Good evening, I've just seen an endocrinologist again today (31 Oct 2019.) I was first diagnosed with Hyperthyroidism in early June but my thyroid quickly went underactive following carbimazole in late July. I've now been diagnosed with Hashimoto's Thyroiditis, after having positive antibodies for Hashimoto's ( Anti-TPO > 1300 is what my blood test says.)
I wasn't placed on any medication, just monitoring thyroid activity at the moment.
I've been dealing with quite frustrating symptoms, extreme fatigue (sleeping anywhere between 9-14 hrs and then feeling exhausted after being awake for about 3 or 4 hours) muscle weakness, constantly cold and drying skin.
A relatively new feeling has been a dull and low mood for days at a time. Almost as if it's happening in phases. My GP heard of this and explained to me that it could be a possible symptom of an underactive thyroid, and that I shouldn't worry too much about it and it should level out as my thyroid's activity does. This gave me such peace of mind as I was so confused as to where this feeling was coming from. However, while speaking with the endo, he said he has no knowledge of low moods/depression being linked with thyroid under activity and suggested I go back to my GP stating depression symptoms.
I was wondering what anyone else's opinion of this is? I've never before experienced feeling so down without any trigger or cause. So, I'm now wondering if there is any truth behind what my GP has told me, or if I should actually be worried about my mental health.
Any opinions or personal experience would be helpful
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Oh dear, seems like another wrong diagnosis, we are seeing quite a bit this I'm afraid.
Your raised antibodies confirm Hashi's and it's very likely that you would have had this all along and never did have hyperthyroidism nor should you have been prescribed carbimazole. Did you have TSI and TRAb antibodies tested before being prescribed carbimazole, because that's what should have happened.
Hashi's is where the immune system attacks the thyroid and gradually destroys it, it causes fluctuations of symptoms and test results and you can swing from hyper to hypo. It often starts with a "hyper" episode.
So now you are hypothyroid and are experiencing hypo symptoms. Please check this list of signs and symptoms of hypothyroidism from ThyroidUK's main website, particularly the symptoms under "Mental and Emotional" :
Also, supplementing with selenium l-selenomethionine 200mcg is said to help reduce antibodies.
Hashi's tends to cause low nutrient levels and deficiencies so you should ask for the following to be tested, then post resukpts and reference ranges on the foeum:
Thankyou for replying! I recall having some kind of antibody tested before carbimazole but I'm not sure what it was or what the result of that was. The GP who initiated that didn't really give me clarity when it came to my results. My new GP seems a lot more knowledgable so hopefully will have a better time with him.
Unfortunately, my most recent blood test results seem to have gotten lost somehow. I have no idea how that could have happened. I had them done August 29 at an endo appointment and the only results the endo and GP have are from July 24. So after seeing the endo today, he requested new bloods which I've been told will then decided if I need levo and what dose. I also have a vit. D deficiency that I'm on supplements for.
I can give you those previous results, they were:
TSH: 0.11 (0.27-4.2)
FT4: 11.8 (10-23)
FT3: 4.0 (3.1-6.8)
TSH Receptor antibody <0.9
Anti-TPO >1300
Anti-Thyroglobulin 31
Thank you for providing the links! I will definitely check them out.
I've never had to deal with any kind of health issue before so navigating the medical world has been a little but daunting for me, especially after hearing a recent bloodtest seems to have gone completely missing!
The blood test results will be on a computer so it's hard to understand how they have disappeared.
Your FT4 and FT3 from July are low in range showing hypothyroidism but they're probably waiting for your TSH to be higher. Make sure you ask for a print out of your new results when they are back (it's our legal right here in the UK to have our test results).
TSH Receptor antibody <0.9
Although there is no range I believe that result is negative (that is the TRAb test). Did they also do this test prior to prescribing carbimazole?
