My underactive thyroid was discovered a few years ago because i was given a change if medication for my mental health which had bad adverse effects and i was really poorly i believe this is what started me on the thyroid journey even now im unsure if my symptoms are mental health related or thyroid doctors in uk dont have the time now to want to find out
Mental health and thyroid: My underactive thyroid... - Thyroid UK
Mental health and thyroid
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222222Kc
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Hey there. If you're looking at your post, look on the right-hand side (on a pc - at the bottom of the scroll I belive on a phone...) and you'll see a list of 'related posts'; these might be worthwhile clicking on. Mental health issues are common with hypo 😩
i believe this is what started me on the thyroid journey
More likely that you had an undiagnosed thyroid problem that caused your mental health problems. The brain needs an awful lot of T3, so if there's not enough then you can get all sorts of 'brain symptoms' - for want of a better term - depression, anxiety, paranoia, forgetfullness, dyslexia, bi-polar, and so on, and so forth. All these things are hypo symptoms.
No because the mental health has been ongoing for 20years,+
But it's perfectly possible that you've had a thyroid problem for 20 years. I was hypo for about 40 years before I was ever tested. I only worked this out in retrospect, and my suspicions confirmed by a hormone expert.
Were you every tested for thyroid during those 20 years?
No never tested i was in hospital when they first tested and found underactive the symptoms are so bad i would have known at some point because i just couldn't function with the fatigue and tiredness etc it was horrific
Yes, but you don't seem to realise that thyroid problems don't happen over-night. They can take years before symptoms drive you to the doctors. And, mental issues could be the first symptoms. Hypothyroidism affects every single cell in our bodies. So, anything and everything could be - and usually is - a symptom of low thyroid. Often people look at the list of symptoms and realise they've had some of them for a long time, but didn't associate them with thyroid. And, doctors are no help in that direction because they know nothing about symptoms.
But, I get the impression that you're not going to take my word for it. But, I think it's something that you ought to bear in mind. 
Thank you yes you could be right i u derstand what your saying
When we're hypothyroid our body cannot function properly because we have millions of T3 receptor cells in our body. T3 is the Active Thyroid Hormone and both FT3 and FT4 are rarely checked.
Levothyroxine is a synthetic T4 and has to convert to the Active Thyroid Hormone, i.e. T3 which is required in our millions of T3 receptor cells, the brain and heart need the most.
T3 is never checked in uk
It is occasionally and I believe it is because we are expected to be on levothyroxine alone and because they are directed to only take notice of the TSH and T4. Unfortunately for us, the patient, we don't feel well until TSH is 1 or below and have a Free T4 and Free T3 in the upper part of the ranges. These latter two are rarely tested too.
I have T3 tested as that's what I take.
RedAppleAdministrator
222222Kc, What was your original mental health diagnosis (e.g. depression, psychosis, bipolar etc), and what medication/s have you been taking for your mental health?
Certain medications do impact thyroid hormone levels, such as lithium prescribed for bipolar. Patients taking lithium should have their thyroid levels tested frequently, and adjustments made to their lithium dose, and given thyroid hormone alongside as necessary.
BPD severe depression ive tried lots of medication over the years at the moment its venlifaxene mirtazapin and lamacil
As commented by SlowDragon below, BPD and Treatment resistant depression can both be strongly linked to thyroid hormone levels. Unfortunately, medics are very quick to diagnose mental health problems and prescribe medications like the ones you mention.
Before doing this, in an ideal world, they would thoroughly test for thyroid hormone issues, but they very rarely do. One GP I saw was very quick to send me down the mental health path, wanting to start me on antidepressants, counselling etc. Fortunately, I resisted this and saw a different GP who decided to rule out 'physical illness' as well, and in his words, nearly 'fell off his chair' when my TSH came back at 69 with off the scale thyroid antibodies. He was still convinced that this was unrelated and that I should at least start on Prozac, but very reluctantly agreed to me not doing so until my thyroid levels were back under control.
It's an appalling fact that even in these so called enlightened times, most medics have no idea how much havoc inappropriate thyroid hormone levels can wreak on the brain.
Yes this is true. I get annoyed because ive followed all the rules yet i feel yuk bloods done in the week after a year so we'll see if they come back ok then thats all the gp wants to no
Bloods should be retested 6-8 weeks after each dose increase in levothyroxine (or brand change in levothyroxine)
How much levothyroxine are you currently taking?
List of symptoms of hypothyroidism
thyroiduk.org/wp-content/up...
