My nhs endo is adamant that I’m depressed and i... - Thyroid UK

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My nhs endo is adamant that I’m depressed and it’s not my thyroid

Jamima profile image
17 Replies

I sent my latest test results to my endo and he wrote back today. Essentially he told me there’s nothing wrong with my thyroid or my pituitary and that I should seriously consider that I’m just depressed and that I should buy a blood glucose monitor and treat the adrenaline/blood glucose drops with a sugary snack. He also suggested that I should use the highest oestrogen patch/tablet to make me feel better. I can’t even tolerate the lowest dose so that would be a disaster.

Some quotes:

‘No, in my strong opinion. You have had many thyroid function tests since 2018, including many in which free T3 was tested as well as free T4. All of these are normal, and there is no trend suggesting a drift into underactivity. These findings are strong evidence against primary or secondary hypothyroidism.’

‘It is also remarkable how mood disorders can show themselves in a wide variety of physical symptoms. Even while you work with your doctor and other specialists to find any underlying physical cause, I would strongly encourage you to consider of depression/anxiety seriously as a possible or likely contributor to your current problems.’

So there we have it, another man telling a woman it’s her silly hormones and just to take some happy pills. I can’t describe my levels of anger right now, but I’m not a quitter, I’ve made an appointment with a private endo for a month’s time.

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Jamima
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17 Replies
shaws profile image
shawsAdministrator

Your Endo's statement is one whose patient will either choose to look after their own thyroid gland and try to source whatever they'd like to trial.

This is an excerpt from following link:-

"Objective: The objective of this review is to discuss triiodothyronine’s (T3, liothyronine) mechanism of action, efficacy in enhancement and augmentation trials, and dosing and safety considerations for the treatment of depression.

ncbi.nlm.nih.gov/pmc/articl...

Maybe you should post a copy of the above document.

Jamima profile image
Jamima in reply to shaws

Thank you shaws. I’m not depressed, although I’ll admit that this continuing struggle does have days when it gets me down, but I’m not clinically depressed. I know this because I was treated for post natal depression, and this is a very different beast. If I thought for a moment that anti depressants would help, I’d try them, but I already know what they do, and they don’t treat the very physical symptoms I’m experiencing. They are amazing drugs when used efficiently, closely monitored and within their remit, but they’re not what I need right now.

DippyDame profile image
DippyDame

I'd be depressed too if I had low labs ( previous post) like yours!!

They appear to have been falling over time....

It's not "all in the mind"

It's because you are hypothyroid and need to be medicated.

FT4 is 8% through ref range

FT3 is 21.62% ditto

Both should be approaching 75%

Your GP is diagnosing by TSH which tho' in range only gives a fraction of the story

TSH is a pituitary hormone not a thyroid hormone and is a signal to the thyroid to produce more or less hormone...but gets more complicated than that!

This mistake is causing a lot of misery for patients.

FT3 is the important lab...

T3 is essential to every cell in the body and should be available in an adequate and constant supply...

Not in your case!

T3 is the active thyroid hormone but to become active it must reach the nuclei of the cells

Low T3 = poor health and low energy

I'd suggest it's not "sugary snacks" you need but replacement T4/ levothyroxine which will help your metabolism produce more heat and energy.

Initially 50mcg levothyroxine

You can expect to feel worse initially until your dose is very slowly increased ( every 6 weeks after further testing) until you feel well

It's not a quick fix so patience is essential...I see you gave up because this wasn't explained to you

You appear to be adequately converting the storage hormone T4 that is available in the body....to T3.

But replacement T4/levo and further tests will verify this.

Ensure vital nutrients are optimal to support thyroid function

You have previously been given good advice about this

Vit D, vit B12, folate and ferritin.

I feel angry for you....but you should not have to go private to get this rectified

The problem is poor diagnosis on the part of this endo ( likely a diabetic, not a thyroid specialist)

Can you see another GP who might be more open minded!

Jamima profile image
Jamima in reply to DippyDame

Thank you DippyDame. I agree that my levels are too low, and I understand that levo supplementation is tricky to navigate initially, but I’m not bog standard hypo in that my TSH is already low so when I take levo, reducing it further really makes me very unwell. And you’re right, I’ve been given some excellent advice on here, I’ve already optimised my vits and am now gluten free which has definitely helped, however I couldn’t possibly withstand 6 weeks of being sofa bound and my business just left in the lurch to get stable on levo. I feel I have no option but to see the private endo and hope that she might offer an alternative, or even a carefully monitored plan with levo and something else, I don’t want to self experiment anymore.

Thank you for your advice and support.

DippyDame profile image
DippyDame

I did wonder about Central Hypothyroidism...

bestpractice.bmj.com/topics...

