Hypothyroid and Continuing Symptoms : Hi everyone... - Thyroid UK

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Hypothyroid and Continuing Symptoms

Bluey777 profile image
24 Replies

Hi everyone, new here and don't often use forums so hoping this is a positive experience :).

I was diagnosed with Hypothyroid secondary to thyroiditis in 2015. I was placed initially on 100mg Levothyroxine which was subsequently reduced to 75mg. Although my general symptoms improved I developed quite bad anxiety and depression. This has been getting worse in the last 18months or so. I have taken counselling for my anxiety and depression which has improved somewhat. However I am concerned that my mental health state may be partly caused by my thyroid dysfunction. Unfortunately the three health professionals I have seen (2 consultants and my GP) never even mentioned the possibility of a connection between mental health and my thyroid. It was only some personal research which indicated it CAN be associated with thyroid dysfunction.

As recommended by my consultant I have been having annual blood tests for my thyroxine levels. However every blood test I have had in the last few years (apart from the initial and follow up tests) only test for TSH levels and nothing else. After some research I have learnt that this may not be giving a full representation of my thyroid health and correct blood levels. My GP also ran various other blood tests and discovered I was low in B12. She suggested a multi vitamin which I now take everyday and this seems to have stabilised my B12 levels.

Basically I'm after some advice and information on whether I should be seeking further tests either privately or via my GP on my thyroid levels. Is it possible my mental health issues are linked to incorrect levels of thyroxine and an incorrect Levothyroxine dose? From my very basic research it appears that thyroid function is complex, blood tests are often misleading and many health professionals don't fully address poor health issues in their patients.

Any help and guidance would be greatly appreciated.

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Bluey777
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24 Replies
MissGrace profile image
MissGrace

You are right Bluey777, it is more complex than many health professionals would have us believe and balancing meds is straightforward for some and like an art form for others! It could well be that you are under medicated and this is causing your symptoms. Do you have any blood results with ranges? Have you been tested for hashis antibodies? 🤸🏿‍♀️🥛

Bluey777 profile image
Bluey777 in reply to MissGrace

Hi and thanks for the reply. Latest tests were done in January this year. Result was:

Serum TSH level 2.3 miu/L [0.2 - 5.5]

Serum C reactive protein level 3 mg/L [< 5.0]

greygoose profile image
greygoose

Hi Bluey777, welcome to the forum.

It's more than likely that your anxiety and depression are due to your poorly treated hypothyroidism. They are not diseases in their own rights, they are symptoms. And, very often symptoms of under-medication - although most types of hormonal imbalance can cause them.

It is very likely that you are under-medicated on only 75 mcg levo. It's a very small dose. Or else, you are a poor converter of T4 (levo) to T3. But, the NHS, in all its wisdom, has decided that the TSH is all that needs to be tested. In reality, the TSH alone tells you next to nothing, especially when on thyroid hormone replacement.

I would strongly advise you to get private tests, and to get the whole bundle:

TSH

FT4

FT3

TPO antibodies

Tg antibodies

vit D

vit B12

folate

ferritin

That will give you a much better idea of what is going on, and what you should be taking, both in the way of thyroid hormone replacement and supplements. :)

SlowDragon profile image
SlowDragonAdministrator

75mcg is a low dose of Levothyroxine

Anxiety and depression are symptoms of being hypothyroid

Low vitamin levels are frequently the result when under treated too

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

Have you had TPO and TG thyroid antibodies tested?

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)

ask GP 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 or all vitamins

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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

Medichecks currently have an offer on until end of May - 20% off

thyroiduk.org.uk/index.html

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

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 .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

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

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

List of hypothyroid symptoms

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

NHS guidelines on Levothyroxine including what foods to avoid (note recommended to avoid calcium rich foods at least four hours away from Levo)

nhs.uk/medicines/levothyrox...

NICE guidelines

cks.nice.org.uk/hypothyroid...

The initial recommended dose is:

For most people: 50–100 micrograms once daily, preferably taken at least 30 minutes before breakfast, caffeine-containing liquids (such as coffee or tea), or other drugs.

This should be adjusted in increments of 25–50 micrograms every 3–4 weeks according to response. The usual maintenance dose is 100–200 micrograms once daily.

Bluey777 profile image
Bluey777 in reply to SlowDragon

Have you had TPO and TG thyroid antibodies tested?

I've only had this tested in 2015 at initial diagnosis. The consultant commented:

"Thyroid peroxidase antibody is positive at 73.6 (less than 50 negative) indicating he has autoimmune thyroid disease"

Apart from that the only tests I've had are for TSH on an annual basis.

I've looked at Medichecks and have found the Thyroid Plus test but not the vitamin tests. I'll have another look and book these. I shall update you with results when these come through.

SlowDragon profile image
SlowDragonAdministrator in reply to Bluey777

This one

Thyroid plus ultra vitamin

medichecks.com/thyroid-func...

Bluey777 profile image
Bluey777 in reply to SlowDragon

Thanks. That's the one I've ordered. 👍

NWA6 profile image
NWA6

You’re damn right they’re linked!! I am now properly medicated after 10yrs of Hashis and NOW I feel well. I’ve been fobbed of with antidepressants and they’ve tried to stick me with a Fibromyalgia diagnosis and CFS but No!! It was just my flipping thyriod! Low Vit D was also a big issue for me!

