Could it be Manic-Depression?

[teenarocks]

My doctor insinuated I may be suffering from manic-depression. I believe I am suffering from the highs and lows of Hashimotos. She does not test antibodies. I've had Hashimotos for 30 years and still have ups and downs that affect my mood and energy levels. Is this possible or is it more likely to be manic-depression? Thank you for any help you can give me.

[greygoose]

Four months ago, you said you'd been told that your thyroid was basically dead. I don't know how they would know that without stopping your thyroid hormone replacement for a few months, but if it is dead, you won't be experiencing the 'highs and lows of Hashimotos', But you could be under-medicated which would cause depression.

You also said you were going to get tested soon and post the results. Did you do that? Do you have the results? Only by seeing those can we tell if you're under-medicated.

I would question if your doctor even knows what manic depression is - does she have psychiatric training. Doctors are always very keen to blame our symptoms on mental problems and shuffle us off to a psychiatrist and off their hands.

[teenarocks in reply to greygoose]

Thanks, greygoose. I am due to be retested in January. If my thyroid is dead, would my antibodies still go up and down?

graph

[greygoose in reply to teenarocks]

Probably not, but I'm not sure about that. As I said, I don't know how they can tell for sure. I was told when I was 60 that my thyroid was dead, but when I was about 68, I came off my thyroid hormone replacement for about six months and my thyroid came back to life and produced enough hormone to keep me alive for that period. I was very hypo, of course, but alive!

[teenarocks in reply to greygoose]

Thank you, see below.

[teenarocks in reply to greygoose]

These results are from 10/03/23

thyroid test results

[SlowDragon Administrator in reply to teenarocks]

These results suggest you need increase in replacement thyroid hormones

What are you currently taking

Levothyroxine?

How much

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

ESSENTIAL to also test vitamin D, folate, ferritin and B12

What vitamin supplements are you taking

As you have Hashimoto’s are you gluten and/or dairy free

[teenarocks in reply to SlowDragon]

Thank you, see below

[DippyDame in reply to teenarocks]

With an FT3 result as low as yours it is little wonder you feel under par.

For good health every cell in the body must be flooded with T3 by way of an constant and adequate supply...

The brain needs a huge amount of T3 and your system is not providing that

Low cellular T3 can cause depression

Are you currently medicated?

If so with which thyroid replacement hormones and in what dose(s)

Your labs show high FT4 with relatively low FT3

This suggests poor T4 to T3 conversion with resultant low FT3

Have you optimised vit D, vit B12, folate and ferritin to support thyroid function

Hashi's can cause thyroid hormone levels to fluctuate but this is transient and will settle after a "flare up".

A gluten free diet usually helps

BUT....if your thyroid is " dead" you will no longer experience fluctuating hormone levels so latest labs should be stable

Just my opinion but I'd suggest you are under or wrongly medicated with replacement thyroid hormone(s)rather than manic depressive.....and that your doctor's knowledge of thyroid disease is sadly lacking.

I'd suggest you need an increase in T4 or more likely a combo dose of T4 + T3. I would explore the former first!

[teenarocks in reply to DippyDame]

Thank you, see below

[greygoose in reply to teenarocks]

Your FT3 is very low, there. Low enough to cause depression, I would say, quite definitely.

[pennyannie]

We generally feel at our best when the Free T3 is up in the top quadrant of it's range with the Free T3 tracking just behind at around 60/70% through it's range :

looking at these results - your Free T4 is just around 40% through its range with your Free T3 coming in at around 8% through it's range.

You are very under medicated - what thyroid hormone replacement ere you taking - ?

No thyroid hormone replacement works well until your core stength vitamins and minerls are up and maintained at optimal levels -

Do you have any readings / ranges for ferritin, folate, B12 and vitamin D ?

I'm not suggesting you have Graves Disease but seeing as you are in the States dip into and register on Elaine Moore's forum for AI thyroid disease and try and find a recommended endo/thyroid specialist in your time zone / zip code.

elaine-moore.com

The thyroid is a major gland responsible for full body synchronisation which includes your physical, mental, emotional, psychological an spiritual well being- your inner central heating system and your metabolism.

