Hi

[Rhiana89]

Been here for about a week, just wondering is depression a thyroid symptom?

Diagnosed hypothyroid 2012 taking 25mcg levo from 175mcg levo and 10mcg T3

TSH 4.8 (0.2 - 4.2)

FT4 14.8 (12 - 22)

FT3 3.2 (3.1 - 6.8)

[SeasideSusie Remembering]

Yes it can be. List of signs and symptoms of Hypothyroidism thyroiduk.org/tuk/about_the...

[Rhiana89 in reply to SeasideSusie]

Ok thanks GP won't give me results

[SeasideSusie Remembering in reply to Rhiana89]

Why wont GP give you the results? If you are in the UK then GP is breaking the law. The Data Protection Act allows you to have your test results. Ask at the reception desk, if still refused then mentin that you are legally entitled to them under the Data Protection Act 1998 and say that you're sure no-one there wants to break the law. Ask for a print out, don't let them give results verbally or write them down (mistakes can be made). You could ask to see the computer screen and take a photo on your phone. Some surgeries in England have online access to test results.

[Nanaedake]

Depression/anxiety are symptoms of an incorrectly treated thyroid condition. If you are under or over medicated you may get symptoms like this. Thyroid conditions often coexist with nutritional deficiencies due to lack of absorption of vitamins, especially if dose is insufficient and this can also cause symptoms.

[Rhiana89 in reply to Nanaedake]

I have vit/thyroid levels do I post please? Or am I not meant to?

[Nanaedake in reply to Rhiana89]

Yes, you've got the vitamins guru SeasiSusie above so do post your results.

[Rhiana89 in reply to Nanaedake]

Thyroid ones added

[Nanaedake in reply to Rhiana89]

TSH 4.8 (0.2 - 4.2) You are undermedicated to have a TSH of 4.8. 25mcg of levothyroxine is a starter dose and you should never have been reduced to 25mcg. How long have you been on 25mcgs? Who ordered the reduction in dose and what reason did they give?

FT4 14.8 (12 - 22) FT4 is very low and you don't have enough FT4 to make enough T3. FT4 is best in the top third of the range.

FT3 3.2 (3.1 - 6.8) FT3 is very low, only just in range but at the bottom of the range evidencing that you are undermedicated. You don't have enough T3 and you are likely to have symptoms as a result..

[Rhiana89 in reply to Nanaedake]

On 25mcg since Nov 2017, I reduced it

[Nanaedake in reply to Rhiana89]

What reason did you reduce to 25mcgs?

[Rhiana89 in reply to Nanaedake]

I didn't feel any better and I was getting fed up of the endo reducing it due to fluctuating TSH

[Nanaedake in reply to Rhiana89]

Very understandable as changing thyroid meds based on TSH is a very bad idea. Also, lots of rapid changes in thyroid hormone makes us feel very unwell.

The ENdo should have looked at FT4 and FT3 alongside TSH and symptoms too. Very likely low vitamin levels playing a part and possibly gut function too. Do you have thyroid antibodies? How are you feeling now?

If you were diagnosed in 2012 are in the UK, there was a problem with thyroid medication. It was reviewed and a report published in 2013 by the MHRA but all the unreliable meds were not removed from all shelves until 2015 I believe. It means that you may have been getting unreliable amounts of thyroid hormone without knowing it which may have contributed to your fluctuating results. It could also be due to thyroid antibodies of course A combination of this may have caused a lot of variation. If your pharmacy swapped you between brands it may have caused significant variation in the amount of levo you were getting.

Although TEVA had their license for levothyroxine production removed at that time, the other thyroid medicines were not sufficiently bioequivalent either. Strangely, Endos and doctors don't seem to be aware of the extent of the thyroid hormone medication problem even though it's on the internet to view.

In any case, you now need a dose increase of thryoid meds and retest in 6 weeks time. Just get your dose increased through your GP if you're not in touch with the Endo. Show your GP the MHRA review of levothyroxine if it helps.

MHRA 2013 Review of Levothyroxine

gov.uk/government/publicati...

gov.uk/government/uploads/s...

[Rhiana89 in reply to Nanaedake]

Thanks yes I have thyroid antibodies,

TPO antibodies 277.5 (<34)

TG antibodies 1200 (<115)

I also have symptoms like feeling tired, feeling cold, anxiety, breathlessness, swelling in neck, losing hair, puffy feeling eyes, looking tired, depression, weight gain.

[Angel_of_the_North in reply to Rhiana89]

Those symptoms show undermedication.

[Nanaedake]

Well the fluctuations could have been down to thyroid antibodies. Breathlessness can be a symptom of low iron and low B12/folate. Puffy eyes could be hypothyroid symptom along with weight gain, tiredness and feeling cold. Swelling in neck is likely due to autoimmune thyroid disease which is indicated by your thyroid antibodies. It's called Hashimotos thyroiditis. Losing hair can be low ferritin and/or other minerals.

[Rhiana89 in reply to Nanaedake]

Thanks, GPs not helping me with any of the vitamin levels

[Nanaedake in reply to Rhiana89]

What are your vitamin levels?

[Rhiana89 in reply to Nanaedake]

Ferritin 57 (15 - 150)

Folate 4.1 (4.6 - 18.7)

Vitamin D 60.4 (50 - 75)

B12 injections every 3 months, ferrous fumarate once a day, vit D 800iu once a day

[Nanaedake in reply to Rhiana89]

Ferritin is best around 70 to mid-range. For hair regrowth it needs to be above 70 to mid-range I believe. You can raise your iron levels by diet if you eat meat.

Folate is very low and under range. B12 and folate act together and both need to be good. I took 400mcg methylfolate for 4 months until my folate was in mid-range, then I took a good B complex to balance the B's. You could ask your doctor's advice since you're having B12 injections and ask why he/she thinks folate is below range.

It looks like you're on a maintenance dose of vitamin D? Was that prescribed by your doctor?

As you have Hashimotos thyroiditis you need to look at SlowDragon 's advice about gut function and going gluten free. Read her posts to other people.

[Rhiana89 in reply to Nanaedake]

Yes vit D prescribed by doctor

[SlowDragon Administrator]

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

Persistent low vitamins with supplements suggests coeliac disease or gluten intolerance

gluten.org/resources/health...

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...

Your vitamins were slightly slow, but not really low enough for GP to treat. However you do need to self supplement to improve

Reducing your Levothyroxine will result in vitamin levels getting much, much worse

Detailed supplements advice on how to improve Low vitamins due to under medication

healthunlocked.com/thyroidu...

[Rhiana89 in reply to SlowDragon]

Supplements on prescription

[SlowDragon Administrator in reply to Rhiana89]

Yes but you need more than that

Vitamin D likely 3000iu daily

Ferritin needs to be at least 70

Folate below range

Adding daily vitamin B complex will help

But you need to remember to stop this 3-5 days before any blood tests as biotin can falsely affect test results

[SlowDragon Administrator]

Yes sorry I mean to say GP not treating adequately, we see this hundreds of times

Reducing Levo dose will make vitamins much worse.

We need Levo high enough to get TSH around, but just under one and FT4 towards top of range

Vitamin D needs to be around 100nmol.