Thyroid UK

I think I am depressed

I am new and I think I am depressed because of how my symptoms are making me feel. Period pain, dry skin, feeling cold, no motivation, constipation, breathless. I am planning to go to GP on Monday to ask for antidepressants because of how low I feel from my symptoms. Diagnosed hypothyroid 2012 taking 150mcg Levo thank you

TSH 6.70 (0.2 - 4.2)

FT4 14.8 (12 - 22)

FT3 2.0 (3.1 - 6.8)

TPO antibody 1200 (<34)

TG antibody 376 (<115)

38 Replies
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Do not ask for antidepressants, you need treating properly for your Hypothyroidism. Your problem lies with being undermedicated and the fact that you have Hashimoto's as confirmed by your high antibodies.

Others will be along with more information, and SlowDragon has lots of links and info regarding Hashi's.

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You are extremely under medicated

Your FT3 is way BELOW range

You need a 25mcg dose increase in Levothyroxine.

Retesting 6-8 weeks after each 25mcg dose increase

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, lowest FT4 and most consistent results

Dose should be increased until TSH is around one and FT4 towards top of range and FT3 at least half way in range.

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 articles from Thyroid UK email print it and highlight question 6 to show your doctor

please email Dionne:
tukadmin@thyroiduk.org

Your extremely high thyroid antibodies confirm cause is autoimmune thyroid disease also called Hashimoto's

Essential to test vitamin D, folate, ferritin and B12.

Always get actual results and ranges.

Post results and ranges if you them, members can advise

If not been tested ask GP to test tomorrow

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

Ask GP for coeliac blood test first

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

thyroidpharmacist.com/artic...

Prof Toft - article just published now saying T3 is likely essential for many

rcpe.ac.uk/sites/default/fi...

However with Hashimoto's we must get vitamins optimal FIRST, plus dose of Levothyroxine increased so that TSH is around one and FT4 towards top of range

Gluten free diet is likely to help or for many of us it's essential

If after all these steps, your FT3 remains low then, like many of us with Hashimoto's you may need addition of small dose of T3

Email Dionne at Thyroid Uk for list of recommended thyroid specialists some are T3 friendly

Read as much as possible about Hashimoto's. Medics are mostly ****** clueless

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Thank you FT3 has always been low or below range despite being on adequate doses of Levo

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Well your dose is totally inadequate at moment

Have you been on higher dose in past ?

Or had T3 started then stopped

You might look at getting DIO2 gene test

Lots of us have tested positive and has helped many to persuade medics to add T3

thyroiduk.org.uk/tuk/testin...

Swale CCG in Kent are even offering this test on NHS now. And prescribing T3 if positive and/or if gluten intolerant or coeliac too

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Thank you I have been on 150mcg Levo and 10mcg T3 and in August 2017 my endo stopped my T3 which I was on for 2 years.

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Then no wonder

Essential to get vitamins tested

They crash right out after T3 withdrawn

Typical posts after T3 stopped

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Thyroid UK are collecting evidence of malpractice due to removing clinically needed T3

Please consider sending a brief outline of this. How T3 improved you and the subsequent disaster since it was stopped. I would include the dire vitamin levels (assuming you have them)

thyroiduk.org.uk/tuk/get_in...

T3 debate in Scottish parliament

scottishparliament.tv/meeti...

Get list of recommended thyroid specialists from Thyroid Uk some are T3 friendly

Must get vitamins optimal first and Levo dose increased first

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For god sake, please don’t ask for antidepressants!!!

You are depressed because your thyroid is not working properly.

The experts on here have confirmed this and I see they have said you are under medicated.

My Endocrinologist tried to give me antidepressants and I refused them, GP just recently told me it was anxiety.

Luckily, I’m not a walk over and I have my family supporting me.

I still don’t feel great ( I’m going to self medicate), but I’m not in that dark black hole I was in.

I made it quite clear that I was depressed due to my thyroid issue.

It maybe a case of taking matters into your own hands, self medicating?

It became quite clear after seeing an endocrinologist and my GP that don’t really give a damn and just want to dish out antidepressants.

They stick to guild lines that don’t apply anymore. I have read that some people can’t get on with Levothyroxine either.

Have you been told yet to go on holiday? My Endocrinologist told me that too, as if that’s going to solve the problem.

Oh and don’t let them tell you it’s all in your head either, that you are mentally ill, that’s another one they like to label you as.

