and neurological problems with thyroid related problems I would be most grateful, so that I can then take my dad to the psychiatrists appointment when it arrives to deal with it if necessary.

Sorry, ..... in addition

.........also his serum cortisol was tested and is 407 (193-690) in case this is of relevance because he also cannot sleep well at all, waking 4-5 times a night.

and..... Serum parathyroid hormone is 4.0 (1.6-6.9)

thanks again in advance

(also, both myself and my sister have hypothyroidism, so I am thinking there is quite a lot of relevance to his higher TSH result)


31 Replies

Depression can be the result of too low a Free T3 level in the blood. As hypo runs in your family it is very probable your Dad has it too and I assume never been diagnosed. This is good info from our main website and I think it will be an eye-opener:-

T3 is the active hormone required in every one of the billions of receptor cells and levothyroxine should convert to T3 but sometimes doesn't sufficiently. Our brain contains the most T3 receptor cells but doctors (if patient is hypo) usually prescribes anti-d's instead of (I believe and am not medically qualified) some T3.


I have finally managed to get dad to have the Free T3 blood test done through his GP and the result is 4.9.

Does anyone know how high or low this is and how it correlates with TSH of 4.02 and T4 of 17?

It may be better if I post this as a separate item to get more responses.



I am sorry for my late response and yes it would be better to get more responses if you make a fresh post. We also need the ranges to be quoted along with the results. The reason being that labs differ throughout the UK thus they have different ranges.


P.S. In other countries a person would be diagnosed if the TSH is above 3. Unfortunately (and it puzzles me and others) the British Thyroid Association inform doctors not to prescribe until it reaches 10!!

Before blood tests were introduced along with levo we were diagnosed upon our blinical symptoms alone and given NDT. Nowadays doctors are poorly trained in that they know no symptoms but rely on the blood test alone. I doubt they know anything about T3.


It is my experience that stress can have a huge impact on the thyroid.I experienced a prolonged period of stress & after 14 years on thyroxine I nose-dived into depression with severe anxiety.After 4 years of this & chronic fatigue,my new GP(I relocated)liased with the endo & they agreed to add T3 to my thyroxine.This has had a big impact on my mental health.At present I take T3-only.

Most people do well on thyroxine & I know of one aquaintance who was hospitalised for depression who went on to recover well when thyroxine was added to his SSRI.

I now believe my adrenals "crashed"as a result of prolonged stress in addition to long-term use of thyroxine mono therapy.

I am now feeling much better mood-wise,except when stress impacts.I now realise I have been left with a form of PTSD

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400 is much too low for B12. Optimal is 1000. And, anything under 500 can cause irreparable neurological damage. If I were you, I would give him 1000 mcg sublingual methylcobalamin daily. With that, give him a B complex daily, containing methylfolate - not folic acid - to balance the Bs. You can find everything you want on Amazon. Good brands are Solgar, Jarrows and Thornes.

If he get's his B12 up, I'm sure it will make an enormous difference to him. :)

Oh, also, does he get enough good fat in his diet?


I have managed to dose dad up with Jarrows 5000mcg B12 and have finally convinced his GP to give him a B12 shot to see if it helps any of his symptoms!

How long would it likely be for him to see any improvement in his depression/anxiety if B12 (if indeed it is the problem) if his B12 was 400 prior to B12 lozenges or the injection today? 5 injections were mentioned to my mum and dad at his appointment but they cannot remember how often they will be (i.e. weekly or daily for a week etc) but they will find out from the nurse today.


Low B12 is one of the problems. He also has a high TSH, which means he has a thyroid problem. So, there's no knowing how long it will take for him to feel better.

Are you also giving him a B complex, to keep the Bs balanced?


yes he has been on a B Complex for over a month now and an additional 100mcg B6 to try to help the depression. Also Omega-3.

I am going to have to get him a Blue Horizon blood test I think.

I asked his GP specifically to run all tests for Adrenal Fatigue too but he has not actioned any of them.

I asked for a uMMA and homocystine blood test this week, I think he has actioned the homocyctine one, but mum couldn't remember if that was right so have to wait for the results next week to see if he does have a B12 problem too.

I am wondering whether to get the private bloods done then try him on NDT if I get nowhere with the GP.

I am a bit nervous of trying T3 myself, although I am sure I will need to, but have just started NDT bought privately and this may be easier to try dad on without worrying about different doses through the day as I may have to with T3 etc.


Be careful with B6. It's the one B vitamin you can have too much of.

I find it strange you think that NDT can be taken all in one go, but you have to multi-dose T3. Not strictly true. A lot of people split their NDT throughout the day, and a lot of people take their T3 all in one go. I take my 75 mcg T3 in one go just before bed. :)


Ah thank you greygoose, treating myself is all new to me so I am trying to read up on as much as I can at the moment.