Central hypothyroidism is the result of anterior pituitary or hypothalamic hypofunction. It may be the result of congenital, neoplastic, inflammatory, infiltrative, traumatic, or iatrogenic aetiologies. It is characterised by decreased thyroid-stimulating hormone secretion in turn causing decreased thyroid hormone synthesis and release.Treatment of central hypothyroidism is by thyroid hormone replacement (levothyroxine).

I'm afraid there is unlikely to be an " overnight" resolution

I'm not " bog standard hypo" either!

Good luck

Jamima profile image
Jamima in reply to DippyDame

Thank you DippyDame, my nhs endo ruled out central hypo but I’ll ask the private endo when I see her. I didn’t mean to be flippant about ‘bog standard’, just wanted to share that I don’t have the standard high TSH/low ft4 and wondered if that’s why even a small dose of levo made me feel so unwell.

DippyDame profile image
DippyDame in reply to Jamima

I didn't see it as flippant at all!I'm now hugely cynical about current diagnoses and treatments!

The endo that I saw very briefly was adamant that I did not have Thyroid Hormone Resistance and that I did not need T3.

He was wrong on both counts!

He said I needed levo...which after 20+ years had left me barely able to function.

I now do OK on high dose T3-only with most of my many symptoms cleared.

In the end I had to learn, then self-diagnose and self medicate....

with the help of this amazing forum.

Good luck

Batty1 profile image
Batty1

Dealing with Mr. Sunshine would make anyone depressed… 😢

Jamima profile image
Jamima in reply to Batty1

What’s interesting is that, at the end of my 1st consult, he snorted and said ‘that’s exactly what my wife’s suffering, but it’s obvious that this isn’t an anxiety issue, you’re not that type of person.’ I’m not depressed, but if I were or experiencing serious mood problems, you’re right, he certainly wouldn’t help. I just can’t believe that here we are, 21stC, and women are still labelled as hormone lunatics. 100 years ago they’d have sent me to a sanitarium for menstrual madness. Unbelievable. Very pleased my private endo is female, I can’t take much more of this patronising.

strawberrysorbet profile image
strawberrysorbet

Hi Janina, I just looked at your results from a previous post and your results are not dissimilar to mine when I was diagnosed with secondary hypothyroidism. I think my results were slightly lower but only just. If you’ve not had one I would recommend a TRH test (via IV) to rule it out. You’ll probably have to go private as I did, and there are not many places offering it, but it’s the only way to tell.

Jamima profile image
Jamima in reply to strawberrysorbet

Thank you strawberry sorbet- is the trh test the same as short synacthen test? I had a SSTALMODT 2 weeks ago and am awaiting results.

Jamima profile image
Jamima in reply to Jamima

Sorry, that should say SST.

strawberrysorbet profile image
strawberrysorbet in reply to Jamima

No, the short Synacthen test is a test of adrenal insufficiency nothing to do with pituitary / thyroid.

Jamima profile image
Jamima in reply to strawberrysorbet

Many thanks.

HeartWoman profile image
HeartWoman

I understand the whole hormone thing and it can make you feel like you are going mad. Fortunately, I love my estrogen and it loves me. I started seeing a Natropath and he greatly lowered my 2mg oral estradiol to almost nothing and I absolutely was losing it. I started back on my 2mg about 10 days ago and slowly getting past the worse. He also lowered my NDT, so trying to get that back up. It has been a very trying couple of months.

Sorry you and estrogen don't get along. Progesterone and I don't and thank goodness I don't need to take it because of a hysterectomy. I am currently taking a tiny bit of testestrone as well.

I have decided there is really no normal because we are all created very different from each other. Our hormones are very important for our physical and mental health. I hope you find a doctor to help you sort this out.

Jamima profile image
Jamima in reply to HeartWoman

Thank you heartwoman. I also used to love my oestrogen, but something altered and it makes me tired and cold now. I suspect its a combination of thyroid/adrenals and I'd be happy to restart hrt if/when I'm treated for the symptoms I have now. I've no doubt that my now almost non existent oestrogen level has some part to play in my symptoms but it's not the only player, and I need to find out what's going on. Unbelievable that your oestrogen dose was decreased when you're hysterectomised! There's very little source of alternative oestrogen for you. Glad you're starting to feel better now your back on the upward swing with hrt.

HeartWoman profile image
HeartWoman in reply to Jamima

Hopefully you will get it all figured out and be on the road to feeling well soon. It is hard to know which defiency has the most impact on which symptoms. For me, anxiety and mood swings are low estrogen. Fatigue and sadness are low thyroid.

I don't know how it is in the UK, but there is this anti-estrogen thing going on in rhe Naturopathic/Functional Medicine world here. I sometimes get caught up in it and end up feeling worse. I need to stick to listening to Louise Newson and Menopause Taylor. Naturopath and Functional Medicine are better about helping with thyroid issues, but not usually other hormones or at least that has been my experience.

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