Hi im on 75 at the moment
75mcg is only one step up from starter dose of levothyroxine
How long have you been on 75mcg?
Bloods should be retested 6-8 weeks after each dose increase
Even if we don’t start on full replacement dose, most people need to increase dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until on full replacement dose
NICE guidelines on full replacement dose
nice.org.uk/guidance/ng145/...
1.3.6
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
gp-update.co.uk/Latest-Upda...
Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months.
RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.
For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.
For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).
If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.
A small Dutch double-blind cross-over study (ArchIntMed 2010;170:1996) demonstrated that night time rather than morning dosing improved TSH suppression and free T4 measurements, but made no difference to subjective wellbeing. It is reasonable to take levothyroxine at night rather than in the morning, especially for individuals who do not eat late at night.
BMJ also clear on dose required
bestpractice.bmj.com/topics...
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many patients 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 note 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
Thank you i have been on various doze for last 8 years now 75 for over 18months bloods done last week waiting on result
Was test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test?
Yes it was i dont no what to think if it comes back okay
Full test should always include TSH, Ft4, Ft3, vitamin D, folate, ferritin and B12
Well tests back at 2.3 which she said isnt bad and ive to reduce so 75 one day 50 next for 6 weeks. Hopefully i wont feel so tired
Do you mean your TSH is 2.3? If so, you need a dose increase by 25mcg a day not a decrease! What is your doctor thinking!? You are on medication. Your TSH needs to be around 1 or below.
I hope i havent picked it up wrong i thought she said between 3-5 is okay
If your doctor thinks a TSH of between 3 and 5 is OK, she doesn't know what she's doing with thyroid.
There are others on here with lots of experience, but I think the last thing you need to do is reduce your dose. You will feel worse. You need to increase and try to get that TSH down. Just because you are in range some GP's think that's all they need to do. But you aren't feeling well are you? So the answer isn't going to be going backwards.
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
Just testing TSH is completely inadequate
Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine
Ft4 should be near top of range
(Many of us need TSH nearer 0.2 than 2.0 to feel well)
See box
Thyroxine replacement in primary hypothyroidism
pathology.leedsth.nhs.uk/pa...
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.
Most patients will feel well in that circumstance.
But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor
please email Dionne at
tukadmin@thyroiduk.org
I wasnt aware of this. Thank you
If that’s TSH of 2.3 you need a 25mcg dose INCREASE in levothyroxine
TSH should be under one for most people on levothyroxine
Just testing TSH is completely inadequate
Strongly recommend you get FULL thyroid and vitamin testing privately
List of private testing options
thyroiduk.org/getting-a-dia...
Blue Horizon likely best option...also includes cortisol testing...might be useful for you
Blue Horizon Thyroid Premium Gold includes vitamins
bluehorizonbloodtests.co.uk...
Thyroid plus vitamins including folate (private blood draw required)
medichecks.com/products/thy...
Medichecks often have special offers, if order on Thursdays
Thriva Thyroid plus vitamins
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. Teva contains mannitol as a filler, which seems to be possible cause of problems. 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
Teva and Aristo are the only lactose free tablets
healthunlocked.com/thyroidu...
Teva is a Marmite brand....some love it ...but many can’t tolerate it
Teva poll
healthunlocked.com/thyroidu...
academic.oup.com/jcem/artic...
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
verywellhealth.com/best-tim...
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
Ive been on omeprazole for about 15 years and was never told about the 4 hour gap so thank you
It’s difficult to stop omperazole.
Ask GP to test magnesium and B12 levels as these are likely low as result
Vitamin D, folate and ferritin tested too ...plus coeliac blood test
Many many hypothyroid patients have LOW stomach acid
All PPI are for HIGH stomach acid
Frequently given omeprazole ...which lowers acid even further
Thousands of posts on here about low stomach acid and how to improve
healthunlocked.com/search/p...
Links about low stomach acid and Hashimoto’s
nutritionjersey.com/high-or...
articles.mercola.com/sites/...
thyroidpharmacist.com/artic...
stopthethyroidmadness.com/s...
healthygut.com/articles/3-t...
naturalendocrinesolutions.c...
Long term ppi can lower vitamin levels
pulsetoday.co.uk/clinical/m...
gov.uk/drug-safety-update/p...
Going on absolutely strictly gluten free diet frequently helps improve IBS
Important to get coeliac blood test BEFORE cutting out gluten
What a disaster there is in the UK with so many diagnosed as having a mental health problem and given medications that may not help and may even cause additional problems and never testing FT4 and FT3. It is barbaric!