I’m now on some great supplements and the rights meds. All because of these wonderful people on this forum and their dead on advice 💐

Are you in a position to get yourself some home blood tests done? This will give you the FULL picture. You post your results here and these lovely people will help you get on the track to optimal health. But I tell ya patience’s is needed in abundance! That and a cool temperament to deal with all the BS that Gps and Endos try to dole out 😩

So glad you found us 🤗 Welcome to the start of getting well 🥳

Bluey777 profile image
Bluey777 in reply to NWA6

Thanks for your informative post. I really really hope it is my thyroid as I've been going nuts wondering what the hell is wrong with me. The number of times I've broken down recently and completely lost all sense of what's going on has been frightening. Even just knowing it's not me going mad would be a huge relief.

NWA6 profile image
NWA6 in reply to Bluey777

You’re not going mad! (well actually you are but it’s reversible 😂)

Bluey777 profile image
Bluey777

Just ordered full tests with Medichecks. Will let you know the results once they're in.

Bluey777 profile image
Bluey777

All tests now back from Medichecks.

All indicates normal so not sure where I go from here:

Inflammation

CRP HS 0.95 mg/L (Range: < 5)

Iron Status

Ferritin 206 ug/L (Range: 30 - 400)

Vitamins

Folate - Serum >19.8 ug/L (Range: > 3.89)

Vitamin B12 - Active 73.700 pmol/L (Range: 37.5 - 188)

Vitamin D 67.7 nmol/L (Range: 50 - 175)

Thyroid Hormones

TSH 2.34 mIU/L (Range: 0.27 - 4.2)

Free T3 5.16 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine 18.300 pmol/L (Range: 12 - 22)

Autoimmunity

Thyroglobulin Antibodies X 498.000 kU/L (Range: < 115)

Thyroid Peroxidase Antibodies X 123 kIU/L (Range: < 34)

pamela22 profile image
pamela22 in reply to Bluey777

I have no idea about these results but I'm sure SlowDragon and greygoose or some of the very knowledgeable members of this forum will be able to decipher what's going on and give you some excellent advice,

I hope you get everything sorted and are feeling much better soon.

All the best

XxX

Bluey777 profile image
Bluey777 in reply to pamela22

Thank you for the reply and kind words.

Bluey777 profile image
Bluey777

Anyone any comments about these results?

Hay2016 profile image
Hay2016 in reply to Bluey777

Hiya. I think Your Tsh is still too high,( should be around 1) may be worth an alternate 25 increase and see how it goes after 6 wks.

I say alternate days because t4 fairly high in range and you don’t want it going over as I found that reduced my t3.

The guys with the proper links to guidelines will be about soon I’m sure.

greygoose profile image
greygoose in reply to Bluey777

Doubt if many people have seen them. It would have been better to start a new thread. On this forum, posts do not jump back up to the top when someone comments on them, they continue on down the list.

Well, your TSH is still too high. Any doctor that things a TSH of over 2 for someone on thyroid hormone replacement, should be struck off! It should come down to 1 or under. Hypos need a lower TSH than people with healthy, working thyroids - but even in them, over 2 would be suspect.

Your FT3 is just over mid-range. Most hypos need it higher than that.

Your FT4 is good, but that suggests that your conversion may not be too good. However, you need to bring your TSH down to one before you can say for certain. You need an increase in dose, that is clear.

Your B12 is on the low side, although your folate is good. And a multi-vit is not the way to raise it - shame on your doctor for suggesting it! There are multiple reasons why a multi is a very bad idea. Put it in the bin where it belongs, and get yourself some sublingual methylcobalamin (B12) 1000 mcg, and a B complex. When you've finished the bottle of methylcobalamin continue with the B complex for maintenance.

Your vit d is also too low, should be up around 100.

Marz profile image
Marz in reply to greygoose

B12 result from the Active test - so result is fine 😊

Bluey777 profile image
Bluey777 in reply to Marz

Now I'm confused. So is my B12 normal or not???

Marz profile image
Marz in reply to Bluey777

As I said it is fine ! An Active Test result around 75 is fine. Please read Posts by SeasideSusie as suggested - full of details you need ... Have explained more on your latest post/thread.

Bluey777 profile image
Bluey777 in reply to Marz

Thanks for that and for your other post. Hope you can appreciate that when one member says it's low and another it's fine, you get a little confused 🤔

Marz profile image
Marz in reply to Bluey777

There are two B12 tests - and the one you had was described as the Active Test so 70+ is a good result. Have you found SeasideSusie's posts ? Please ask if you do not know how ...

greygoose profile image
greygoose in reply to Marz

Yes, I know it's the active test, but I'm not convinced that that result is fine. As Susie says below, it's borderline. So, I suggested a booster dose, followed by a maintenance dose. :)

Bluey777 profile image
Bluey777

Thanks for replies. Sorry I didn't know posts didn't move when commented on. I'll repost results in a new thread. Thanks for the input.

Ends and GP all think everything is fine and no need for adjustment of dose.

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