Are you on loading doses for your Vit D deficiency? Once these have finished you need to retest to get your new level and base your new dose on that level. Your GP may only prescribe 800iu as a maintenance dose and that won't be enough. Your GP may not retest, many don't, in which case you need to do it privately and we can give you details of where to get that done.
Your GP won't know but there are important cofactors needed when taking D3.
D3 aids absorption of calcium from food and K2-mk7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissue where it can be deposited and cause problems. Magnesium is needed for the body to use D3, it helps the body convert D3 to it's usable form. There are many forms of magnesium so we need to choose the most appropriate one for our individual needs:
I have no idea what has happened with my August results. They checked their system and there was nothing at all. I usually receive a letter with results from the endocrine clinic but I received nothing. Definitely going to be calling up to check up on the results this time around.
Things get a little foggy with the TRAb test. I was tested by my GP (which I've been told is a little unorthodox for the GP request) and was told I had positive antibodies for Grave's so was started on carbimazole straight away (I was started on 20mg a day but broke out in hives a week later, so reduced to 5mg for the 3 or so weeks that followed.) I was unaware that I could request my results in writing from the GP, so I will be doing that from now on but at the time, I'm afraid I'm unsure what exactly that result was. At my first endo appointment, however, I was told that result was actually negative for Grave's. Seems my previous GP had gotten it wrong?
My D3 was prescribed by the GP and is 20,000 IU colecalciferol. I'm actually in the last week of this prescription so I will chase up further levels and also enquire about the others. Thank you so much for all this information! It's really helpful.
Nice, good, complete answer. No gluten, low carb , low GI, only fermented milk products, no goitrogen food or chemicsls is one of the best things for anybody and can last for life.
When thyroid hormones are out of whack it can cause low mood or anxiety or alternating between. You might feel like you only have 70% of your function or that the ability to experience joy is missing. However, this will all sort itself out once on the right dose of thyroxine. It can take a few months once on the right dose to start to feel right again. Low vitamin levels will compound thyroid imbalance so make sure vitamin levels are all optimal. That can take a few months to sort out too.
Sounds like you maybe didn't need carbimazol so that will have taken its toll on your health if that was the case. Everything about Thyroid health is slow so treat yourself gently and if you need lots of rest then let yourself have plenty and do gentle exercise like walking.
I've dealt with anxiety a few years ago so was really worried when I started feeling little shakes and cold sweats again suddenly a few weeks back. Also the low moods have been horrible! Generally a really positive person so it's really thrown me off. Glad to see that this actually isn't out the ordinary though, the endo had me feeling like I was going mad.
The more I've been checking this forum, it really does seem like I may not have needed carbimazole in the first place! It's quite worrying to think how many others are in this position too.
I agree with Slowdragons comment that it's extraordinary fo an Endo to deny low mood is connected to thyroid imbalance. You're not going mad, it's a symptom that your thyroid hormone is not yet balanced. You'll get back to normal again but it can take time.
Relaxation may help you ride the storm, like gentle yoga, hypnotherapy relaxation CD, or other calming therapies.
Also agree with recommendation that it's essential to test vitamin levels and correct those that are low. You need optimal vitamin levels, not coasting along the very bottom of the lab range.
I’m sorry to hear you are feeling low with your thyroid, but just to reassure you a lot of people get very low mood with Hypothyroidism . My dr and Endo suggested antidepressants and all sorts but as soon as I was on the correct dose of Thyroxine my mood lifted and I felt much better
Don’t worry you are not going mad and this will soon pass and if you have bother with blood tests and results etc you may have to resort to private blood testing just so that you get accurate results and then can medicate accordingly .
Thank you for the reassurance! I'm not yet taking levo or any medication so you can imagine my levels are still out of wack. I'll be looking into and trying a few of the suggestions on here though!
