Does anyone know if hypothyroidism exacerbates depression and anxiety or have any experience with this?

[ilovedoggos]

I'm on 25mg of levo, 4 iron tablets a day, and high dose of antidepressants and I still don't feel right. I'm 26 y/o for reference and had a subclinical diagnosis of hypo/hashimoto's earlier this year.

[lucylocks]

Hi

25mcg. is a very low dose, how long have you been on that dose ?

Do you have any blood results to post, and yes hypothyroidism can exacerbate anxiety and depression.

Post your results and the more experience members will advise.

[ilovedoggos in reply to lucylocks]

I've been on this dose for about half a year. I don't, I had a blood test done a while ago to check up, they said all was fine, and I was feeling okay too, my GP has said I can't have a test done for another 3 or 4 months. Good to know that it does

[lucylocks in reply to ilovedoggos]

As others have said you really need a dose increase.

I was left on 50 mcg. for over a year, some doctors think once your TSH goes in to range you should be O.K.

My TSH went to 4.2 top of range 4.5 from 8.9 on 50 mcg. and doctor said there was no need for a dose increase.

I later went back and saw another doctor and she gave me an increase.

Push your doctor for an increase now, your anxiety and depression will be because you are not on an optimal levo. dose.

Good luck.

[SlowDragon Administrator]

Yes and you are almost certainly under medicated

Standard STARTER dose levothyroxine is 50mcg

Bloods should be retested 6-8 weeks after each dose increase in levothyroxine

Aim of levothyroxine is to increase the dose slowly upwards in 25mcg steps until on approx full replacement dose

When were thyroid levels last tested

ALL thyroid tests should be done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Which brand of levothyroxine are you currently taking

guidelines on dose levothyroxine by weight

Even if we frequently don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near 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.

Also here

cks.nice.org.uk/topics/hypo...

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.

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

bestpractice.bmj.com/topics...

Guidelines are just that ....guidelines.

Some people need more ……some less

healthunlocked.com/thyroidu...

[ilovedoggos in reply to SlowDragon]

Thank you for youe response, my doc has raised my antidepressants instead, he said he can't testw again because I had one done a few months ago. All really useful info thank you. Just want my life back lol

[SlowDragon Administrator in reply to ilovedoggos]

What were results at last test

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

How long had you been on 25mcg

Is it always same brand levothyroxine

Which brand

Strongly recommend getting FULL thyroid and vitamin testing done privately if GP is obtuse

ALWAYS test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Private testing, only test early Monday or Tuesday morning and then post back via tracked postal service

When left ludicrously under medicated this can lead to low vitamin levels

Low vitamin levels tend to lower TSH

If GP only testing TSH that’s completely inadequate

Guidelines are quite clear on dose by weight

How much do you weigh approx in kilo

[SlowDragon Administrator]

Previous posts show you have Hashimoto’s (autoimmune thyroid disease) confirmed by high thyroid antibodies

ESSENTIAL To regularly retest vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common with autoimmune thyroid disease

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)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease).

About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s.

Gluten intolerance is often a hidden issue too

Request coeliac blood test at next test

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

List of hypothyroid symptoms

Depression is extremely common hypothyroid symptom

thyroiduk.org/if-you-are-un...

[tattybogle]

hello . i remember you posting months ago.. with TSH 7. something and a GP saying you were 'borderline'.. Very sad to hear you've been left on 25mcg for all this time.

You should have had a test 6 weeks after starting 25mcg , and then it should have been increased.

My TSH was 6.8 at diagnosis . my T4 was in range , i started on 50mcg , then 100 mcg and ended up on 150mcg for years . I am now on 112.5mcg.

My TSH was 'in range' (2.9)on the 50 mcg , but i didn't feel better for more than a few weeks on that dose, so it was increased.

I'm not surprised you are still having issues with depression, taking just 25mcg. (half the usually recommended starting dose )

( I can't remember if there was ever a good reason for GP starting so low in the first place .. but whatever that reason , it should have been increased by now.

[ilovedoggos in reply to tattybogle]

Hi, I remember you too. It's nice to hear from you and thank you for your support. My doctor has raised my antidepressants (now on maximum dose) he said from my last test my levels are fine and that I can't be retestes for a few months

[tattybogle in reply to ilovedoggos]

i'm swearing now .... right ....ask them to give you the actual result of the last test that was 'fine' .. 'fine' is just an opinion .. (and i don't trust your doctors opinion , since he wasn't going to give you any Levo with a TSH of 7ish and an fT4 that was nearly at the bottom of the range).. you want the numbers [and the lab range] for ~TSH (and fT4 if they did it )

unless it showed the TSH was below the range/ or fT4 was above the range (on 25mcg levo) then your dose of Levo could/should have been increased ... and since depression is a well known symptom of hypothyroid.. it would have been a much better idea to increase your Levo than to increase an antidepressant . which presumably risks umpteen side effects and can be hard to withdraw from.

Did they do another test after the TSH 7 /fT410 ...before they started you on 125mcg ? if so do you have those results too ?

[SlowDragon Administrator in reply to ilovedoggos]

Suggest you see different GP

A TSH of 7 is very hypothyroid…..not borderline at all

YourGP is either ignorant or way out of date

[Buddy195 Administrator]

If I were you I’d push for a Levo increase, as you are on a starter dose. My anxiety dramatically improved when on sufficient Levo to get TSH under 1. I followed forum members advice to improve key vitamins and this also benefited my mental health. Perhaps if you increased your Levo & got key vitamins optimal, then you could hopefully look to reduce your dose of anti depressants.