Please use this forum as your support network. They have been absolutely fantastic.

Best wishes

Peanut31

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Thank you I tried to self medicate before but I was not under any guidance so gave up. I didn't know what I needed to do to make myself well at the time. Never been told to go on holiday

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Check your PM.

I take

Vitamin C

Iron

Vitamin D

Selenium

I’ve gone gluten free and given up the fizzy drinks. Looks like I’m going to give up milk now as I have terrible tummy, gut issues, this is all linked to Hashimoto’s.

Best wishes

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Thank you have registered with TPA UK now as well

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I have lost my way with what supplements I am meant to take do I post results here?

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Please do post your results for members to comment and give you some advice :-) Am thinking your B12 is on the floor ....

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Ok here are results

Before T3 taken away (January 2017)

Ferritin 110.3 (15 - 150) iron tablets stopped May 2016 due to iron infusion

Folate 2.35 (2.50 - 19.50) given folic acid after result

Vitamin B12 547.3 (180 - 900)

Vitamin D total 72 (50 - 75 vitamin D suboptimal) taking 1000iu vitamin D from prescribed 800iu given to me in 2013. Started vitamin D 1000iu in March 2015

After T3 taken away (Results taken December 2017)

Ferritin 22 (15 - 150) no iron tablets

Folate 2.10 (2.50 - 19.50)

Vitamin B12 202 (180 - 900) waiting on B12 injection

Vitamin D total 59.9 (50 - 75 vitamin D suboptimal) taking 100iu vitamin D drom prescribed 800iu given to me in 2013. Started vitamin D 1000iu in March 2015

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Wow - i have read so often that taking away T3 trashes the vitamin and mineral levels - and it has happened to you too. Although it could be other reasons too. It would seem that your body was unable to hang onto the Iron transfusion for some reason. Your Ferritin needs to be around 70 so maybe start the tablets again and take them with VitC to aid absorption.

How often do you have B12 injections ? Maybe you need them more often to help with the low mood. Your Folate-Folic Acid needs to be mid range too so I would supplement with a good B complex which should boost the Folate and keep all the B's in balance. How long have you been on B12 injections ?

I would increase your dose of VitD to at least 3000 IU's - not forgetting to also take VitK2-MK7 and Magnesium. Re-test at the end of winter.

grassrootshealth.net

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Marz

I am pretty sure this happens EVERY time T3 is stopped with Hashimoto's

It's utterly appalling that medics have zero idea

Endocrinologists are not remotely interested in gut, gluten or vitamins

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It was from reading your posts that I had come to that conclusion - I agree it is a shocking state of affairs.

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Thank you I have iron deficiency anaemia secondary to heavy periods and haematologist refused to put me on maintenance dose of iron after infusion had been done. I am meant to be on B12 injections every 3 months but had my last one 7 months ago

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You must shout loudly for a B12 injection. Do you have PA ?

You must get back on the iron too ...

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Thank you I tested negative for intrinsic factor twice, never had MMA or homocysteine checked so can't say for certain I don't have PA

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Raised Homocysteine and MMA will confirm B12 deficiency in the cells. But then your blood test has confirmed Low B12 - so I guess that is what they are treating ....

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Have only had 1 B12 injection so have only been taking it for 7 months if including the time I have had to wait.

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I think you will have to chase this up as I do not think they will offer it by knocking on your door. What symptoms did you have with Low B12 - were they neurological ? - if so you should be having injections every other day until symptoms have improved. This is laid down in the Guidelines your GP should have read from the British Haematological Society for Cobalamin and Folate Deficiency .... available on-line.

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Thank you I have neurological symptoms yes

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I will send you a link or you can find the Guidelines on-line. Cannot do it on my phone !!

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onlinelibrary.wiley.com/doi...

I expect you know that Cobalamin is B12 :-) Scroll down and down to read the - Treatment of Cobalamin Deficiency and you will see you need more regular injections where neurological symptoms are involved. These are Guidelines your GP has on his/her desk and SHOULD have read.

Also the first sentence at the beginning of the paper is VERY relevant as it mentions Clinical symptoms being part of the diagnosis and not just the blood test.

b12deficiency.info/signs-an...

The above link takes you to all the signs and symptoms of B12 deficiency. Neurological come first ....

Please read and arm yourself with relevant information or show your GP the link if you are using a phone :-)

Hope all goes well ...