If your not taking thyroid meds you could try sea kelp for normal thyroid function. As for the tiredness after 3/4 hours you could have a look at diet, are your foods energy rich???. Quality beats quantity. What are you doing within those 3/4 hours to use up all your reserves. I don't have a magic cure but complete B vitamins can help with tiredness along with iron but check iron levels first. B vits are usually safe to take. If you find a miracle cure for tiredness please message me too with cure.
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 you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Ask GP to test vitamin B12, folate, ferritin levels
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood 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)
The endo honestly looked at me as if I was mad for stating my low mood as a symptom and said "I have no knowledge of low mood being linked to the thyroid. are you depressed? You should see your GP about this for mood stabilisers." Was quite shocked to hear that.
Thank you for the tips! Not currently on levo or anything yet, just monitoring activity, but will keep those tips in mind for my next blood test.
This I can’t believe. He / she must receive patients who have been misdiagnosed in the past. And one of the common misdiagnoses for thyroid conditions is depression. And doctors have to learn to do a differential diagnosis to rule things out - so it’s hard to see how they could have missed that part of their education.
Yes I suffer with Graves' disease and was over medicated by my so called Consultant expert. My TSH was 9 and I felt dreadful his response after reading my results was to offer me counseling so I walked out on him never to return! I then went to the wondeful Dr Gordon Skinner who gave me a prescription for Levothyroxine which helped my thyroid to work again and I went into remission. Read my story on my profile page.
Hi, I’m sure others on here will confirm but hypothyroid has been linked depression. Obviously you have to go with your doctors advice but I would caution against going on antidepressants if offered.
Your new doctor is good. Endokrinologist is not good. Find another one with references for thyroid troubles.
I hope you are not that case, whose levels jump up and down in weeks.
Read about symptoms of hipotiroditis hipertiroidis and lack of iodine and conseqvences of each. This is basic knowlage. Use internet and YouTube. Write down everything not to search 10 times for same question.
Managing troubles by symptoms is good way. By tests it should be proven if your observations are correct.
Ask for copy of test every time. Demand! For analise and second opinion.
High TSH is something like inflammation. Take natural things which can help. Like I know and I'm not totally sure conseqvences of strong Hashimoto is that thyroid gland shrinks and don't work. So T4 supplement is prescribed. But conseqvences of lack of iodine are fatal. Wish You a lot of good mood and calm waves of hormones.
Yes, lack of iodine is dangerous, but too much iodine will also do harm. Apparently it was used originally in treatment for Graves as it suppresses thyroid function
I did not notice this use. But I was questioning myself of that possibility. I'm not that case. But to have more than 200 mcg iodine per litre is in theory enought to stop sintesizing thyroid hormone. I have done hormone test while daylly tacking 10 mg of iodine. Normal resaults. But some people become hiper. It is big confusion. 10 mg means that I should have at least 1 mg or 1000 mcg iodine per litre in urine. (80 % go out trought kidneys). Everything is complicated and cnotted. Only way is ito try, do tests and manage with symptoms. That theory from 1948 has big rating and and even bigger holes. It was done on rats.
Low mood is definitely a symptom. My doctor decreased my thyroxine and gradually along with a lot of other symptoms I began to feel down, depressed and a lack of motivation. It sort of crept up on me and it took a while for me to link it all with my hypothyroidism. It has been seven weeks since he increased my levothyroxine back to original amount and gradually over this time i have returned to how I used to feel when on the higher dose. Don't listen to the endo that's all i can say.
I’ve been hypo for 26years was diagnosed at age 13. Mine started as hyperthyroid and quickly changed the other way. My thyroid still fluctuates between the two. It’s always been a case of tweeking my thyroxine. Everything you are feeling is real and it all comes with hypothyroidism unfortunately. I would say your Endo doesn’t have a clue and probably doesn’t care. Mental health has always been a problem for me depression and chronic anxiety. You seem to have a gp that knows what there talking about. I would go back to your go who can offer you options to help with your mood.
