Hypothyroidism & mental health

I’m 19 and have been taking levothyroxine to treat my hypothyroidism since the age of 13. Lately I’ve experienced some deterioration in my mental state which I’ve been finding particularly disturbing. I’ve always had anxiety issues but in the last 3-4 months I’ve been either really distressed (often by simple things such as having to leave the house or social gatherings) or experienced low moods (these have been manifesting particularly when I’m alone once the anxiety has subsided). I am always tired and irritable, have little energy for things that used to excite or motivate me. My memory has also suffered and I’ve been finding it much harder to recall things I never had any trouble recalling or memorising things for my exams. Furthermore, I’ve been particularly disturbed by the fact that my thoughts have “slowed down”. By this I mean that I often can’t keep up with what is being said by someone I’m listening to (both in real life and on TV) as well as myself at times and I often have to replay it several times in my head before actually processing and understanding it. My mood swings have gotten to the point where I can be in a tolerant mood one minute and be on the verge of crying due to a minor inconvenience the next. I can’t help but be irritated at others and end up snapping at them, often without any reason whatsoever. I honestly wouldn’t have made a big deal about any of these issues if I hadn’t felt effectively stuck in this mood for the past several months and it only seems to get worse.

I was wondering if these symptoms were related to my hypothyroidism possibly deteriorating, particularly since a close relative of mine also has hypothyroidism and has been suffering from depression for years. Should I get my TSH levels tested (the last time I did it was last January) or are those issues unlikely to be related to my under active thyroid?

I’d be extremely grateful for any guidance as I had no idea whom to turn to about this.

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27 Replies

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  • Your symptoms are very likely related to hypothyroid condition but you can only know for sure or eliminate the possibility with full thyroid tests. Make sure you get a copy of blood test results. GP's often say they are ok when they are anywhere in range, however, anywhere in range does not always make us feel well and people on this forum can advise you.

    Get your GP to test:

    FT4

    FT3

    TSH

    Thyroid Peroxidase antibodies (TPO)

    Thyroglobulin Antibodies (TgAb)

    Vitamin B12

    Folate

    Ferritin

    Vitamin D

    Vitamin levels can all be low in people with hypothyroidism, this is often due to poor gut function, poor absorption of nutrients and an imbalance of stomach acid and/or iimbalance of normal gut bacteria.

  • Pastelesque, if you struggle to get the full set of tests from your GP, the second option is to get a mail order private test. The easiest option is to do a tiny pinprick blood collection yourself.

    Medichecks and Blue Horizon both do these, you can find more detail on the ThyroidUK website.

    The complete set is around £100, or if money is tight the thyroid panel should be more like £40 (you may be able to get as low as £20 if you find a Thyroid Thursday sale on Medichecks). If you get the smaller panel, save up and get the full vitamins and minerals 6 weeks later - after you've had a dose adjustment based on the first set.

  • Pastelesque,

    Thyroid levels can change within the year so I don't think it is premature to request a thyroid function test to check levels as you've been feeling anxious and depressed and experiencing mood swings.

    I hope you feel better soon.

  • Just another thought, the pharmacy hasn't by any chance swapped the formulation of levothyroxine you take has it? If so, did the symptoms start afterwards?

  • I would suspect thyroid levels are out of whack and/or nutrient levels have dropped too low for good health.

    Whatever you do, don't accept anti-depressants or anti-anxiolytics. They will just add side effects of the meds and addiction to the meds to your existing problems without fixing the underlying problems at all.

  • I hope you are ok.

  • I found these symptoms a side effect of levothyroxine but no one seems to acknowledge it, all I see in these posts is ‘your under medicated’, it’s a synthetic drug with horrible side effects I don’t rate it’s effectiveness.

  • If in the UK there were serious problems with Levothyroxine. The MHRA reviewed Levothyroxine and made quite a few significant changes. The old formulations were finally cleared off shelves in 2015 I believe. You can read the reports on the MHRA website. The regulations are much tighter now. Recent research showed Levothyroxine causes small intestines bacterial overgrowth which may cause symptoms.

    There's no saying they've got the medication right for us yet so if you have problems do a yellow card report.

  • Hey, thanks for answering. I'm gonna make an appointment with my GP asap. With regards to the medication formulations, I've never checked but it is possible that my pharmacy has changed them since sometime in 2015 since I had been taking levothyroxine before then. The thing is that I didn't really notice any radical changes until a couple of months ago so it could be the case that I just need a higher dose of the meds (I've been on 25mg a day for 6 years now). Hopefully I'll get some clarity once I see my GP and have my tests done. Thanks again.

  • Good. You'll find most GPS know nothing about the 2013 review of Levothyroxine in the UK and are completely unaware of the quality issues surrounding Levothyroxine. However, they can read the report on the MHRA website. Quality and Clinical Considerations of Levothyroxine 2013 report.

    Most likely levels are out of whack but ask for vitamins to be checked. Low ferritin can be a problem for young women. When we are hypothyroid we feel worse than other people with the same deficiencies it seems.

