Mood swings normal?

[Purple_dog]

Hi, i have Hashimoto’s and experience symptoms even though my bloods are always in range, diagnosed a year ago. the doc did prescribe me thyroxine which has helped with my symptoms. However, I recently had my left side of my thyroid removed because I had a tumour on it and it was causing me difficulty swallowing and a lot of neck pain, thankfully the results came back benign. I have noticed since my operation my moods swings are really bad. I did up my thyroxin from 75mg to 100mg as I was getting symptoms again although it had done nothing for my mood swings. I have a 3 year old and I am normally very patient but recently with him acting out, as a typical 3 year old would, I go from 0-100 angry because I can’t get him to listen and it is completely out of character for me. I can actually feel my blood boil, to the point I scare myself to my reaction from my child not listening to me. It’s something I have discussed with my husband as he has commented it not like me. Is this something that is normal to experience and can it be sorted by upping or lowering my medication? Anytime I try to talk to my doc about a change in mood they always go to depression. Or anxiety which is so frustrating because that is symptoms of this condition when my meds are out. I genuinely don’t feel depressed or anxious, I have a great family and it’s me that has this overreaction at the slightest thing but I feel like I can’t control it, it’s only been this way since I’ve had this operation. Any help would be appreciated!

[TDaniel33]

Hi my name is Tiffany and I have hypothyroidism and a pituitary macroadenoma and i suffer with the same lashing out you do. The past few days have been bad for me talking to my family like I don't have no respect at all. Then after I lash out all I can do is cry and I do suffer with anxiety and depression as well. That is a big factor for me to. It is a horrible feeling and I want you to know maybe the anxiety and depression is a huge factor for you to. It is a bad feeling.

[Purple_dog in reply to TDaniel33]

Thanks for your reply! Maybe anxiety, if I was depressed I thought it would be more obvious? I don’t know, I know my moods do get low at times, I have an 8 month old as well so I don’t get much sleep or time for myself. I use to be very active but when I took not well I had no energy. With the thyroxin I got some energy back then I fell pregnant! Since I’ve had my baby though I’ve had a few ops and not had a chance to exercise, which is how I let my frustrations out. I maybe need to try make time for myself so I can let some frustrations out. My husband is very understanding, I think it helps I’ve been with him 12 years so the last 2 years is just me trying to get to grips with this hashimoto’s. I’m usually a laid back person. I hate it, some days I just don’t feel like me when I get that angry.

[Lora7again]

100mcg is a low dose and you need an increase. My elderly Dad is on 100mcg because his GP tells him that is all he needs. I disagree because his TSH is about 5 but he will only follow his Doctors instruction. He also has COPD so he blames most of his symptoms on that. I look at his thinning hair because of this and he always had thick hair before he became hypothyroid. His wife is also the same with thin hair and she is on a low dose of levothyroxine. She complains to me about stomach ache and joint pain and I do say it might be your thyroid because you are undermedicated but she is blindly following her GPs advice as well. *sigh*

[SlowDragon Administrator]

First thing is, do you have any actual blood test results?

if not will need to get hold of copies.

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

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 as you have Hashimoto’s

Ask GP to test vitamin levels

Thyroid levels should be retested 6-8 weeks after each dose increase (or brand change) in levothyroxine

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)

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

thyroiduk.org.uk/tuk/testin...

For thyroid including antibodies and 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

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )

monitormyhealth.org.uk/thyr...

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 is in top third of range and FT3 at least half way through range

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

Many people take Levothyroxine soon after waking, but it may be more effective taken at bedtime

verywellhealth.com/best-tim...

Many people find Levothyroxine brands are not interchangeable.

Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Watch out for brand change when dose is increased or at repeat prescription.

Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients. Teva is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half

healthunlocked.com/thyroidu...

Teva poll

healthunlocked.com/thyroidu...

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap. Some like calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

Come back with new post once you get results

[SlowDragon Administrator]

Also ....trying strictly gluten free diet

Many members find this can dramatically improve mood and several members said it reduced anger

Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten intolerance. Second most common is lactose intolerance

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find strictly gluten free diet reduces symptoms, sometimes significantly. Either due to 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

While still eating high gluten diet 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 strictly gluten free diet for 3-6 months

If no noticeable improvement, reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

ncbi.nlm.nih.gov/pubmed/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

ncbi.nlm.nih.gov/pubmed/300...

The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

[Cabernet]

I had anger issues like you out of character, my b12 was low, my vit D was low and ferritin. Once I got my b12 and vit D levels up high the anger, anxiety, and depression went also my ferritin went up higher without taking iron tablets, I also went gluten free.