I'm sorry you had to experience that. I hope things have gotten better for you now and you're on the right treatment plan! I don't agree with taking antidepressants for personal reasons, so hoping my recent bloodtest results show that I require treatment for my thyroid. This has all happened over the space of four months and it's been quite rattling. My levels are being monitored at the moment so I'm not on medication for anything. I may start pushing for medication as I'm quite symptomatic. Even had to leave my job as I couldn't keep up and commuting was becoming extremely painful with severe muscle aches.
Like you, I started hyper and ended up with Hashimotos. Forum members have also questioned my original diagnosis of Graves by my endocrinologist and suggested it could have been a hyper phase of Hashimotos. The anxiety and low mood have been one of the worst symptoms for me. Again GP sent me for therapy and offered antidepressants. I’ve managed not to take them, using mindfulness and CBT techniques to help me refocus. The only thing that’s really helped is increasing my Levo and getting my vitamins in a more optimal range (as advised on this forum). It’s been a huge support being on this forum.
I'm glad you're feeling better and on an appropriate treatment plan. Luckily I have a pretty strong support system around me to keep my mood up but it does dip really low sometimes. Hopefully things will get sorted for me soon
Before I was treated for hypothyroidism I honestly felt as though life wasn't worth living, my mood was low and I felt apathetic about everything. The positivity is slowly returning so please remember there is light at the end of the tunnel.
You seem to have a good and knowledgeable GP which will be a huge help to you as you navigate getting well.
Good luck with your recovery.
On a less positive note, the cynical side of me is wondering if you test results have been "lost" deliberately as they may suggest that you had been treated inappropriately ( for hyper rather than hypothyroidism ) at the start of your diagnosis. You will see from the example below that as a family we have personal experience of a hospital trying to cover up their mistake.
An old aunt, with dementia was discharged from hospital aged 93 with a double hip fracture ( which must have occurred whilst she was in hospital for something completely unrelated ) and advised to have physiotherapy at her care home as she had been bedridden for a few weeks.
The physiotherapist was very concerned because she screamed every time she had to stand and do the exercises, he contacted the hospital and requested all her notes , plastered across them were the X-ray results and the comment DO NOT ALLOW THE PATIENT'S FAMILY ACCESS TO THIS INFORMATION.
We complained but after many months we got the standard reply "lessons have been learned", my poor aunt did not have the capacity to tell us what had happened to her during her stay in hospital.
I hope yours is a genuine mistake and I'm sure with a helpful GP you will soon be feeling better, but I now question everything that I am told which probably makes me a right pain in the neck, and even with a helpful GP I'd still find out as much as you can about your condition, knowledge is power.
Wow, I'm so sorry to hear such mistreatment. Unfortunately, I've heard so many similar things to that experience. Including my own Great Nan but her daughter, my Nan, has always been very knowledgeable and never let a single thing get swept under the rug. Haha, pretty sure the home couldn't stand my Nan but hey, she couldn't let her mother suffer!
The thing with my bloods, at the clinic, if you require a bloodtest, they order it for you after your appointment and you're called to have it done but mine was never ordered so I was in the waiting room for nearly an hour before I started realising that people who were going into their appointments after me, were getting called for bloods before me. I questioned and complained and was taken through to have mine done. I sort of feel as if because it wasn't inputted into the system that they were ever ordered, my blood was never tested. Thats just my theory anyway.
This GP definitely seems like he's more aware of how hypo effects the body and mind. Hopefully I'll have a much smoother experience with him! Thankyou!
He's probably going to be your best ally then, I'd go to him for preference, he might know more than some endo's if he's interested in the thyroid. If you work with him he may be open to listening to anything you find out for yourself so come on here and ask questions, someone will come along and help you, and read up about your condition as much as you can, good luck.
Do you have your blood tests fasting and first thing in the morning? That gives the highest TSH possible as it decreases during the day, and food or drinks, except water, also influence the level.
