Undermedicated

[Zoey20]

Hello, I am newly registered. I currently take 175mcg levothyroxine and I have been advised by GP that I am undermedicated.

My problem is that my endocrinologist has said I have a mental illness and that my below symptoms can not possibly be thyroid, please see below:

Low energy levels

Slow metabolism

IBS symptoms

Dizziness

Tiredness

Hard stool

Periods draining me

Absent periods

Weight gain

Looking ill, pale and tired

Bone and muscle pain

Diagnosed 2012, I am starting to think the endocrinologist is right and I should be going back to my GP to order an antipsychotic or antidepressant.

I take my levothyroxine on an empty stomach with just water and I leave 4 or more hours between the dose and food/drink/supplements/medications.

Thanks for advice in advance.

Serum TSH 7.2 mIU/L (0.2 - 4.2)

Serum Free T4 13.1 pmol/L (12.0 - 22.0)

Serum Free T3 3.2 pmol/L (3.1 - 6.8)

Thyroid Peroxidase antibodies 1078.5 IU/mL (<34)

[bluebug]

Hello and welcome.

Your GP is right and your endo is wrong. Just because someone is a specialist in something doesn't mean they can't be a £$*&^% buffoon.

The first thing you can do is ask your GP to test your ferritin, folate, vitamin D and vitamin B12 levels if it hasn't been done. Make sure you get the results and ranges. The reason for this is because you have autoimmune thyroid disease commonly called Hashimotos. People with that condition are frequently found to be nutrient deficient in one or more of these.

Getting these levels right helps you to process your levothyroxine.

Once you have your tests come back here and post the results and ranges so you can get detailed advice. Be aware the NHS can only treat you if you are severely deficient in any of the nutrients. If you are "just" sub-optimal, like most people, you need to treat yourself.

Also ask the GP for a dose increase in levothyroxine.

There are other recommendations that will help you and others will be alone shortly to help.

Tell the GP you got this advice from Thyroid UK, a charity for those with thyroid disorders recommended by NHS Choices. DO NOT tell the GP you got this advice off the internet unless you want him/her to regard you as a crackpot like the stupid £$*&^% endo you saw.

[Zoey20 in reply to bluebug]

Thank you I already have vitamin and mineral levels checked so will post

[Gillybabe in reply to bluebug]

I agree. It may well be why you feel mentally ill also. My daughter had very low B12 and had all the above symptoms. So check that too. It is about how you are feeling too. So a higher dose is worth trying and monitor your mental health too. As some of the drugs do affect your thyroid like lithium.

[Clutter]

Zoey20,

You are undermedicated. Tell your GP you don't want to see that endo and you would prefer your GP treats you.

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 [e-mail] if you would like a copy of the Pulse article to show your GP. The Thyroid UK office opens on 3rd January.

Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

chriskresser.com/the-gluten...

thyroiduk.org.uk/tuk/about_...

[Gillybabe in reply to Clutter]

Totally agree.

[Mary-intussuception]

What date were these tests done?

As you can see they are way out and need addressing. Why would you consider asking GP for antidepressants or antipscychotics?

You have raised Antibodies - therefore Hashimoto's Autoimmune Thyroiditis.

Your TSH is far too high and needs to be below 2.

Your FreeT4 & FreeT3 are too low - bottom of the range.

It's no wonder you feel so unwell.

You appear to have been undermedicated at the time the tests were done and should have increased by 25mcg - then be retested in several weeks.

You don't have to leave 4 hours between your dose and food. Just 30 to 60 minutes. Levo needs stomach acid.

Have you had any tests to check your Adrenals?

You mention supplements - have you had blood tests to check nutrients levels of Vitamin D; B12; Folate and Ferritin?

[Zoey20 in reply to Mary-intussuception]

Thanks the bloods were taken 22 December, endo suggested to GP I would benefit from antidepressants and antipsychotics and I thought he was correct in saying this. Will post vitamin and mineral levels now. I have low cortisol and high cortisol found on private saliva tests.

[bluebug in reply to Zoey20]

I didn't realise the endo was a psychiatrist.

It would be worth contacting the patient association/support group at the hospital where you saw the endo, and putting in a complaint about them. Point out your test results are out of range and instead of at least trying to treat that the endo, who isn't a psychiatrist, suggested anti-psychotics. Also if you deficient in one or more nutrients add that in the complaint letter as well.

Your complaint will likely go no-where but you could help stop the endo killing/seriously injuring someone else.

[Gillybabe in reply to bluebug]

Yes I agree. Because my daughter went for thyroid test which we had to push as she was feeling so ill and the doctor then did the full spectrum of tests and her B12 was dangerously low and she needed injections. She felt as if she was going mad and they gave her a prescription for antedepressants but she has been feeling so much better that she has not needed to take them. You just have to politely stand your ground.

[Mary-intussuception in reply to Zoey20]

As already advised - don't go back to Endo - see GP.

You could report / complain about Endocrinologist if you wish.

[Jazzw]

Endocrinologists should leave diagnosing mental health conditions to those qualified to do so!

What an absolute idiot of an endo! He doesn’t deserve to use that title. You’re definitely undermedicated.