I was prescribed anti depressants when T4 only stopped working as well as it once did for me -

and they didn't help - other than confuse my understanding of what was going on -

once I improved my core strength vitamins and minerals and then introduced some T3 alongside my T4 - it was like a light switch being turned from off to on -

and my mental , emotional and psychological outlook changed improved with my thought process clear and focused with even my dyslexia becoming less of a challenge.

A fully functioning working thyroid would be supporting you on a daily basis with trace elements of T1, T2 and calcitonin + a measure of T3 at around 10 mcg + a measure of T4 at around 100 mcg.

Some people can get by on T4 only : Levothroxine / Eltroxin :

Others find they need to add back in a small dose of T3 to restore T3/T4 hormonal balance.

Some can't tolerate T4 and need to take T3 only Liothyronine / Cytomel :

Whilst others find their health improved better taking Natural Desiccated Thyroid which contains all the same known hormones as that of the thyroid and derived from pig thyroids - dried and ground down into tablets referred to as grains and the original, successful treatment for hypothyroidism for over 100 years.

[teenarocks in reply to pennyannie]

Thank you, see below

[Charlie-Farley]

Hi teenarocks

I wrote a post on how most doctors interpret tests - link below- the others are right under medication affects mental health. Or should we say under education of doctors causes mental health 🤔

healthunlocked.com/thyroidu...

[teenarocks in reply to Charlie-Farley]

Thank you, see below

[Brightness14]

More than likely that the Doctor doesn't know what he/she is taking about.

[teenarocks in reply to Brightness14]

Thank you, see below

[teenarocks]

Thank you to all for your responses. I take Levoxyl 75 mcg daily and Cytomel 5 mcg daily prescribed by my endo. My primary care doctor prescribed an antidepressant which I don't like to take but had no choice as I could not function. I will look into undermedication on the T3 and check out Elaine Moore (thank you for this info) to see if there is a registry for doctors. I am so grateful for this forum.

[SlowDragon Administrator in reply to teenarocks]

How long have you been on this dose

Was test in March on same dose

Many people on Levo plus T3 find they need BOTH Ft4 and Ft3 at least 70% through range

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

On T3 - day before test split T3 as 2 or 3 smaller doses spread through the day with last dose 8-12 hours before test

[teenarocks in reply to SlowDragon]

Yes, test in March was same dose. I take my T4 and T3 first thing in the morning. I don't take it on day of test and test around 9 am. I have never split my T3 before day of testing.

[SlowDragon Administrator in reply to teenarocks]

March test - Ft3 false low result as last dose should be 12 hours maximum before test

So next test …test correctly

Last dose levothyroxine 24 hours before test

Day before test split dose T3 and take half dose waking and half dose at 8pm evening before test

Test 8am following morning

Test vitamin D, folate, ferritin and B12 too

Stop any supplements that contain biotin 5-7 days before any blood test

[SlowDragon Administrator in reply to teenarocks]

March results

FT4: 1.34 pmol/l (Range 0.82 - 1.77)

Ft4 only 54.74% through range

FT3: 2.2 pmol/l (Range 2 - 4.4)

Ft3 only 8.33% through range

If you took last dose T3 12 hours before test Ft3 would have been a little higher…….but unlikely more than 20% though range

Come back with new post once you get results

[DippyDame in reply to teenarocks]

Based on the above labs I'd start by increasing T3 to10mcg.....maintaining 75mcg T4

The new dose will take time to settle so be prepared to be patient and to sit it out....if it feels too much cut back to 2.5mcg increase and then slowly raise the dose.

The bottom line is....you will need more T3.

There is no quick cure but with appropriate medication there is usually a cure for out of whack thyroid function.

20+ years after wrong diagnoses and medication I discovered that I need high dose T3-only to reach my therapeutic dose....we are all different!!

5mcg is a small dose and if you continue on that dose it's unlikely to raise your FT3 to a level even close to your therapeutic dose.

Test after 6/8 weeks and the results will point to the way forward.

How you feel must be considered during any diagnosis....not just numbers!

Post new labs for advice

Medics are too quick to prescribe antidepressants which they use as " sticking plasters" when they don't have another idea of what to use!