My bloodtests are usually done at the endocrine clinic following an appointment. My appointments have been around 9-10AM each time, with my bloods done after so I'd say anytime between 10 and 12. Usually done fasting, not by choice, I just barely have an appetite at the moment.
You raise a really interesting treatment question, though.
I wonder whether for some others who are adequately treated for Hashi’s, symptoms of low mood never fully go away? Your TSH must go up and down during the day for one, even if suppressed some of the time.
And whether, for this group, conventional depression treatments - whether CBT / exercise / meds / other - are needed to put life fully back on track.
Certainly for me, post Hashi’s diagnosis my mind has never been the same as it was before. My IQ has definitely been reduced, I have swings of emotion I didn’t have before and the before / after demarcation is distinct. My new, permanent Hashi’s state is a definite downgrade on my old one and there are mental health consequences to pay for feeling that you are living in someone’s else intelligence / mental health.
So that’s one question - to others reading. Have you found it helpful to “treat” your new state of mind as well as treat your thyroid condition? Has it helped?
I often think it would be useful to have a local talking shop with other hypo lifers, in person, as well as here. I know that Thyroid U.K. offers some kind of support for those setting up a help group (self-help if I must call it that). Does anyone have that or do that?
Second question slightly off-topic. Happy to set up other thread if not following chat protocol.
These are great questions. Not sure I can personally answer it fully as I've only been aware of my condition for 4 months and I haven't really been treated adequately yet. My levels are still being monitored so not started levo or anything yet. But, could I suggest maybe not looking at your 'new state of mind' as new? and comparing it with your 'old' one? I feel as though drawing this comparison with yourself will most definitely rattle you. I may be speaking out of terms, please do let me know if I am!
This is a useful “kidding yourself” suggestion / approach.
The complicating factor is we know ourselves better than anything / anyone else being as “we” are conjoined. How do we “unknow” or walk away from that person. And whereas couples can grow apart and separate if they change so dramatically that the centre can’t hold, what does a person do? For a start, the people we know and are friends with / family to expect us to be that old person.
It is something I am wrestling with - definitely the worse aspect of Hashi’s for me!
I had a major accident in my 20s and had to rebuild my life in a major way then - that physical re-learning was a lot easier than this psychological one.
Not so much "kidding yourself" more just accepting that something has happened to alter your state of mind so learning to adjust to this and work through it without attempting to move backwards into a previous mind state. Sometimes, all we can do is move forward instead of trying to go back! As for people you know, in my opinion, all you can do in these situations is attempt to educate with hopes they'll have some understanding.
Sorry to hear that that happened to you. I hope all is well with your physical health!
I can confirm that low, flat, blue mood is definitely associated with being hypo. In fact, it was the original symptom I had that my ob/gyn thought unusual for me. He put me on Prozac that day, but tested my thyroid- low and behold, I have hashi’s. Onto to treatment I went, and off Prozac. Recently, they lowered my dose of NDT and once again, for first time since it all began, my mood plummeted. My doctor upped my dose back to at least midway of the prior largest dose- and that lowest dose where I was “blue” and now I am back to normal. For me, the t3 is the saving grace to beating the low mood issue.
Thank you for this, I am definitely going to start looking at my results more carefully and posting on here. Seems you guys can interpret results better than some of these doctors can!
Hi there, I think that low mood is definitely associated with being hypothyroid. I have battled all my life with it, always being told my bloods were fine......doesn't matter how I feel. The vast number of antidepressants I tried did nothing until a trainee GP put me on Venlafaxine. This changed my life. I believe the difference is that it works on the noradrenaline levels as well as the serotonin levels. I did think having cancer of the thyroid would solve everything because now I was BOUND to get the right amount of medication and that would help the depression....:)....how naive I was!! Thank goodness for groups like this and for the book Stop the Thyroid Madness. I will add, if anyone is interested, a side affect of Venlafaxine is insomnia. It became unbearable and I changed to Mirtazipine which works well. There is SO much to consider when you are thyoidless, hyper or hypo!!