I am starting on one grain of 60mcg of NDT (Thyroid-S) and have dropped the Levo for now, hope that is right. I am finding it all rather overwhelming tbh!

I am taking my temperature, day 3 and always 36.6 and pulse has gone up from 70-80bpm today.

I'm sure I will post for advice soon!

Thanks for your


How much levo were you on? Are you doing a straight swap? I doubt you want both.


Doctor started me on 25mcg in April, and 50 in July, then as symptoms did not improve and TSH reduced from 4.2 to 2.85 she said she would not increase it any further! So I knew I had to take it into my own hands from now on.

Crazy low doses and proves that she has no idea about thyroid!


The thing is, my face is becoming more and more puffy, my knees are twice the size and painful to bend, along with all the other small things like eyebrows 1/3rd outer no hair, tongue massively crimped from teeth pressing on it, hair patches falling out in two places behind head, and constant pain in joints. So you'd think the doctor would see that symptoms are obviously still there and help me to increase the dose of Levo, but nope!


Doctors know nothing about symptoms. They don't learn them in med school. They only know about blood tests - well, to a certain extent they do, but they believe that anything in range has got to be perfect, doesn't matter how wide the range is. So, your results are in range. As far as she's concerned, her job is done, and anything you complain about now, has either got to be due to 'something else', or is all 'in your head'. Because that's what they learnt in med school, and they won't listen to anything else!

So, you were on 50 mcg levo. One grain might be a bit much - especially with the T3, which your body isn't used to. Personally, I would have started at half a grain, and dropped the T4.


ok thanks so much greygoose, I'll think about that then and I'll get Blue Horizon bloods done in Oct to check everything then post back on here again.

I'm also trying to increase my folate and ferritin with diet as I know they are both important to help improve thyroid hormone absorption.


greygoose, I not only gave him sublingual B12, I also convinced his GP to give him 5 B12 injections. He has now had 2 days without the depression, he is coping MUCH better with daily life and it has had a massively positive impact so far!

Thank you for the advice above which was posted a month ago, and I also followed with the B-Complex + methylfolate.

Just wanted to update this thread because your advice has been invaluable yet again!

jbthyro x

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Well, I'm really happy that it worked! :) x

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Would you kindly tell me what prostate AB is? ...Same as PSA? Thanks


I've suffered with depression since I was a child - and I'm now in my 50s. What has made a huge difference to my levels of depression is :

a) Getting as many nutrients as possible up to optimal levels. I'm referring to vitamin D, ferritin, folate and vitamin B12.

b) I take other supplements for nutrients which I've never had tested - but I supplement cautiously. Magnesium, selenium, vitamin C, vitamin A (NOT beta-carotene, instead I take retinyl palmitate). Many hypos cannot convert beta-carotene into proper vitamin A very well so they can be deficient. I also take a good B Complex rather than a separate folate supplement. I also supplement zinc but I really ought to get it tested, along with copper.

c) I take omega 3 fish oils, Co-Q10.

d) I treat my thyroid myself.

e) Although my depression has improved a lot, I still need to treat myself to keep the depression at bay. I use 5-HTP, 50mg just before bedtime. Some people take far more, but I find it gives me the jitters if I take more. I do well with 50mg anyway. Do some searches on the forum for discussions about 5-HTP. It doesn't work for everyone.


Hi humanbean,

that is all very interesting indeed!

I have set him up with Omega-3 1000mg daily, along with a high stress B complex (with 50mcg of vit B's and 400 of Folic Acid), he has started a Selenium and Zinc supplement today and I have sent a bottle of Jarrows 5000 B12 which should arrive at their house today.

I have read a little about 5-HTP and heard conflicting responses so will delve more into that and maybe try him on it.

I need to check his vit D levels too, you have reminded me!

He has had more blood tests done today so next week I may have more to juggle with! lol.

How do you treat the thyroid yourself, T4, T3 or combo?

I'm just about to go down that route myself!

Thanks again for writing about your experiences, it is all so very helpful to myself and I am sure others will also benefit.

jbthyro x


I've been on levo, T3, NDT, T3 again, NDT again, and now I'm trying NDT + T3. Both NDT and T3 help me, but not sufficiently on their own, but a combo seems to be working.

What works for one person won't necessarily work for someone else. I would always recommend starting on levo. The medical profession approves of that far more than any other treatment, and 85% of people do well on it. So why make life difficult for yourself?

Folic acid isn't something that is recommended on this forum.

If you get the right kind of B Complex it will already contain folate. Extra folic acid is not required.

