Thyroid UK
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is your car engine running to fast

Hello, I am hypothyroid and am on 100mg Levo and am trying Cymbalta anti depressant on doctors advice.I feel terrible!!!!

Just had my blood taken and:

TSH is 5.29 0.27-4.20]

Free T4 is 14.6 [11-22]

Vitamin D 73 nmol/L [70-200]

Vitamin B12 413 [pg/ml 191-663] Serum folate 7.6 ng/ml >4.5

My doctor described me being hypothyroid as if I was a car driving along the road, the speed limit on the road is 70mph [i.e. upper range of the Free T4 [11-22] and I am driving under the speed limit[ i.e. my Free T4 is 14.6], that part is good. The problem he tells me is my TSH being 5.29 using his car analogy he says my cars engine is running too fast for the speed I am doing. His suggestion is that I increase Levothyroxine by 25 mg, when I mentioned T3 he said they didn't prescribe it, when I said I could buy it online myself he said that was my choice but I wouldn't get it from him. So the question is should I take the extra 25 mg of Levothyroxine or buy T3 myself

9 Replies

I would think reducing the TSH should be your first aim. How long have you been taking 100mcg of Levo ? You do not have a FT3 result so it is difficult to see if you are converting well. Do you have Thyroid anti-bodies - Hashimotos ? The T3 results is so important as that is the active thyroid hormone needed in every cell of your body.

May I ask why you were prescribed anti-depressants ? - what were your symptoms ? Many people suffer very low mood when Hypo and improve with adequate treatment.

How do you take your T4 meds ? Away from foods and milky drinks for at least an hour ?

You should feel better with improved levels of VitD and B12 - are you supplementing ?

You will also need good levels of Ferritin and Folate. Have you been tested ?

Apologies for all the questions.

Have just looked at your thread of 3 months ago when I suggested you to have your FT3 tested - oh dear :-)


Hello Marz, thanks for your reply. I have been taking 100mg of Levothyroxine for about nine months now. Doctor says they only test for Free T4 and TSH. I am taking anti depressants because I was basically on the floor and had nowhere else to go. I do take my Levothyroxine at least an hour before anything else. No I am not supplementing as this is the first time I have had Vitamin D levels checked so I didn't know if I had to or not. I do Have a Serum Ferritin level test it is 154.3 [ng/ml 30-400.0] Another doctor tells me I am RO 60 positive and ANA positive but I am still trying to work exactly what these terms mean

Thanks Tom


It is certainly too low a dose if you've been taking levothyroxine for nine months. Your doctor would might be more caring if he increased your thyroid hormones to bring your TSH down to 1 or lower.

There's no blood test for depression but they prescribe antid's due to symptoms and if hypothyroid low FT3 might be the reason.

I don't understand why they don't test FT3 but it may be to do with money.

You need an increase in levo to bring your TSH to around 1 or lower. Many, many doctors make the mistake of thinking if the TSH just reaches the top of the range the patient is taking enough. They need a refresher course in the treatment of hypothyroidism. It's not as easy as they may think.

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You should grab the offer of an increase in Levo dose with both hands. You are woefully under-medicated for a treated hypothyroid patient.

Under-medication will definitely make depression worse. I don't know how long you have been on Cymbalta, but personally I wouldn't touch it with a barge pole. It is notorious for having extremely severe withdrawal symptoms. If you have only been on them briefly then I would get off them as soon as possible if I was you.

You would be far better off getting your thyroid meds optimal and also getting nutrients to optimal. Being deficient in either thyroid meds or nutrients will definitely cause depression in many people. If you haven't got a ferritin (iron stores) result you should ask your doctor to test it for you.

Incidentally, having a Free T4 in the bottom half of the reference range is rarely adequate to keep most people feeling well, despite your doctor's approval of such a low level.


Hello Humanbean, thanks for your reply. I have been on Cybalta for a couple of months now, before that I was on Fluxotine for a few months. I took them because I had nowhere else to go. I do Have a Serum Ferritin level test it is 154.3 [ng/ml 30-400.0] I have thought about a private blood test but what is the point of having a Free T3 reading if doctors don't recognise it


But you did have somewhere else to go. You could have learnt more about your thyroid, and taken charge of your own health. Had you read the symptoms of low thyroid, you would have seen that depression is a symptom of hypo.

Your doctor may not take any notice of your FT3 reading, but at least you will know. You will know if you're converting ok, or if you need to bring up the subject of adding T3 to your levo. Or if you're converting well, and just need an increase in levo - well, you do need an increase in levo, that much is clear. The more information you have about your thyroid status, the better. Knowledge is power, and will give you more confidence in your dealings with your doctor - who obviously doesn't know very much at all!

Have you had your TPO antibodies tested? Your doctor won't take much notice of antibodies, either. But, there's a lot you can do for yourself. You need to know these things. :)



My advice would be to try the extra 25mcg Levothyroxine which will raise your FT4 and FT3. If in a couple of months there is no improvement at all in symptoms it may be worth you ordering a private thyroid test to see what your FT3 level is and if it is low to add some T3 to Levothyroxine.

I would supplement 1,000iu D3 during October-April when vitD levels drop due to lack of ultraviolet light stimulating vitamin D. Take it 4 hours away from Levothyroxine.

I would also supplement 1,000mcg methylcobalamin to raise B12 and take a B Complex supplement to raise folate.


I am not a medical professional and this information is not intended to be a substitute for medical advice from your own doctor. Please check with your personal physician before applying any of these suggestions.

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Hello Clutter, thanks for your reply. I am wary of increasing Levothyroxine as I'm not sure the benefits outweigh the negatives:

Hair is falling out in clumps, feel bloated all the time, I'm growing breasts even though I am not overweight, complete lack of sex drive, and to top it all Levothyroxine has not helped me with symptoms of exhaustion, confusion, wild mood swings. I will think about what you have said before making up my mind which direction to go in. Thanks Tom



You are under medicated so Levothyroxine hasn't had a chance to work on your symptoms. Wild mood swings aren't typical hypothyroid symptoms.

Your GP should check your pituitary function if you are developing breasts and lacking sex drive.

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