Has anyone had any success with CBT?: As per the... - Thyroid UK

Thyroid UK

127,212 members149,387 posts

Has anyone had any success with CBT?

bristolboy profile image

As per the title. CBT was suggested to me by one of my GPs a few months ago, but I declined it. Her predecessor actually suggested anti-depressants but I politely told her where to shove them!

I'm hypo, on Levo but still symptomatic. I've done my homework, and consider myself reasonably intelligent and clued-up about hypo problems (when the foggy head allows!!). I've been having Medichecks tests, and supplementing with advice from the wonderful people on this forum, and I also have a plan of action going forward (1. One further tweak to the supplements, 2. Try gluten free for a few months, 3. Consider DIO2 gene test to check if not converting, 4. Consider adrenals test, 5. If all else fails, then I have a name of a private endo that could possibly help).

HOWEVER, we all know what a long tortuous journey this can be, and I find myself getting very "low" and frustrated at times because nothing is happening quickly enough for my impatient self :-) . So I'm wondering whether CBT might help me cope better whilst I work through my action plan. Has anyone used it successfully? I know there are different types, depending on what illness you have. I also know there have been recent reports/studies saying CBT is not the wonder cure that the medics claim, so I'm getting confused! I'm more than willing to try any positive action that will help me along this journey, but I don't want to waste my time on something that might be pointless, or might do more harm than good. Any advice or tips would be much appreciated xx

40 Replies

I've never tried it, but I don't see how CBT can possibly replace missing hormones. If you are hypo, what you need is thyroid hormone replacement in the correct form and the correct dose. It sounds do me as if you are under-medicated, and your doctor needs to go back to school!

You don't need an expensive gene test to see if you're converting. You just compare your FT3 with your FT4 and it becomes as clear as day - to patients, if not to doctors. A gene test wouldn't cut any ice with doctors, anyway. If they know little about hormones and nutrition, they know absolutely zero about genes. But, if you post all your results on here, there are people that will be able to help you and suggest less expensive solutions. :)

bristolboy profile image
bristolboy in reply to greygoose

Hello greygoose, I wasn't expecting CBT to replace my missing hormones, just to give some emotional support while I get advice from the experts and get my levels correct. I mentioned the DIO2 test because some have mentioned that it might be unequivocable proof that I wasn't converting, which could persuade Endos to prescribe T3. It's only on my list of "possibles" at the moment :-)

No it's not "unequivocal" proof as a polymorphism indicates a variation, but not how that variation will impact health, or if at all.

greygoose profile image
greygoose in reply to bristolboy

As far as I know, CBT is devoted to convincing you that your symptoms are all in your head. How will that help you? This is probably just your GP's way of getting you off her hands and making you someone else's responsibility.

bristolboy profile image
bristolboy in reply to greygoose

It sounds more like a distraction than anything else. I've just crossed it off my list!!

It's rubbish. NHS wastes millions of pounds on CBT for all sorts of stupid reasons. Most people need help with getting well not fobbing off with CBT.

greygoose profile image
greygoose in reply to bristolboy

Good! :)

MiniMum97 profile image
MiniMum97 in reply to bristolboy

I have had CBT before and also done an 8 week mindfulness course. I have had psychotherapy and person centred counselling in the past. I have had problems with anxiety and depression most of my adult life. In the last few years I have developed thyroid issues.

I have coped pretty well with a chronic illness but have started to struggle in the last few weeks so have gone back to see a counsellor for support. She is by no means telling me my health problems are in my head and is providing me with some support when I am struggling which is what I needed.

Having tried lots of counselling personally I wouldn’t want to start CBT right now and if you are struggling with your symptoms still I wouldn’t recommend it. CBT is quite challenging and a lot of work in terms of time and emotionally. It’s dry effective but doesn’t always feel very “supportive”.

The counsellor I am seeing at the moment is using a range of approaches, some CBT, some person centred, some mindfulness with a view to helping me through a difficult time when I am feeling physically terrible. I am finding it very helpful.

You may be able to get a referral to a talking therapies service in your area and you will be assessed. Some services have specific help/programs for people with long term health conditions. You should be able to say at the assessment what you need (eg I said “someone to talk to”) and they should let you know what they can offer you. You could always decline at that point if you don’t think it would be helpful or add more pressure but I think they are unlikely to do that.

Mindfulness (MBCT) was first “invented” for people with chronic pain and I am using some of these techniques to try to help me cope with feeling ill all the time and the impact that has had on my life.

It’s not a cure. It won’t take your health condition away but it might help you cope with it. MBCT is generally offered as a 8 week course once a week with “homework” of daily meditations which may be too much for you though if you are feeling unwell.