  • To be quite honest I had no idea about these issues either, it was perhaps slightly ignorant of me to have been on a drug for so long and yet know so little about it. Hopefully it turns out to be a levels problem like you said so I can have the dose readjusted. I'll make sure to request a vitamin levels check as well. Thanks a million once again, you've been enormously helpful.

  • Well, we assume the quality controls are sufficient and effective in the UK. The Commission for Human Medicine and the MHRA are the regulators but their scientific advisers misunderstood the dissolution properties of Levothyroxine and wrongly classified it. This meant the manufacturing quality controls and dissolution tests were inadequate.

    I hope it's being kept under review as the report states but if you or anyone has problems with any medicine side effects do a yellow card report. I don't have weblinks to hand as on my phone but just Google yellow card MHRA and you'll find it.

  • Someone with low or high cortisol can struggle to tolerate levothyroxine at sufficient doses to make the patient feel well. (Cortisol is produced by the adrenal glands.)

    If the cortisol level is improved - raised or lowered as appropriate - thyroid meds may become more tolerable with fewer side effects.

    It even mentions on the Patient Information Leaflet for Levothyroxine that people with any condition affecting their adrenal glands shouldn't take levothyroxine.

    But of course, the big problem is that doctors don't believe that the amount of cortisol produced can ever be a problem unless the patient has Addison's Disease (i.e. produces virtually no cortisol at all) or Cushing's Syndrome (produces massive amounts of cortisol, usually caused by a tumour on the pituitary or the adrenal glands). Any level of cortisol produced between these two extremes is "normal" according to a doctor.

    Patients also find that they tolerate thyroid meds rather better if they have good levels of nutrients. But again, doctors think any result in range, is absolutely fine and dandy. The concept of optimal hasn't worked its way into the medical profession yet, and somehow I doubt it ever will as long as Pharma companies call the shots.

  • Sjyaylorni, 'undermedicated' can include being on the wrong medication. The most common advice on looking at blood tests will be: increase dose, introduce T3, and supplement to improve vitamins.

    Overall the forum prefers NDT and T3 to Levothyroxine. But it seems that some large percentage of people, maybe 80% do fine on Levothyroxine. It's certainly an easier life to be on an NHS, relatively well understood medicine. But you will also find a lot of advice and support here if you want to self medicate, or to treat adrenals, go gluten free or other approaches to treating the thyroid.

  • Sjtaylorni, I was treated with levothyrox (synthroid) during thirty years and I agree with you, it was a rotten wooden crutch.

  • I had similar mood issues earlier this year and my GP wanted to put me on antidepressants again as I have had a history of depression and anxiety. So I obliged, but I felt worse not better so after doing some reading I started taking magnesium supplements and stopped all antidepressants and have felt really good mentally of late, my sleep has also improved.

    I agree that checks regarding your thyroid would probably be a sensible thing to do along with a discussion with your GP, but Inthought I’d let you know what has helped me in the last 6 months 😊

  • It's a good idea to take magnesium, many people are deficient.

  • I actually used to take magnesium until fairly recently so I'll raise this issue with my GP as well. Thanks.

  • Don't be surprised if GP looks blank. They do not study nutrition. Worth asking what he/she knows about the role of magnesium though.

  • I got under active thyroids and that is exactly how I am reacting it is so bad I have never been like that it started with thyroids that is how I found out about it when u feel like that go out than come fresh home ,I used to be so calm but now I am like a devil ,but I chech my thyroids level they are good it must be the medication I am on I take oroxine (Thyroxine) 100micrograms

  • How long have you been on thyroxine for? I've never really experienced any negative side effects until now (if my symptoms originate in the medication, that is). Hope you get better soon, thyroid problems can get truly unbearable so it's always good to seek an answer x

  • Let us all know how you are.....support is always here xxx

  • I'm doing ok thus far, thank you so much, it's honestly a massively reassuring change to finally be able to talk to people who experience similar issues, makes a significant difference in itself xx

  • All good advice, If GP will not do full thyroid bloods,usually only test Tsh and T4 check out Medichecks,

    Hope you feel better soon, horrid for you and all us hypo's,

    Big hugs 😘

  • You sound like my granddaughter.....she was on antidepressants from 16 to 21 and they did not work.......we then discovered how important vitamin d and b vitamins were to mental health and after high dose supplementing and now on maintenance dose she is off antidepressants and enjoying life. Don't underestimate the power of these vitamins especially with hypothyroid problems

  • The significance of getting thyroid antibodies tested is that 90% of people with hypothyroidism have antibodies that progressively (but not steadily) destroy their thyroid. This means that over the months and years their thyroid is capable of producing less and less hormone, so you need a higher dose of Levothyroxine to keep up. The antibodies attack in fits and starts, and as the thyroid cells are destroyed they dump Thyroxine into the bloodstream, making you first slightly hyper, then increasingly hypo.

    If you do have high levels of thyroid antibodies some people find that it helps to go gluten free, and at your age I would consider it, since you want to preserve as much of your own thyroid activity as possible for as long as you can.

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