I have heard that Lithium can affect thyroid function.
I am aged 35 and have been taking thyroid hormones since aged 16 due to Hashimotos Disease. My psychiatrist wants me to trial Lithium to help my Depression in addition to taking the antidepressant I am on.
Is this a good idea, or could it affect my thyroid hormone levels in a negative way or will it not matter that most of my thyroid gland has probably already been destroyed by the Hashimotos?
I would be grateful if anyone has any knowledge/experience of this.
Many Thanks ad blessings to you all.
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thyroid555
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If you have Hashimoto's then vitamin levels are frequently too low this can hinder conversion of FT4 to FT3
Resistant depression can be due to low FT3
Psychiatrists can prescribe T3
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if Thyroid antibodies are raised
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw). This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
If/when also on T3, make sure to take last dose 8-12 hours prior to test
Is this how you do your tests?
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins
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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random
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. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
Ideally ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
Assuming test is negative you can immediately go on strictly gluten free diet
(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)
Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse
Thankyou so much for your kind advice. I take T3 which my Pyschatrist prescribes 20mcg daily and recently he suggested increasing this to 40mcg a day, I tried this but got some racing thoughts and I am not sure it is too much.
My Endocrinologist is very nice and he is very interested in the vitamin connection also. He is fairly new there and young and seems interested in the wider treatment of Hashimotos.
He agreed to test me for vitamin deficiencies. I make sure I don't take any thyroid hormones 24 hours before a blood test.
I take 150mcg of Thyroxine daily and Vitmain D 800 Iu daily.
These are my latest blood tests.
Vitamin D 89. Range 50 to 120
Serum Calcuim 2.41 Range2.15 to 2.5
Serum Adjusted Calcuim 2.37. Range 2.15 to 2.5
Serum Phosphate 1.03 Range 0.81 to 1.45
Serum Alkaline Phosphate 38. Range 35-104
Serum Total Protein 67. Range 66-87
Serum Albumin 42. Range 35-52
Serum Globulin 25. Range 18 to 36.
Serum Urea 3.1 Range 2.8 to 8.1
Serum Free Thyroxine 22.9 Range 12-22
Serum Free Tridothyronine 8.5 Range 3.1-6.8
Serum TSH 0.01 Range 0.27 to 4.2
Serum Ferritin 43. Range 13-150
Serum Reactive Protein less than 1. Range 0-5.
Serum Vitamin B 12 455. Range 197 to 771
Serum Folate 11.7 Range 1.9 to 25
Serum Iron 20.7 Range 5.8 to 34.5
Serum Transferrin 2.3 Range 2-3.6
Serum Transferrin % Saturation 36. Range 25-45
I started taking the 40mcg of T3 about a week before this blood test. Since being on Vitamin D my levels have gone up, last year my Ferritin level was at 18. I have been taking 12.5mg Iron a day (Contained in two high strength multivitamins). Do you think I need to get my iron level up higher and what is the best way to do this. Also do I ned to get my folate levels up a bit higher?
I am not sure if I should take Lithium, but it does frighten me how depressed I get.
I would be most grateful for any advice. With Kind Wishes and blessings to you all.
B vitamins best taken in the morning after breakfast
Recommended brands on here are Igennus Super B complex. (Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks ).
Or Jarrow B-right is popular choice, but is large capsule
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results
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. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
Ideally ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
Assuming test is negative you can immediately go on strictly gluten free diet
(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)
Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse
Thankyou so much for your kind reply, I will definitely try and get the vitamin levels up. I am not sure I have the willpower to go gluten free at the moment, but definitely something to consider for the future. Thanks for your superb helpful advice, warm wishes to you.
Lithium can affect good thyroid function & if this were me, I would not consider medicating lithium before ensuring an adequate FT3 level for several months.
Low FT3 levels can be responsible for depression, anxiety, magnified emotions, psychosis and much more. Many members including myself have found medicating either T3 with T4, or NDT (that incorporates T3) has helped to alleviate these symptoms.
I would also ensure thyroid antibodies were low and nutrients & iron were optimised as good thyroid hormone synthesis depends on adequate levels.