SlowDragon profile image
SlowDragonAdministrator

Looking at your last post, things are improving

healthunlocked.com/thyroidu...

I'd be more inclined to try strictly gluten free diet next. Rather than CBT

Have you had coeliac blood test? Best to rule out first

Ask GP or buy online

Hi SlowDragon,

Yes, my numbers are improving - I only wish the symptoms were diminishing, but I recognise it's a slow process/battle. I'm going to act on SeasideSusie's recent suggestions re B Complex and an increase in Vitamin D, then move on to a gluten free diet next (my GP has tested for coeliac, and I'm not). I was just thinking that maybe CBT, done alongside my supplementation/diet changes, might make the journey a little easier to cope with. But I'm starting to get the impression that it's not very highly regarded?! Thanks, Nick :-)

SlowDragon profile image
SlowDragonAdministrator in reply to bristolboy

I was sent for CBT when very immobile/stuck in wheelchair due to Hashimoto's

Getting vitamins optimal and strictly gluten free were far more effective

I am also not coeliac, but turned out to be extremely gluten intolerant despite no obvious symptoms ....other than couldn't walk! More on my profile

You may still need T3

Getting DIO2 gene test is good idea

I would suggest Blue Horizon one as looks at other DNA issues too

bluehorizonmedicals.co.uk/t...

Thanks for your thoughts. I've just crossed CBT off my list of "possibles"!!

You could simply learn to meditate at home. You will find lots of help on YouTube for this. I love meditation. It's easy to learn and simple to do. If you want to you can light a scented candle, drop the lights and just sit and meditate for 15-20 minutes a day. It really helps calm the brain. Lots of apps available to help with it too.

It might work for some people, but it is basically a form of brainwashing that teaches you to ignore how you feel instead of dealing with the root cause and fixing it. My friend died after having that and graded exercise.

So sorry to hear about your friend. I've read about the graded exercise causing problems when used on inapplicable patients, but that's awful.

No CBT isn't a form of brainwashing; but like any talk therapy, is only as good as the therapist delivering it.

I'm not aware that CBT has different types according to different illnesses. CBT is Cognitive Behavioural Therapy and addresses how attitudes, beliefs, thoughts affect behaviour and feelings; which are the key issues driving and underpinning our experiences, irrespective of our illness. However, as with all talk therapies, different practitioners will have different attitudes and approaches to its application, dependent on their training and own belief systems. Often, if not always, the therapist is as important as the therapy, and underpins the relationship between them and the client. I'm not a fan of CBT, in part because no therapy can be as successful, or successful for all undergoing it, as the NHS and NICE has had us believe (which is the fault of NICE rather than of CBT to be fair). Whether someone needs, or think they need, CBT or any other therapy, is a matter for them to decide; and there's no reason it shouldn't underpin or run alongside their physical recovery. It certainly won't harm them (subject to the therapist being competent and qualified of course). If you've got some wonky thinking around your health matters, it could be good to resolve that - for instance I worry about people who see themselves as "victims" of their health condition, because it can impact directly on their response to it. So if you think you need it, or could benefit from it, go for it. (But it isn't emotional support btw, it's about helping you think, feel, and behave effectively for you). If however, you were able to finance it yourself, I'd suggest you consider ALL the different models of therapy out there, and chose the one which speaks to you the best.

Many thanks for your very considered reply, MaisieGray. I might see if there are any alternatives available, but I think CBT is a non-runner.

SlowDragon profile image
SlowDragonAdministrator

On the plus side my CBT therapist actually listened to what I said, and her evaluation said I was coping extremely well with positive outlook despite profound physical disabilities

Only on her say so, did I get what I originally wanted....a referral to a proper thyroid specialist as my NHS second option

Some psychiatrists, psychologists and therapists have convinced the NHS and the powers-that-be that sick people whose ailments can't be identified have MUS - Medically Unexplained Symptoms, which means they are hypochondriacs. And when that is the case all biomedical treatment or testing should stop and the patient should be treated with CBT and Graded Exercise Therapy. They should also be diagnosed with Chronic Fatigue Syndrome, and their medical records should be marked to prevent repeated testing of whatever has been tried before. In many cases their benefits ought to be stopped (if they are on benefits) and they should be made to get off their bums and go back to work.

What the psychiatric lobby are trying to persuade patients of :

Patients think pain and other symptoms are caused by physical illnesses that should be tested for and treated. If the source of the problem can't be identified then they get depressed and anxious.

But these patients are all wrong according to psychiatrists!

