Thyroid UK
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GP says I have stress

Hi everyone I am new to this forum. Although I have what I think is Hashimotos my GP has said since my level for TSH is low and my thyroid levels are in range my symptoms are thought to be caused by mental stress. I was diagnosed 2012.

I was told I am over medicated a week after being told I have stress and I had my levothyroxine reduced to 50mcg from 150mcg and a retest in 6 to 8 weeks time.

I always have bloods drawn early and I leave 24 hours between blood draw and dose and I fast for them.

Symptoms are returning one by one - hard stool, goitre, dry skin, hair loss, puffy eyes, heavy periods, tiredness , feeling cold and weight gain. Muscles also feel heavy as well.

Results below on 150mcg levothyroxine, thanks in advance.

TSH 0.05 (0.27 - 4.20)

Free T4 20.9 (12 - 22)

Free T3 4.3 (3.1 - 6.8)

Thyroid peroxidase antibodies 288.5 (<34)

Thyroglobulin antibodies >1300 (<115)

15 Replies
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You do have Hashi's, but you were far from over-medicated!!! Your doctor is not thyroid literate. He was only looking at the TSH, which is low. But, it doesn't matter and it doesn't mean anything! Your FT3, the most important number, was below mid-range, which is far too low for the majority of people.

His second mistake was to reduce your dose so drastically - he really is very ignorant. Increases and reductions should be done 25 mcg at a time, not 100 in one go! Your poor body must be totally confused, so really little wonder that you now feel so bad. Your doctor is making you ill, rather than better.

Your real problem is that you don't convert very well. So, you need your FT4 up the top of the range, to get a half-way decent amount of T3. What would happen in an ideal world is that your levo should be reduced - by 25 mcg! - and some T3 added. But, there's not a hope of that happening in this world! Not in the UK, in any case. Unless you do it yourself. But, given your doctor's lack of knowledge, it would probably give him a heart attack if you did that! So, I would change your doctor, first. In any case, you need to do something, because this idiot will keep you very sick.

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Thanks greygoose I have T3 left over but afraid to add it back in

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Why are you afraid?

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In case GP finds out I'm taking it

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Ahhh I see. But, you're never going to get well without it. What's more important, pleasing your GP or getting your health back?

What exactly do you think he will do if he finds out? He's not there to dictate to you, he's not your boss. He's there to advise you, but there's no law says you have to do what he advises.

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I'm just worried I'll be struck off from the surgery or struck off by the endo or have my levothyroxine taken away

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If that's the case, buy your own. I'm really not sure of the legality of striking people off, or removing their medication. Your life does depend on the levo, if not the T3. Does your doctor have a legal right to stop it? May be you should enquire at the citizens advice bureau. It doesn't sound right to me. Anyway, isn't there another practice you can go to?

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GP stopped it before saying she was no longer managing my care but there is another practice I can go to

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She sounds a bit of a prima donna! I would try the other practice, if I were you.

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I'm afraid greygoose is right. There was nothing wrong with your results. If you were feeling unwell and had symptoms on your previous dose, your doctor should have checked vitamin and mineral levels not altered your dose of levothyroxine. You should not alter it in big leaps as it will make you feel ill.

As greygoose says, find a doc that actually knows something about thyroid conditions and how to manage them otherwise you'll have to train this one. In the meantime I'd get back to the doc, tell him to increase your dose and then get your vitamin levels checked out at your next blood test in 6 weeks if you have not already done so.

Vit D, B12, folate and ferritin.

Thyoid imbalance can make you experince things that you would normally sail through as being more stressful than usual. It can change your perceptions temporarily so it's sometimes hard to judge what is stress and what is the effects of the disease. I would not be too quick to accept the doctors judgement about stress as they know nothing about how thyroid conditions affect people's responses, only what they've read in a text book. If the doc successfully helps you manage your thyroid condition to keep things balanced then you will not experience things as being stressful.

You have elevated thyroid antibodies so have you tried taking 200mcg of selenium and a little magnesium? Magnesium helps the body relax.

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Thanks I have results of vitamins and minerals but they are still low despite supplementing. I haven't taken magnesium or selenium before so will try this

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If your vitamin levels are still low despite supplementing, post them here and people can see whether you are taking a high enough dose and make suggestions. In addition, you may have absorption problems which many with thyroid conditions suffer from. As you have Hashimotos thyroiditis it's common to suffer from gut problems. Many find that going gluten free helps. Apparently gliadin in gluten can trigger antibodies activity so you could read up about it and do a 3 month trial of gluten free to see if it helps. Don't substitute with gluten free products but simply eat fresh meat, veg, fruit and non gluten added dairy products for a healthy diet. Olive oil is good too.

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It may be helpful to fill in PHQ-9 (clinical cut off 9/27 indicating mild depression) and GAD-7 (clinical cut off 7/21 indicating mild anxiety) (you can download them on the internet) which are the measures used in primary care to identify depression and anxiety disorders (along with clinician's assessment). These questionnaires are used as an initial measure before disorder specific questionnaires are used. Your GP should not be suggesting you are suffering from a mental health problem without carrying out some kind of assessment (e.g. filling in the above questionnaires or carrying out an assessment to check if you meet the clinical criteria for a mental health problem as stated in DSM). If your GP asks you to fill in the questionnaires, you fill them in accurately and your scores are below the cut off, your GP should not be suggesting you are suffering from a mental health problem. Perhaps they could explain what clinical criteria you meet? However, even if you met the clinical criteria for a mental health problem, they would need to have ruled hypothyroidism out as the cause which is hard to do if you are not optimally treated.

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GPs seem to forget that stress, anxiety and depression can actually be normal HEALTHY responses to a situation too. If we feel unwell for prolonged periods of time of course we are going to feel one or more of these reactions. MANAGE the CAUSE PROPERLY and the symptoms will go away, if they dont THEN is the time to start treating them as conditions rather than symptoms.

PS your GP is an idiot, dropping you 100mcg in one go!!! The only reason to note low TSH is as a signal to check FT3 has not gone above range. Yours hasnt, not even close, if he cant read basic blood tests he will never get you well.

SeasideSusie sorted out my nutrient levels which fixed my conversion issues a treat, search her user name for good advice on levels and how to get there.

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You are right in saying that stress is a normal and very adaptive response to some situations and sometimes GPs are too quick to dismiss physical problems as mental health problems. Obviously this is problematic for several reasons, one being that if the primary problem is not a mental health problem but an undertreated physical problem such as hyperthyroidism, then even if there were symptoms of a mental health problem but secondary to the physical problem, no psychological treatment would be able to make a sufficient difference to the person's wellbeing. If it is any consolation, should you speak to a highly qualified mental health professional (specifically, clinical psychologist/psychiatrist/CBT therapist), they should have the clinical skills to differentiate between a mental health problem, stress, natural reaction to loss (e.g. bereavement) and mental health symptoms secondary to physical problem. Saying this, you will find that not all know the difference (e.g. if they cannot quote from memory clinical criteria for different mental health conditions and how to distinguish between them i.e. carrying out a differential diagnosis), but they should and most do. Therefore, speaking to them can be off help if the GP/doctor insists the problems are psychological when you know they are caused by a physical condition.

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