Now Diurnal Depression... caused by Hypo?

[AlisonMox]

Finally on Levo 50mcg daily after years of typical TFT (T4 11.4 TSH 3.4 ranges 12 and 4.0 respectively, then T4 12.0 and TSH 3.2, my T4 never above 12 in over 5 years) 6 weeks on Levo now T4 14.0 and TSH 2.4....has years of non treatment caused clinical depression? Now been prescribed Venfelaxine ... any contraindications? Recent B12 normal.

Thanks

[shaws Administrator]

I am not medically qualified but I, myself, would refrain from anti-depressants until my thyroid hormones were optimal.

I assume your GP is unaware that low T3 (the only Active thyroid hormone) can cause, anxiety, depression etc. In fact I will give you a list of clinical symptoms. They are all so smart that they will give the patient an array of medications for symptoms (they know none at all nowadays), whereas we used to be diagnosed upon clinical symptoms alone and given NDT (natural dessicated thyroid hormones) before blood tests and levo were introduced.

You need a Full Thyroid Function Test (all thyroid tests should follow this method) and it should be the earliest possible, fasting (you can drink water and allow a gap of 24 hours between dose of levo and test and take afterwards.

A FTF is - TSH, T4, T3, Free T4, Free T3 and thyroid antibodies.

Some labs wont test all if TSH is in range but we have two labs and they can do all of the tests we need and they are home pin-prick tests. If you decide to do this make sure you are well-hydrated a couple of days before and arms/hands are warm so blood flows easily. They can also make an arrangement for you to have blood drawn:-

Medichecks have a special offer of some sort every Wednesday and Blue Horizon is also another good lab.

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

Your GP should test B12, Vit D, iron, ferritin and folate as these cause symptoms if not optimum.

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

Put your results with the ranges on a new post for comments. Ranges are important in order for members to respond. Labs differ and so do ranges.

[SlowDragon Administrator]

If your TSH is now 2.4 after 6 weeks on Levothyroxine you are ready for next dose increase.

Dose of Levothyroxine should be increased in 25mcg steps, retested 6-8 weeks later each time.

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

Incredibly common to also have low vitamin D, folate, ferritin and/or B12

Do you know if you have raised Thyroid antibodies? Have you had TPO and TG thyroid antibodies tested? If not they need testing to see if cause of hypothyroidism is due to autoimmune thyroid disease also called Hashimoto's diagnosed by high antibodies

Make an appointment to see GP and request 25mcg dose increase in Levothyroxine plus vitamin and antibodies testing.

NHS guidelines saying standard starter dose is 50mcgs and that dose is slowly increased to somewhere between 100mcg and 200mcg for most patients. (Exact level determined by TSH, FT3 and FT4 results)

beta.nhs.uk/medicines/levot...

So full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies. Plus very important to test vitamin D, folate, ferritin and B12

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

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

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should ideally be done as early as possible in morning and fasting. If on Levothyroxine, don't take in the 24 hours prior to test, delay and take straight after

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

About 90% of all hypothyroidism in Uk is due to Hashimoto's. Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

Always take Levo on empty stomach and then nothing apart from water for at least an hour after. Many take on waking, but it may be more convenient and possibly more effective taken at bedtime

verywell.com/should-i-take-...

Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased

[Angel_of_the_North]

Not unlikely as the brain needs lots of T3 and low T3 is cause of "depression". But treating the thyroid doesn't get them extra funding like treating depression