Hi all, I have been suffering from depression for basically all my life (25 years old now). I suspected hypothyroidism and got tested. The following were the results:
I posted these results about a month back and people were pretty supportive and gave me a bunch of advice. I am currently just over 3 weeks into 50mcg levothyroxine, as well as Vitamin D (4000IU) and iron and have seen noticeable improvement - better mood, less fatigue, less bleeding during time of month. However, my mood is still not great and I am still depressed and not able to work/really interact with people. From reading everyone's comments about T3 and NDT, I am confused about how I should systematically go about finding the right dose and medication for me. I would love a step by step treatment plan or advice on one. Thank you
Written by
Sg14
To view profiles and participate in discussions please or .
This would not be the right time to switch to NDT or add T3. You need to stay on the 50 mcg levo for six weeks - another three weeks - and then get retested and see where you are. Too many changes in a short time can set you back enormously.
When you've had the six week test, post the results here, and then it will be possibly to give informed advice about the way forward. Nothing happens quickly with hormones. Patience is the key.
He said that he's used levothyroxine before and it's converted to T3 anyway in the body. But yes, I've read multiple research papers staying that T3 is more effective than T4 for treating depression.
In theory, that is correct. But, not everybody is able to convert well. We cannot tell how well you convert at the moment, because you are only at the beginning, and not on a high enough dose, yet.
You said that it is important to be patient, which is correct. But I've been dealing with this for 15-20 years and my parents think I'm lazy and tell me I'm entitled and should get a job, that's why I wanted to speed up things. Not to mention that I feel like I'm wasting my life doing nothing.
It's very hard for people to understand hypothyroidism if they don't have it themselves. But one of the most important tips anyone can give you is to go slowly. Trying to take short-cuts and speed things up will just fail and leave you back where you started. You know the old adage 'more haste less speed'? Never was it more true than with the treatment of hypothyroidism.
It's been six weeks since I started levothyroxine 50mcg. Just to reiterate, I have been suffering from depression for basically all my life (25 years old now). Here are my results -the first number is six weeks ago and the second number is now.
What do you all suggest (should I add T3 or levothyroxine and how much?)
(I took Vitamin D 4000IU for 3 weeks so a bit surprised)
Biochemistry
Inflammation Marker
CRP - High Sensitivity 0.23, 0.6 mg/L (0.00 - 5.00)
Iron Status
Ferritin 31.1, 26 mcg/L (13.00 - 150.00)
(I took spatone for 28 days but bled it all out towards the end it seems (I bleed a lot during the time of the month). Might have to take tranexamic acid which my GP had prescribed once to reduce blood loss.
To reiterate, I have experienced better mood, less fatigue during the past six weeks. However, my mood is still not great and I am still depressed and not able to work/really interact with people.
I have read multiple research papers about how T3 is a more effective adjunct for depression than T4:
Your TSH may be in-range, but it is still too high for someone on thyroid hormone replacement. And, no, you don't want to add more T4 - you notice how your FT3 has dropped since your FT4 went up to 19? That's because the T4 is now converting to more rT3 than T3. So, what you really need to do is reduce your levo, and add some T3. You obviously don't convert very well.
(I took spatone for 28 days but bled it all out towards the end it seems (I bleed a lot during the time of the month). Might have to take tranexamic acid which my GP had prescribed once to reduce blood loss.
I'm not sure that that is how it works. Your periods are heavy because your iron is low, not the other way round. Spatone probably doesn't contain enough iron to help, and 28 days isn't long enough to resolve the situation.
Instead of prescribing drugs, your doctor would do better to investigate your low ferritin, and do an iron panel.
Hi greygoose, so if I understand you correctly, the increase in T4 is being converted to rT3 a lot more than T3? I am confused as I am feeling better though (a little).
How much should I reduce levo and how much T3 should I add? And what should I tell my psychiatrist? Thank you!
Well, rT3 doesn't make you feel bad. But, you do have less T3 in your system.
You could try reducing your levo by taking 50 one day and 25 the next. Do you have 20 mcg tablets of T3 or 25 mcg? Whichever you have, take 1/4 tablet.
I have no idea what you can say to your psychiatrist except that you have a conversion problem. You are a poor converter of T4 to T3, and your FT3 is much too low.
I know six weeks has seemed like an eternity, so congratulations on making it this far. Greygoose didn't get to be grey by accident, Sg14. You'll find T3 to help you immensely now that you've established yourself as a poor converter of T4.
The amount of T3 will be the question that you and your psychiatrist will have to work out. Expect to start on 10 mcg T3 daily and have follow-up thyroid lab at 10 days or two weeks. Increases in units of 10 mcg are cautious. Some people end up taking nearly equal amounts of T3 and T4, so you'll just have to work it out over the next months.
We're all happy that you've got a good start on your treatment path. Please keep us informed of your progress. 🤗
If GreyGoose says to reduce, then by all means reduce to 25. That is the sensible thing to do. One does not need to have wild daily fluctuations in cellular energy production while transitioning onto the more powerful T3. The T4, after all, is only a storage hormone for your body to draw from and convert to T3 as needed, and as able.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Should I stop T4 and take T3 only medication?
Test Results - Underactive Thyroid
Time to add T3
Any assistance will be gratefully appreciated. 
