No medication : So I finished my meeting with the... - Thyroid UK

Thyroid UK

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No medication


So I finished my meeting with the endo, she said my symptoms were mainly due to anxiety and depression and so she prescribed me Cipralex (Lexapro).

She said as I was subclinical, if she were to prescribe me with thyroid medication, it will make my anxiety worse.

I have another meeting with her in 2 months to see how it goes.

I was wondering if Lexapro is a safe medication? Is it safe for the heart? Did anyone suffer any side effects?

21 Replies

I would either see another Endocrinologist or start to self medicate because you clearly need Levothyroxine not anti-depressants. I was offered counseling as well as anti-depressants by a couple of doctors when all I needed was treating. I think anti-depressants would have made me feel worse as I was already nearly bedridden with no energy to wash or get dressed.

Your results show that you are hypothyroid

TSH: 5.5 (0.5 - 4.0)

FT4: 15 (10 - 20)

FT3: 4.8 (3.5 - 6.0)

Here is a link about the medication


My antibodies also showed no sign of Hashimotos. However, I recently had a thyroid scan which suggested I have Hashimotos which prompted my gp to send me to an endo.

My recent blood test results are:

TSH: 5.5 (0.5 - 4.0)

FT4: 15 (10 - 20)

FT3: 4.8 (3.5 - 6.0)

20% of Hashimoto's patients never have raised antibodies

Ask your Doctor to test vitamin D, folate, ferritin and B12

These are frequently very low with Hashimoto’s

Come back with new post once you get results

Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.

Evidence of a link between increased level of antithyroid antibodies in hypothyroid patients with HT and 25OHD3 deficiency may suggest that this group is particularly prone to the vitamin D deficiency and can benefit from its alignment.

There is a high (approx 40%) prevalence of B12 deficiency in hypothyroid patients. Traditional symptoms are not a good guide to determining presence of B12 deficiency. Screening for vitamin B12 levels should be undertaken in all hypothyroid patients, irrespective of their thyroid antibody status. Replacement of B12 leads to improvement in symptoms,

Your high TSH shows your thyroid is struggling

Median TSH graph is around 1-2

Very important when you test TSH ....

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 .

Was this test done early morning?

According to the current TSH reference interval, hypothyroidism was not diagnosed in about 50% of the cases in the afternoon.”

“Further analysis demonstrated inadequate compensation of hypothyroidism, which was defined in 45.5% of the morning samples and in 9% of the afternoon samples”

TSH levels showed a statistically significant decline postprandially in comparison to fasting values. This may have clinical implications in the diagnosis and management of hypothyroidism, especially SCH.

TSH daily variation

Can see you are in Australia


Have you had BOTH TPO And TG thyroid antibodies tested?

List of hypothyroid symptoms here

Anxiety is common hypothyroid symptom. Many Hashimoto’s patients find strictly gluten free diet improves symptoms and may reduce anxiety

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

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 gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

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

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

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

Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.

Why gluten intolerance can upset cortisol levels

Sometimes I think I’m living in a parallel universe 😡

. If you haven’t yet started Lexapro, I would urge you to consider carefully. Your bloods indicate Hypothyroidism - symptoms of which are anxiety and depression.

I spent two years on Prozac because of similar medical ineptitude. The side effects were horrendous and every time I saw my GP he upped the dose.

I would urge you to seek a second opinion.

Totally agree with Scrumbler. An endo is not qualified to diagnose you with 'anxiety', she is not a psychatrist. And, I doubt she knows anything about the side-effects and long-term consequences of Lexapro.

She said as I was subclinical, if she were to prescribe me with thyroid medication, it will make my anxiety worse.

That is complete and utter BS. Why on earth would thyroid 'medication' make your anxiety worse when it's lack of thyroid hormones that is causing it? She's just fobbing you off by saying the first stupid thing that comes into her head.

Anxiety and depression are not a diseases, they do not cause symptoms - they are symptoms. And, should not be treated as if they are a disease.

You are hypo when your TSH reaches 3, but you can have hypo symptoms long before it gets that high. I'm willing to bet that this so-called endo is a diabetes specialist who knows nothing about thyroid!

Before I knew I had subclinical hypothyroidism I was put on four different SSRIs (one at a time, not altogether) over a period of about 10 - 15 years. None of them eased my anxiety and depression. I would never take another one - they are addictive, can be extremely difficult to get off of, and have lots of unpleasant side effects. And to make matter worse, many doctors don't believe that the symptoms that patients get are related to the SSRIs, they believe that the patients' mental health problems are getting worse and start adding other drugs to the original SSRI. I've seen people on here say that they were put on multiple anti-psychotics and SSRIs and end up on 5 different psychiatric meds, when what they actually have is a thyroid problem with lots of nutrient deficiencies. And they are still depressed and anxious.

Instead of putting a sticking plaster on the problem like your doctor has suggested you could actually try to fix it.

I would suggest that you get nutrients tested and then start to supplement to get them optimised (just being in range isn't enough - you need levels which are optimal for you). Once you've started that process you might find your anxiety and depression start to ease. And you can then start to think about self-medicating your thyroid - although your thyroid might improve with better nutrients anyway - we don't all have autoimmune hypothyroidism.

In my own experience it was improving my iron and ferritin that eliminated my anxiety and reduced my depression. For other people it could be optimising vitamin B12 and folate. For yet others it could be vitamin D or magnesium or several other nutrients or a combination of all of them that are the root cause of their anxiety and depression.