I began with hyperthyroidism 14 yrs ago and the 1st thing my gp did was prescribe me anti depressants which he said I would need to balance my hormones. After 2 years in carbimazole and then levo thyroxine added because I went underactive I remained in anti depressants for about 4 years. Had been in thyroxine since then and started getting chest pain etc early this year and discovered I had relapsed and overactive again. Long story short I had radioiodine therapy on Wednesday 30th October and currently in isolation but in answer to your problem depression and agitation is connected to thyroid problems for sure. Good luck hope you feel better soon.
I started hyper and was started on Propranolol for my palpitations while waiting for carbimazole dosage. I've never really heard of antidepressants being used to balance hormones, forgive me if I'm wrong.
I've had the radioiodine therapy and doing grand thank you. Hardest part is being isolated but at least its temporary. My son in law 31 had 2 malignant brain tumors removed this time last year and underwent radiotherapy over Christmas and new year and was doing well but it has returned. Needless to say I'm sad & frustrated I cant comfort them. Hopefully I can do that soon. Hope you keep well🙏
I have Hashimotos. For a number of years I had that awful dragging low feeling, low fatigue, general exhaustion. I then bought books on Hashimotos (there's a book list you can get from Thyroid UK), and went totally gluten free. Within a week my low mood feeling & exhaustion, which I had no reason to be feeling, began to improve. Over the years my TPO antibody level has reduced. I've just paid for further tests and found I'm also allergic to cow's dairy, egg, and yeast. Avoiding these allergens, being strictly gluten free, taking Vit D and B12 supplement, and the correct level of Levothyroxine, all has helped get me as close to my old self as I'll ever be.
Thankyou for sharing! Still waiting to see if I'll need levo or more monitoring. Been looking into the gluten free thing, may give it a try! Glad things have improved for you
Low mood, depression both symptomatic of Hypothyroidism.
" ...said he has no knowledge of low moods/depression being linked with thyroid under activity "
!!!!!!!!!!!!!!!!!!
Haven't read other comments yet but this really does show his incompetence as far as thyroid problems go!
Before being started on thyroxine (after what seemed like a virus infection) I had so little mental energy it was almost impossible to function. I would sit for hours wondering how soon I could go back to bed (I would be unable to sleep if too soon).
It was the boredom that was the worst. I couldn't read or watch a film, or even think anything interesting to pass the time. The thought of maybe being like this for the rest of my life was very scary indeed.
This state of oppressive lethargy must be very like true depression. I came near that once, though thankfully didn't tip over the edge, and have been fine since. The major difference was that, instead of being unable to concentrate on thinking anything at all, the negative thoughts were only too active, running around like rabbits in my mind.
So yes, depression, and other psychological problems is VERY MUCH a symptom of hypothyroidism.
I read recently that hypothyroidism affects serotonin levels, which among other things makes a person feel happy.
Mine is quite frustrating. I dont feel fully symptomatic every single day, some days are definitely harder than others. I'll have a really good day and the smallest thing would ruin it and my mood would dip tremendously, way more than anyone would expect. Or I'd just wake up feeling extremely exhausted and just sad and stay in bed all day. Really hoping for some answers with my latest bloods which I'm waiting for.
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I'm sorry you had to experience that. I hope things have gotten better for you now and you're on the right treatment plan! I don't agree with taking antidepressants for personal reasons, so hoping my recent bloodtest results show that I require treatment for my thyroid. This has all happened over the space of four months and it's been quite rattling. My levels are being monitored at the moment so I'm not on medication for anything. I may start pushing for medication as I'm quite symptomatic. Even had to leave my job as I couldn't keep up and commuting was becoming extremely painful with severe muscle aches. 
Low mood 
Low T4 and low TSH
Hypothyroid Symptoms - am I low end of normal?
Overmedicated but low temperature readings?
Hashimoto's or Hypothyroid?
