Any advice gratefully received... Could this be more than depression/anxiety?

[ukred]

Hi, been feeling really 'out of it' since March last year. My GP diagnosed anxiety/depression over the phone and gave me antidepressants....which I finally gave in to a few months later after FOUR migraines in one day and hardly any sleep...

Over the last year, I have researched anxiety/depression/physical symptoms/meditation//B12 deficiency/Thyroid issues. I've taken antidepressants for 9mths and still not right. In February this year I did a private blood test as the GP refused to test thyroid...only gave in to a basic blood count.

On the private test my Folate was low 5.54 (range 3.89 & above). My ACTIVE B12 was low 45.3 (range 37.5 & above). In the 1st NHS test, my cholesterol was high...even though I was in starvation mode....and high again in February.

My TSH was 4.7 (Range 0,27-4.2) which was slightly higher than the NHS one. (This had been 1.47 the previous March!) Free T3 5.27 (Range 3.1-6.8). Free Thyroxine 15.500 (Range 12-22). Thyroglobulin antibodies - 11.400 (Range up to 115) and Thyroid Peroxidase Antibodies 9.0 (Range up to 34)

My GP won't test my thyroid again. I am depressed and anxious, puffy face, aching limbs, fatigue, always cold (was never cold before!), yet sensitive to heat... very dry skin, hair thinning, spaced out feeling most of the day. sleeping about 7hrs a night so grateful for that, think that's the Magnesium... . Some symptoms may be the antidepressants themselves....and I have bombarded myself with vitamins and magnesium. I should be healthy. I'm nearly 63 and feel 90.

I'm going to stop the majority of the vitamins and go for another private test in a few weeks (3mths after last). Any advice please?

[Buddy195 Administrator]

Hi ukred,I was diagnosed by my GP as having health anxiety & saw a psychotherapist for over a year. Joining this forum helped me realise that my symptoms were all related to me being under-medicated thyroid wise and key vitamins not being optimal. Members encouraged me to test privately & empowered me to challenge some things I’d been told by medics.

Could you see a private endocrinologist (using recommended practitioners from the Thyroid UK list)?

[HashiFedUp]

Go to another GP. Your results indicate you are hypothyroid!

[buddy99]

Medicating for depression and anxiety seems to be a common approach doctors take. I've been there myself, so has been my daughter and quite a few other people I know. It appears that many people with thyroid issues feel a lot better with a TSH below 2. But this is very individual and needs some trying out to accommodate this individuality. What you describe strikes me as a typical medical response, though. Your TSH is above normal by 0.5, which I would judge to be a sign of hypothyroidism, and it is not treated as such by your physician. I guarantee you, if you were on Levothyroxin and your TSH were 0.5 BELOW normal your dose would be adjusted immediately. If your physician is not open to treating your potential hypothyroidism I would go for a second opinion.

[shaws]

That's the problem of 'phone consultations' even though it is also similar if it is a face-to-face appointment. Doctors know very little about anything to do with hypothyroidism, except to keep the TSH 'somewhere' in range, rather than what it should be, which is TSH of 1 or lower and Free T3 and Free T4 in the upper part of the ranges. Rarely are these two important 'frees' tested.

Always take your thyroid hormones on an empty stomach and wait an hour before eating.

If taking a bedtime dose, allow a gap of 2 hours gap if you've eaten previously.

It is a big learning curve and lots of members have more knowledge than the whole of the thyroid experts and unfortunately many doctors have to 'toe the line stated' as they may lose their livelihoods if they help us to recover our health by prescribing thyroid hormones that raise our metabolism. One is T3 and the other (prescribed since 1892) NDT (natural dessicated thyroid hormones - recently withdrawn) .

The professionals have withdrawn, NDTs despite the safely of them being proven since 1892 when lives were saved from then on.

They have also withdrawn T3 due to an exorbitant rise in cost but I'm sure they could source cheaper ones if they so wished.

This is the method when getting blood tests for thyroid hormones:-

Always get the earliest possible blood draw.

It is a fasting test but you can drink water.

Allow a gap of 24 hours between last dose of hormones and the test and take afterwards.

Allow a gap of 1 hour after taking thyroid hormones before you eat. Food would interfere with the uptake of hormones.

Request also:

Vitamin D and B12

Iron, ferritin and folate.

If GP wont do the tests you can get a home draw private blood tests and many members have done so.

Always get a print-out of your results for your own records and post if you have a query.

[MariLiz]

If your B12 levels are down that could account for many of your symptoms. If we have thyroid problems it’s quite common for us to be low in vitamins too. Once my B12 was treated a lot of my symptoms disappeared. I was constantly cold, had pins and needles in my legs and feet, nervous tics around my eyes, was sleepy, depressed, tinnitus, and had balance problems. I also felt tired all the time, and had a struggle to find the right words when trying to have a conversation. I’d pretty much decided I had early onset dementia! Thankfully the B12 injections have cured almost everything, I do still have a degree of tinnitus, which gets worse just before an injection is due. I hope you will find out what is causing your issues too.

[ukred]

Thank you all so much for taking the time to comment. Once I had the private test done at the beginning of February I started bombarding B12/ D and folate. I am also taking C and magnesium. Mariliz I’m vegan so allowing another test before I consider injections if its still low after high supplementing. Thanks for the advice I’m on the B12 group just in case. I am trying hard to get to the bottom of this. This is why I feel I should be feeling better....

