Thyroid and mental health

[JayeC3]

I am new and a 21 yr old female with hypothyroid diagnosed when I was 14. I am worried about mental type symptoms I have like anxiety jumpiness, inability to remember or understand, I am sometimes scared to leave the house some days and there are times I just want to cut myself off from friends and family. Are these thyroid related. Taking 25mcg thyroxine. Thank you for reading.

Nov 2016

TSH 5.6 (0.2 - 4.2)

FT4 9.2 (12 - 22)

[Clutter]

JayeC3,

If you are undermedicated on 25mcg that could increase feelings of anxiety and depression. If you post your recent thyroid results and ranges since taking Levothyroxine members will advise whether you are optimally dosed.

[JayeC3 in reply to Clutter]

Thanks I haven't test done since Nov 2016.

TSH 5.6 (0.2 - 4.2)

FT4 9.2 (12 - 22)

Diagnosed 2012

[Clutter in reply to JayeC3]

JayeC3,

You were undermedicated to have TSH 5.6 and FT4 9.2 which is below range on 25mcg. Your GP should have increased dosed after those results. Ask for a dose increase.

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.2 - 1.0 with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email dionne.fulcher @thyroiduk.org if you would like a copy of the Pulse article to show your GP.

[SlowDragon Administrator]

You are very under medicated. The aim of Levothyroxine is to take high enough dose to bring TSH down to around one and FT4 near top of range and FT3 at least half way in range.

Your FT4 is actually below range

Make an appointment and ask for 25mcg dose increase, with bloods retested after 6-8 weeks. Likely to need further increases, always in 25mcg steps and retesting each time

Very likely to also have low vitamin levels. Have you had recent tests for vitamin D, Folate, ferritin and B12?

If you have these results and ranges add them to your post. If not been done ask GP to test.

Have you had your thyroid antibodies tested? High antibodies means you have Hashimoto's also called autoimmune thyroid disease

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH and most consistent results

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the article by emailing [e-mail] print it and highlight question 6 to show your doctor.

[JayeC3 in reply to SlowDragon]

Will post these now thanks

[MacG]

Hi JayeC3,

I agree with the posts above that your results do suggest that you are under medicated.

I notice that your last test was Nov 2016. Your GP surgery SHOULD at the very least call you in for an annual thyroid function test, so I think it would be a good idea to contact your surgery and get this organised. If you were first diagnosed in Nov 2016 and started on 25mcg of Levo, they should have called you back in anyway MUCH SOONER (i.e., 6 weeks or so) after you started the medication for a blood test to see how you were progressing. For reference, at any point when you alter your thyroid meds you should be re-tested a few weeks later to see how things are going. This is standard practice, so if your GP surgery isn't following through, don't be afraid to ask yourself. (Sorry if you knew all this anyway.)

Moving on........re. the anxiety, I totally empathise with you. When you are under medicated there are all sorts of very subtle ways in which you feel under par and that can make you feel anxious and yes, I, and others on this forum, certainly recognise what you say about feeling like you need to shut yourself away from people. I have personally noticed on my thyroid journey that when I feel physically well I feel mentally resilient and vice versa. Here is the way I explain it: for ANYONE, if they are going down with a cold, for example, and feeling a bit under par, they don't feel like socialising and being around people and their mood is low. We would all agree with this. Like I said, thyroid symptoms can be very subtle and creep up on you slowly, so perhaps you are not always aware that physically you are under the weather (perhaps it just that you feel a bit washed out, or achey for example). I can say this now with the benefit of hindsight, but I have been there too! I hope this makes sense.

Is there a Thyroid UK support network group near to where you live? Sometimes having the opportunity to chat to others who have experienced similar and have come through it can be very helpful.

The other thing is, keep a note of your thyroid results. I write mine into a table now and it helps me to track how I am feeling (physically as well as emotionally) in relation to my test results. Knowledge is empowering!

Best of luck with it all.x

[JayeC3 in reply to MacG]

Thanks I didn't have much luck with the Thyroid UK support group I was with so currently unsupported

[MacG in reply to JayeC3]

Sorry to hear that. It can be really helpful to spend time with people who understand. There are new groups starting up all the time, so keep an eye out. You will always find lots of support and empathy on this forum. I just noticed your more recent post with your other results (Ferritin, B12 etc. etc.). I am sure once you get these sorted out and you will start to feel emotionally stronger. Sorting your physical health has to be a top priority at the moment then the rest will follow.

Maybe you don't feel up to it at the moment, but one of the most important lessons I have learned since diagnosis re. my health is to "project manage" it myself and not to be afraid to do that and ask for what I need. .