Its quite scarey because sometimes you cant seperate the two
The awful fact is that few doctors know any clinical symptoms. Neither can they diagnose a patient (as they did in the past before blood tests) because they've never been trained or have knowledge about problems with the thyroid gland.
Before blood tests were introduced - making big profits for Big Pharma, patients were given a trial of NDT according to symptoms alone.
In these modern days many doctors have no idea of any symptoms and, if they ever take notice of a patient's TSH have been told to wait until it is 10 before diagnosing. The rules are well out of date.
One of the reason a psychiatrist can prescribe thyroid medication including T3 is for drug resistant depression
Low Ft3, due to inadequate dose of levothyroxine, or poor conversion of levothyroxine (Ft4) into Ft3 is very common
NHS rarely tests Ft3...hence over 109,000 members on here
Essential to test thyroid antibodies and vitamins as well as TSH, Ft4 and Ft3
Add any results and ranges you have already
Or get FULL Thyroid and vitamin testing privately
How much levothyroxine are you currently taking?
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
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 as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
List of private testing options
thyroiduk.org/getting-a-dia...
Medichecks Thyroid plus ultra vitamin (doesn’t include folate)
medichecks.com/products/thy...
Thyroid plus vitamins including folate (private blood draw required)
medichecks.com/products/thy...
Medichecks often have special offers, if order on Thursdays
Thriva Thyroid plus vitamins
Blue Horizon Thyroid Premium Gold includes vitamins
bluehorizonbloodtests.co.uk...
In uk no t3 is done im on 3monthly vit jag. It could even be the brand of levo I'm lost
Vast majority of members on here are based in UK
Majority of us have to test privately
Your psychiatrist could and should test FULL thyroid and vitamin testing
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
Frequently only TSH tested which is completely inadequate
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
Are you getting B12 injections?
Are these being done regularly enough?
Ask GP to test vitamin D, folate and ferritin levels
How much levothyroxine are you currently taking
Which brand of levothyroxine are you normally prescribed
Do you try to stick to same brand at each prescription
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 as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
List of private testing options
thyroiduk.org/getting-a-dia...
Medichecks Thyroid plus ultra vitamin (doesn’t include folate)
medichecks.com/products/thy...
Thyroid plus vitamins including folate (private blood draw required)
medichecks.com/products/thy...
Medichecks often have special offers, if order on Thursdays
Thriva Thyroid plus vitamins
Blue Horizon Thyroid Premium Gold includes vitamins
bluehorizonbloodtests.co.uk...
Add any results and ranges you have
Or come back with new post once you get results from GP
Then we can advise on what other tests you need
SlowDragonAdministrator
Bi-polar can be linked to autoimmune thyroid disease (Hashimoto’s)
Drug resistant depression to being hypothyroid generally
Psychiatrist should be aware of links between thyroid disease and mental health symptoms
Few links
drknews.com/when-hashimotos...
holtorfmed.com/mental-illne...
thyroidpharmacist.com/artic...
drknews.com/when-hashimotos...
hypothyroidmom.com/miss-dia...
In addition to the information you've already been given, a common symptom of hypothyroidism is low stomach acid which leads to poor food digestion. This then leads to poor absorption of nutrients and this results in lots of deficiencies.
Nutrient deficiencies have many symptoms, but in my own case the most important one was low iron and ferritin. Once I treated this myself I discovered that my anxiety disappeared and my depression was substantially reduced.
For other people the things which made the most difference could be vitamin B12 and/or folate, both of which are often deficient in people with thyroid problems.
This is true as i also have ibs and a hernia so have been on omnaprozale for many years then i read it wasnt compatible with levo sometimes you wonder if gp, 's even bother
Doctors do not look at the 'whole picture' of the patient sitting in front of him.
When we think back before the blood tests were invented and introducing levothyroxine, we were all diagnosed upon our clinical symptoms alone - and they knew them. Prescribing a trial of NDT and slowly increasing if patient was improving until their health was restored.
How much the NHS pays for blood tests must surely be astronomical replacing the knowledge past doctors were trained in and patients given a trial of NDTs.
IBS is frequently due to low stomach acid and gluten intolerance
You need FULL thyroid and vitamin testing
Essential to have GOOD vitamin levels
B12 at least over 500
Vitamin D at least around 80nmol and around 100nmol maybe better
Folate and ferritin at least half way through range
Test privately if GP or psychologist won’t
75mcg levothyroxine is only one step up from starter dose
How much do you weigh in kilo approx?
Thank you kindly for replies
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