In March 2020 my TSH came up on a normal NHS blood test as 1.47. Almost a year later in Feb this year it was 3.40 on the NHS one and 4.7 on medichecks. So I’m booking medichecks in a couple of weeks to check it 3 mths on.

In the last conversation I had with my GP (phone) she said my thyroid was well within the normal range at 3.40 and no need for further tests. So if medichecks still find it outside their range at the next test I am going to ask to see a specialist. I will have two out of range tests by then. It’s just so many people are saying they don’t treat under 10. If it comes to it I may need to borrow money and see a private specialist.

[Sharoosz]

Some good advice here. Are you able to take walks? That is very important, especially these days. I know someone who was on anti-depressants for 20 years (he didn't even realize what he was taking, just accepted the prescription for years) and his health took a major nosedive about three years. He lost a ton of weight, had all kinds of health problems, saw loads of doctors and had many tests. It turns out the anti-depressants caused the problems. Doctors seem to hand them out like candy rather than dealing with problems. There are people who need them but the vast majority of people don't. Good diet, exercise, vitamins and proper medical diagnosis. Wish you all the best with getting through this.

[ukred in reply to Sharoosz]

Thanks for this. Yes, I walk a lot. It really helps. Lately though, I am aching a lot and didn't use to. I am dragging my aching body on walks because its better than staying in. I am not sure if the antidepressants are causing that as apparently it is a side effect of them - or if it's a thyroid or even B12 problem. I wish I hadn't started on them as they only seem to have given me yet another problem. I was told it would stop my migraines and indeed they have been a lot less lately. Anyway, I have booked a blood check with medichecks in a couple of weeks so maybe that will make things clearer for me. My TSH went from 1.47 to 4.7 in less than a year. If it's risen any more surely it has to be that that's causing my main problems. Thanks again

[Sharoosz in reply to ukred]

Are you on thyroid meds or just anti-depressants? I couldn't find that info anywhere and if your GP refuses to test thyroid again, it's not only time for a new GP but also maybe something for the fairly high TSH level. Selenium is also helpful for thyroid - my doctor cut my thyroxine dose back after I started on selenium as my TSH went down. One of my students in Poland went to an endo there and she was able to control things with supplements, diet and exercise . Obviously that won't work for everyone and if you are very achy there may be another autoimmune issue. I also take turmeric with pepper and ginger (2x/day) and that helps with the joint aches. Do hope you get things sorted and find a more cooperative doctor too!

[ukred in reply to Sharoosz]

I'm only on antidepressants. Unless my TSH reaches 10, my GP won't retest. The test I have is a private one.

[humanbean]

Personal anecdote : Improving my low iron and ferritin and getting them as close to optimal as possible eliminated my anxiety and reduce my depression a lot too.

Getting your thyroid meds dosed appropriately for you (not for your doctor) is essential too.

[SlowDragon Administrator]

Just read in previous post you are vegan

Obviously you need to take significant supplements to maintain optimal vitamin levels

Exactly what vitamin supplements have you been taking

Extremely difficult/impossible to maintain B12 without daily supplements

Likely to need to supplement iron. Important to do full iron panel test for anaemia

This is also a rare case where you need iodine levels tested

[ukred in reply to SlowDragon]

Yes I'm vegan and was supplementing B12 up until two weeks before the tests. However, I realise now that folate was low and this can affect the absorption? I'm going for a blood test on Monday for a full thyroid check and vits and I have added the IF test. I've been off ALL supplements except Magnesium which I can't sleep without for the last 10 days and I feel absolutely dreadful. I'm dragging my aching body around. I have 'brain fog' and occasional (Thank God) insomnia. I feel ill and getting worse by the day. On Monday I will have my tests then a full breakfast and as many supplements I can get down me! I only stopped the folate a few days ago so I am thinking my body is struggling on no B12. don't think it's an absorption issue. I think I may have been underdosing and not adding folate.

[SlowDragon Administrator in reply to ukred]

Rather than just taking B12 and folate

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial.

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

chriskresser.com/folate-vs-...

B vitamins best taken after breakfast

Igennus Super B is good quality and cheap vitamin B complex. Contains folate. Full dose is two tablets per day. Many/most people may only need one tablet per day. Certainly only start on one per day (or even half tablet per day for first couple of weeks)

Or Thorne Basic B is another option that contain folate, but is large capsule

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Low B12 symptoms

b12deficiency.info/signs-an...

If serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.

B12 sublingual lozenges

amazon.co.uk/Jarrow-Methylc...

cytoplan.co.uk/shop-by-prod...

healthunlocked.com/thyroidu...

academic.oup.com/nutritionr...

The present review of the literature regarding B12 status among vegetarians shows that the rates of B12 depletion and deficiency are high. It is, therefore, recommended that health professionals alert vegetarians about the risk of developing subnormal B12 status. Vegetarians should also take preventive measures to ensure adequate intake of this vitamin, including the regular intake of B12 supplements to prevent deficiency. Considering the low absorption rate of B12 from supplements, a dose of at least 250 μg should be ingested for the best results.3

Vegan diet and iodine

medicalnewstoday.com/articl...

Never supplement iodine without testing and finding iodine specialist

SeasideSusie has details on most accurate iodine test

[SeasideSusie Remembering in reply to ukred]

Ukred

Non-loading iodine test is best one.

Genova Diagnostics do this test.

Test code is END25 (check pdf list of tests to confirm code number)

Details of how to order and receive your results here:

thyroiduk.org/help-and-supp...

[ukred]

Thanks both of you. I’ll read up on all this and act on it