Instead, mental illnesses such as depression and anxiety cause chronic pain and all sorts of diseases. Allegedly, doctors can treat the mental illness, the pain will go away, and doctors have saved money on testing and treatment. Win, win for the psychiatrists, psychologists, the therapists, the DWP and everyone else who holds sick people in contempt and thinks they are malingerers. If the patient disagrees and says they are still in pain then they are clearly more mentally ill than the doctors realised. Some of the more intransigent patients end up locked up in mental wards in hospitals.

For further information see the Royal College of psychiatrists web site on the subject :

rcpsych.ac.uk/healthinforma...

greygoose profile image
greygoose in reply to humanbean

I hate psychiatrists! The one I was tricked into seeing - they told me he was a 'pain doctor'! - told me I had pain in my hip because my kids had all left home and I didn't know what to do with the rest of my life! And that without knowing the first thing about me, and that I'd just started two new careers! Turned out, I had the beginning of arthritis, but for some reason the doctors didn't think of that! Any wonder I despise the lot of them?

I think there are some very unfair things said about CBT on this thread. It can be very effective but won’t work for everyone like any therapy. In my experience you need to try different therapies and different therapists to find what works for you. Obviously, if you have a physical condition it is not going to fix that. And GPs shouldn’t be fobbing people off with anti depressants or talking therapies when they just need a bit more T4 but that’s not what we are talking about here.

The OP is asking about emotional support options WHILE they get themselves well. There is nothing wrong with exploring that as an option and indeed that is exactly what I did a few weeks ago as I identified that I wasn’t coping, and the counselling j am receiving is really helpful and helping me through this difficult patch.

humanbean profile image
humanbean in reply to MiniMum97

The problem is that people who are given CBT to deal with a physical problem, in the case of Medically Unexplained Symptoms, won't have those same (physical) symptoms investigated again. The CBT is assumed to be curable.

But the other issue behind it is that doctors are assumed to be infallible. They can never be wrong when diagnosing MUS. But of course this is absolute nonsense. So many doctors sit in their surgeries staring at their PC screens and hardly ever look at the patient, never mind examine them.

In my opinion, the drop in life expectancy in the UK that has been reported in the last year or so is going to get an awful lot worse.

There’s a quicker route to getting well bristolboy. If you’re on Levo but not well yet there are two possibilities

1. You’re not taking enough Levo, or not enough Levo is being absorbed so you need more Levo

2 you can’t convert Levo and need T3.

Try 1 and if that doesn’t work try 2.

CBT is a good therapy for psychological illnesses but it’s useless in the treatment of hypothyroidism, if you feel depressed it’s because your dose is too low and the depression will lift with an increase in dose, so you don’t need CBT. Perhaps your GP needs it, doesn’t sound like they’re thinking clearly!

bristolboy profile image
bristolboy in reply to Aurealis

Love your analysis - I've never seen it said so succinctly before!! I've had higher doses of T4 in the past but felt worse on them, so now I'm concentrating on improving absorption and conversion. If that doesn't work, then it's T3. I asked about CBT just to see if there was anything that might make me feel better about myself while I'm getting the hormones sorted - although this forum does a pretty job in that respect :-)

Hi. I’ve had CBT, but I’ve also had depression since numerous miscarriages and liver failure. It can help, but you need to have a compatible therapist, and be willing to put the time and effort in. I was hospitalised for a couple of weeks, so had no outside distractions, and with some mindfulness my head is in a better place.

Good luck

bristolboy profile image
bristolboy in reply to Fl0rence

Sorry to hear you've had such a rough time, but glad to hear you're in a better place now :-)

Wow :) CBT, like any therapy, works for some, same as thyroids meds - different ones, for different people :) CBT helped me to an extent, then I needed ACT and just someone to talk to, I have found a psychotherapist specialised in Hashimoto's and that is the best support I have yet had. Yes, it does help me on my thyroid journey as I'm fine-tuning my dose. Is it a replacement for hormones - no, I'd be quite ill without them :)

bristolboy profile image
bristolboy in reply to

Sounds like you were lucky finding that particular psychotherapist! I'm investigating local options. Nick :-)

in reply to bristolboy

I was also told to take anti-depressants on two occasions - by my endo and by my gp, also politely (with rage inside ;) ) declined :)

I battled my incompetent GP for years! He finally agreed in 2015 to test my FT3 after I tried to explain I didn’t think I was converting. The results come back (I was under range) and I said to him ‘that shows I’m not concerting my Levo and need T3”. His reply, “your looking into this far too much and this isn’t normal. You need CBT not anything else”. He also called me a hypochondriac! I said that if he referred me to the Endo team at the hospital and they thought I needed CBT I would take it. 4 years later I’m on T3 and still under the hospital care. I also ditched his terrible practice and am now happy else where. My Endo knew my old GP for all the wrong reasons.