This is the one I take, but there are others - check the ingredients :

Regarding 5-HTP, it is like any anti-depressant, it must not be mixed with other anti-depressants.

When taking B12 supplements, stick them in the mouth out of the way and let them dissolve slowly without sucking or chewing. This is to maximise absorption. Don't worry about B12 levels getting high, it is one of the few supplements which does no harm in high doses, and it is not poisonous, even though many doctors think it is, for some reason.


Thank you so much again humanbean, I will look into some of the things above that I didn't know.

I will also get him a BlueHorizon blood test done to check everything we need to work through.



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I tried 50mg 5HTP at bedtime when I was depressed.It made me more anxious.What pulled me out of a 2 year depression was S-Adenosyl Methionine.I took 200mcgs daily on an empty stomach on waking(research suggests 400mcgs is minimum needed,but 200mgs worked for me)It is important to take B6,B12 & folate with this.I buy from an Amazon shop.I also take L theanine in the early hours for high cortisol anxiety.

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very interesting Naiomi8, I will look into all of that. I already have him on B6, B12 and have sent him to get bloods done at GP yesterday to see what all the rest of his results are. I have read about L theanine and he is having 3 cups of green tea a day plus some herbal tablets with 300mcg of L-Thianine in.

Thanks for sharing your experiences


I've never tried SAMe (one of these days I intend to, because I've heard about how good it is so often) but I have tried L-theanine.

5-HTP is the thing which makes my life bearable. But L-theanine gave me headaches and made me feel pretty miserable!

Dealing with depression is one of those things that everyone has to find their own solution (or mix of solutions) for. I just wish it was easier.


Yes,unfortunately its a very unpleasant trial & error situation.Cetalopran gave me 3 1/2 weeks of even worse hell than I was already in,St John's Wort did nothing.I am hetero for MTHFR & some say I should steer clear of SAMe as it is a methyl doner,but I still take it for shortish periods when I dip,as it just lifts me out of the dark place without side effects. I have to take B6,B12 & folate to counteract the homocysteine issue & with more research have added NAC.


Your dad needs the complete thyroid panel TSH/FT3/FT4/rT3/TPOAb/TGAb. T3 is a great antidepressant, in my experience WAY better than anything from BigPharma. If his FT3 isn't at least in the middle of the 2.77-5.27 pg/ml range, then he has a T4-T3 conversion problem, maybe high rT3, and needs to use T3, or T3+T4, or NDT.

I also take a large number of supplements. Having had celiac, I am extremely aware of what nutritionals have to do with wellness.

I never will understand why so many doctors are timid about correcting hormone levels in older people. It is a crucial strategy for anti-aging - i.e. reducing the length of the period of disability that is inevitable late in life, so the patient doesn't use health-care system resources for a long time. How a doctor can observe a patient with low quality of life, and do nothing, is beyond me.

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Thanks Eddie83, I feel that I am really getting there with the information everyone has contributed to and intend to take my dad personally to his psychiatrists appointment when it comes through to make sure he is not farmed off with just anti-depressants which I know is most likely to happen (despite him having tried Prozac, Mirtazapine and Escitalopram which all had no effect and hospitalised him for a fortnight due to lowering his sodium to cush a dangerous level that he was at the point when he COULD have dipped into a coma!!!!!

It is sinful as you say that the proper care is just not available for all ages but most importantly for the older age range who are the ones needing most care and guidance

I have just ordered my first batch of NDT so at least I can now use it if I need it for my dad too to try and get some more. I have been very nervous about it all but have been pushed into it through no choice of mine and am now armed with the confidence from this group to tackle both my health and my fathers.

I just hope I can help us both to feel better and then go sit in the doctors surgery and say 'I told you so!' x (sadly and also probably say 'thank you for wasting 2 years of my dads quality of life!)


BigPharma anti-depressants are a dead end. I have used 2 of the 3 above (prozac, mirtazapine). The side-effects of prozac were a killer. None of these ADs is anywhere near as good as being euthyroid and having good nutritional levels. For people with a history of GI disorder, or older people, total blood protein is esp. important if there is sleep disturbance, or evidence of muscle/connective tissue degeneration.

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Hi Sandy12, I have spoken to you previously about my own hypothyroidism and potential ISTH and have now read your book twice which is an amazing resource!

My son is also now showing signs of anxiety and depression with a high TSH so am now organising his BlueHorizon blood test to see what the Full Function Test shows for him too.

It is certainly looking very likely that we are all in the same boat through 3 generations so I am going to follow this lead now very seriously.

I have now ordered NDT for myself to try because it was logistically easier than getting the T3, but I will read the treatment section of your book another time to follow the ideas that you lay down in there to finally try to resolve all of our issues!

Thank you again



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