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You may have to get a homocysteine blood test privately. If our homocysteine level raises too high it can cause dementia.

This is a past post:

healthunlocked.com/thyroidu...

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Put in complaint in writing to practice manager over B12 injections

Ask PAS healthunlocked for advice too on that

Many have learnt to self inject as so p****d off at never getting regular enough injections

Lots of us self supplement with sublingual B12 lozenges. Eg Jarrow B12

Also good idea to take good vitamin B complex to keep all B vitamins in balance

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

You need maintenance dose of ferritin or another iron infusion

Heavy periods are classic sign of being hypothyroid

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Complete blood count results

Red blood cell count 4.41 (3.80 - 5.80)

White cell count 4.32 (4.00 - 11.00)

Haemoglobin estimation 116 (115 - 150)

Haematocrit 0.400 (0.370 - 0.470)

MCV 80.5 (83 - 98)

MCHC 378 (310 - 350)

MCH 28.1 (28 - 32)

Platelets 245(140 - 500)

Iron 7.2 (6.0 - 26.0)

Transferrin saturation 13 (12 - 45)

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So you need to take these results into GP tomorrow

They are clear evidence that T3 was helping and levels have dropped significantly

You now need coeliac blood test.

Ferritin. Have you had full iron panel done? Post results if you have.

Are you taking any ferrous supplements at all at moment? If not ask to be prescribed some (ferrous fumerate 2 or 3 times daily)

B12 you need injection urgently. Insist it's this week

Exaggerate low B12 symptoms if necessary

b12deficiency.info/signs-an...

You need to start folic acid supplements. But these should not be started until 48 hours after first B12 injection

You probably need several B12 injections a few days apart

Ask on PAS they are B12 experts

healthunlocked.com/pasoc

Vitamin D you will need to self supplement. Most of us with Hashimoto's find Better You vitamin D mouth spray works best as it avoids poor gut function

Suggest you get 3000iu strength. Try one spray daily

Retesting in 2-3 months

Vitamindtest.org.uk £28 postal kit

Likely to need lower maintenance dose once you improve (aim for around 100nmol)

Retesting twice yearly as it's trial and error what we all need as individuals

See SeasideSusie detailed vitamin supplements advice in replies I gave you earlier

Can you take supportive friend or family member along with your tomorrow?

All this is directly due to having T3 stopped.

T3 being stopped purely fir financial reasons. Ends up in lost lives and further expense of multiple vitamin deficiencies

You must get Levo dose increased in 25mcg steps until TSH back near one

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Thank you I have iron deficiency anaemia secondary to heavy periods and haematologist refused to put me on maintenance dose of iron after infusion had been done. I am meant to be on B12 injections every 3 months but had my last one 7 months ago. My boyfriend refuses to come with me to appointments and family are keeping out of anything health related. Will post complete blood count levels now.

1000iu vit D, 5mg folic acid stopped, B12 injection last done 7 months ago. No iron

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Sorry to hear. It's extremely common for family to be unsupportive.

Roughly where in Uk are you ?

You need to find good endocrinologist and get T3 prescribed once you get vitamins improved

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South West UK.

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Email for list of recommended thyroid specialists from Dionne at Thyroid Uk

Get B12 injections sorted, self supplement vitamin D, and self supplement ferritin if GP refuses - though you have clear low ferritin and should be treated

Get Levo dose increased

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1000iu Vit D is Better You oral spray.

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Then take 3 sprays daily.

Retest via postal kit in 2 months

You may need even higher dose until back on T3

Gluten free diet helps majority too

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T3 - liothyronine - is the only active thyroid hormone and is required in our billions of T3 receptor cells. T4 is inactive and has to convert to T3. Your FT3 is below range, when it should be nearer 6.

You are clearly on an insufficient dose of hormones as TSH nearly 7 with FT4 and FT3 both are too low.

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You are undermedicated and need a dose increase (and some T3) not anti-depressants. The GP will want you to have ADs as he'll get extra money for that (more than £1000, I think), but once you are diagnosed with a mental problem no one will ever take your physical illness seriously again. Anyone would be sad, tired, fed-up and annoyed at feeling ill for a long time with no proper treatment - that's normal, not depression. You TSH should be under 1 and free T4 and free t3 in the top quarters of their ranges when you are being properly treated. Under range T3 will make you feel depressed and T3 is actually prescribed for medication-resistant depression.

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Medication resistant depression aka hypothyroidism/Hashimoto's

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