Post any blood results complete with ranges (numbers in brackets) for members to comment.
Thankyou so much for your kind reply. My T3 levels are above the reference range. See post above with blood levels. I was advised to increase my T3 from 20mcg to 40mcg, but I am not sure if this is too much as I started getting racing thoughts.
Maybe I could try and get my iron and folate levels up a bit and see whether that helps.
I am unsure if to take the Lithium, but it does frighten me how depressed I get.
Thankyou so much for your reply and sending you warm wishes.
I understand your resistance and fear. Depression is awful as we become a person we don’t recognise and our every day responsibilities become unmanageable.
I have no experience of a psychiatrist’s prescription/view point but would suspect that doubling your 20mcg T3 dose was too much, as the standard in the “thyroid world” is to increase by 5mcg every 1 - 2 weeks.
When hormones have been messed up for so long, we often have a slim margin available to regain any sort of recovery. Remember all hormones are dependant on each other so any deficiency (or elevation) may have repercussions up the line. My own experience was once that “sweet spot’ was eventually found, recovery demonstrated a cumulative effect.
Be aware that over range FT3 levels can unbalance sex hormones and it was the balancing of O & P that rid me of my depression. SHBG should positively correlate with thyroid levels so if T3 is elevated, so SHBG will be. Also, falling cortisol can cause oestrogen to soar, causing high SHBG.
Elevated SHBG protein will bind to thyroid hormone making less available for use in the cells (no matter how much the thyroid hormone amount is deemed as ‘normal’ in blood tests) as it has to be cleaved from SHBG to become “free-fraction” before it can activate cellular receptors.
Prolonged cortisol elevations caused by chronic stress (low/high thyroid hormone) also decrease the liver’s ability to clear excess oestrogens from the blood & this can increase levels of thyroid TBG (proteins that transport thyroid hormone). As with the elevated SHBG, elevated TBG can bind too much thyroid hormone.
Your ferritin is low but serum iron isn’t. Your transferrin saturation % indicates how saturated the body’s system is for transporting iron and yours is half way through range. A normal average is around 30% so yours is good. I would not recommend supplementing iron at this stage.
Your Vit B12 could be viewed as low, so in your position I would look to supplement. Remember folate needs to match Vit B12 levels as the two work together in helping to create, develop & regenerate red blood cells and make iron work properly.
Parietal cells secrete hydrochloric acid (HCl) located in the gastric glands found in the lining of the stomach and allow digestion/absorbtion of food/nutrients. Vit B12 should be naturally released for absorption by the activity of hydrochloric acid & protease (stomach enzyme) but low levels are commonly found in Hashi sufferers. Also failing adrenal glands may inhibit our ability to produce adequate stomach acid. So I would also be looking to supplement Betaine HCI with pepsin.
Lastly remember TFT's are only representative of what is within the blood stream & don’t represent actual cellular activity. Pulse & temp can be informative as useful tools to see progress.
I think the 'professionals' should have done a service by testing your Free T4 and Free T3. T3 in particular is needed in our millions of T3 receptor cells and the brain and heart contain the most.
I'd ask but they may not do so as (if you're in the UK) doctors seem to have been directed that a TSH and T4 is fine. NOT SO. The frees are more important and I'll give a link:-
There are private labs that will do home pin-prick tests and if you decide to do so make sure you are well hydrated a couple of days before blood drawn (finger pin prick) and that arms hands are warm on the a.m.
GP should also have checked for thyroid antibodies. Another important test.
Regardless of the TSH if antibodies are present we should be prescribed.
I believe your psychiatrist needs more training on endocrine issues. A jump from 20 to 40 mcg is way too much. Why not try compromising by cutting a 20 mcg pill in half and just taking one and a half 20 mcg tablets per day? In fact, when I began taking T3, I titrated even more slowly, taking 1/4 of a 25 mcg tablet per day for two weeks, and increasing by 1/4 tab every 2 weeks.
Thankyou yes I could try this. When I tried to cut them in half in the past they broke up. Do you find you can cut them ok? My doctor wants me to take it twice a day so maybe 30 in the morning and 20 in the evening. Thanks for your kind advice 😀
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