The simple fact, he knew nothing about Thyroid issues and tried to palm me off because I wanted to feel better and I was questioning him.

I’m mid 30’s now and get anxious about things I wouldn’t have thought twice about in my 20s. I bought a few books written by the Speakman and I’ve found those have helped. I’m not saying it’s for everyone but it’s helped me at time, however, they won’t nor will CBT help replace hormones.

bristolboy profile image
bristolboy in reply to Lindsayf

What an awful GP. I saw an Endo who was like that - I was so angry I could have decked him! But I'm very glad your persistence eventually paid off - it's the only way to make any progress on our thyroid journeys. Luckily for me, a couple of months ago I stumbled across a private GP who is also Hashi's/Hypo. Long story short, she agreed to try me on T3 - and I got her private prescription filled from Germany. I started on a very low dose (5mcg) then recently increased it to 10 (still low). This was only 4 weeks ago, so early days yet. No earth-shattering improvements in symptoms yet, but I'm optimistic that I'll get there after a couple more tweaks to the dosage. Once we get my dose correct, my plan is to go back to my NHS GP (who doesn't yet know I'm on T3!) and ask to see another NHS Endo (I know of a T3-friendly one locally). If I get to see that Endo I shall tell him I'm on T3 and it works for me - and ask him to prescribe it for me (to save me paying for writing private prescriptions). Ideally I'd like to save the NHS the £200+ per month that T3 costs them in the UK, and continue to pay £30 for 3 months supply from Germany. That's the plan anyway - goodness knows if it will work out that way!!

Lindsayf profile image
Lindsayf in reply to bristolboy

My Endo completely agrees with T3 but the NHS pulled it from her. She know that I’m on T3 and I get mine from Mexico and that’s why I’m still under her care. It’s terrible that you and I have to get our life saving medication from abroad. I’m glad you have found a helpful GP to help. Make sure your minerals, iron and vitamins are also good as this helps :)

bristolboy profile image
bristolboy in reply to Lindsayf

Hi Lindsay. I'm keeping my fingers crossed that Brexit doesn't stop German on-line pharmacies from supplying prescription-only medicines to what would then be a non-EU country. If that happened, maybe I could come to you for details of your Mexican supplier? Regards, Nick.

Lindsayf profile image
Lindsayf in reply to bristolboy

Okay course I can PM you the details if you need them

bristolboy profile image
bristolboy in reply to Lindsayf

Maybe do it now, if that's not too much trouble? Then there's no risk of me forgetting who had the details come the day when/if I need them!! Nick.

Hey bristolboy. Well you opened a can of worms here! 😂

I think you’re doing remarkably well and seem very level headed, you’ve got a plan, you’re looking to the future.

You’ve tried a higher dose of Levo, that didn’t work well. Supplements in place. I’d go for gluten free now. Wait 6wks and at the end of that one more test and then try T3. You’re being very patient and that’s commendable but I’d just get on with it now 🤗

You’ll very quickly see that life will change, those low and frustrating days will be long gone. For me I view CBT as a way of changing ones thought process when it’s detrimental to ones life. For example, self harming, smoking, drinking, eating disorders, anger issues, confidence issues. Your frustration and low feelings don’t need ‘improving’ they are your body’s best alarm system to tell you there’s something wrong. I know you might want to learn new techniques to handle those emotions but I don’t think it’ll work because it’s not something you have control over at the moment. No technique is going to help till you are optimally treated 🤗

bristolboy profile image
bristolboy in reply to NWA6

Thanks Paula - very wise words :-) . I tried 100% gluten free for 4 months, but no noticeable improvement in my symptoms - so my (private) GP said to stop (she's also Hashi's/Hypo and GF didn't work for her either). So I'm on T3 now and hoping we eventually find the correct dose before too long and I can R.I.P. (Retire in Peace!!). Nick.

NWA6 profile image
NWA6 in reply to bristolboy

😂 oi oi bristolboy! I only just noticed this post is 8mths old 😂 I wondered how you had gone from your post in that you had a plan to BAM! You’re on t3 a few hours later 😂 doh!

Hope there’s some light at the end of the tunnel. How’d it all pan out in the end?

bristolboy profile image
bristolboy in reply to NWA6

No worries!! It was someone else who re-started the thread, but that's fine - I'm always happy to chat with like-minded peeps :-) . It's very early days for my T3 journey, and not much to report so far, I anticipate a dose increase after my next bloods in a couple of weeks, so fingers crossed.

You may also like...