I would suggest holding off on the anti-depressant - you aren't obliged to take a prescribed drug just because a doctor says so.

humanbean in reply to humanbean

I forgot to add...

I eventually went gluten-free and it made my remaining mood and anger problems practically disappear. It took only five days off gluten for me to realise that something good was happening and it was worth sticking with it. Others have taken rather longer to get improvements, but they have still thought it was worth it in the end.

If you don't benefit from being gluten-free after, say, three months, you can go back to eating it again.

I didn’t have any side effects with Lexapro but I wanted to go more than natural route so I started taking Ashwaghanda which I actually liked better!

Hello, thank you for everybody's comments! I'll be holding off taking Lexapro. (I asked the doctor what the side effects were and she just said dry mouth...)

I'm still quite dependent on my mother for my health appointments as I don't have a car. I'm not sure how to convince her that I need to go to another endo because "people on the internet" tell me to. Also the cost of the appointment was quite high.

I guess I'll just wait for the next meeting with her in 2 months and hopefully then she'll put me on medication.

Till then I'll try out a gluten free diet.

fuchsia-pink in reply to borahae

I feel for you. It seems as though it's no different (ie better) in Australia than here :(

Please don't wait so long you become really ill. If the endo is expensive, how does it compare with the cost of self-treating with 50 mcg of levo to start with?

borahae in reply to fuchsia-pink

Is it possible to get really ill in 2 months? I'm kind of scared of self medicating without doctor supervision.

fuchsia-pink in reply to borahae

You are already hypo - your TSH is out of range. In the UK the GPs are obsessed with TSH, but will often wait until it gets to 10 before they do anything. To which I would reply - but your TSH is more than 10 times higher than the lower end of the range and more than a third above the top end of the range. What is the point in having an upper end of a range if it is ignored?

I don't know how it works in Aus, but it seems to me that you are being really badly let down. The comments here all say the same thing: you don't need anxiety meds when anxiety is a symptom of being hypo and your bloods confirm you ARE hypo.

I have never before suggested to someone that they self-source - I have quite often suggested they change GP or endo :) - but you have explained this is tricky for you.

I've never met you and I don't know you - but you aren't well now and I just worry how much worse you might get if your doctors insist on waiting and waiting - and prescribing something outside their specialist field in the meantime.

I would be very wary of self-medicating too - but I'm not sure what other options you have ... sending you a big hug anyway x

humanbean in reply to borahae

You would probably save substantial amounts of money by paying for your own testing from companies like Medichecks and Blue Horizon. We can tell you which results are good, which aren't, and how to improve them. Supplements can be bought without involving a doctor too.

Finger-prick blood testing is all handled over the web and using the mail to post samples. Buying supplements usually involves just buying over the web too. The only supplements that I buy from bricks and mortar shops are iron pills which I buy from pharmacies.

borahae in reply to humanbean

Thank you! I'll check it out

humanbean in reply to borahae

From the Thyroid UK website :

And something worth knowing :

Medichecks sometimes has larger discounts on Thursdays.

Blue Horizon has much more irregular special offers, but they tend to last longer than the Medichecks ones when they do happen.

If any particular testing company has tests that appeal to you it is worth registering with the company because most of them will send info on special offers to those people who are registered with them.

Hi just want to say i hope you get the correct treatment soon. It seems Dr's are all to quick to blame everything on anxiety/depression 😔

borahae in reply to Macey2009

They do! I've been to 4 different GPs and they all say that I need to manage my anxiety and depression first. Also the fact that my blood test results showed I had subclinical hypothyroidism back in 2017 but they didn't mention it to me at all.

Macey2009 in reply to borahae

It's no different in the uk unfortunately. Fingers crossed you get the help you need. Sending hugs 🤗

humanbean in reply to borahae

they all say that I need to manage my anxiety and depression first

Personally I think that is rubbish. People need to fix and optimise what they can first and only then should they consider whether an anti-depressant might benefit them.

Taking an anti-depressant will not fix an iron deficiency or vitamin B12 deficiency or a folate deficiency or ... or ... or a low level of thyroid hormones.

humanbean in reply to borahae

Another point...

There are over-the-counter supplements that people find have an anti-depressant effect. And they tend to be non-addictive and don't have masses of side effects and/or withdrawal effects.

I take a low dose of 5-HTP and it works brilliantly for me as a mild anti-depressant, and these days I only take it three or four days a week. I used to take it every day, and when I decided to reduce my dose I did so with no withdrawal effects at all - I just took my time over doing it.

Another supplement that some people swear by (I've never tried it myself) is SAM-e (and practically impossible to search for because of the abbreviation being a common word) The full name of it is S-Adenosyl methionine :

Anti-depressants of any kind must never be mixed, by the way.

Please don't accept this cod-diagnosis. The endo is not qualified to make the diagnosis, nor to prescribe you antidepressants. There is nothing "sub-clinical" about your test results, indeed their significance is clear.

I was prescribed several different ADs in the years before hypothyroidism and pernicious anaemia were finally diagnosed. Both conditions can cause mental health issues, but in fact my anxiety was due to having a huge range of distressing and life-changing symptoms as a result of depleted TH and B12. The side-effects of the ADs on top of all these nearly finished me off. It was a terrible experience that blighted my teens and twenties.

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