Mental Health or Thyroid issues. ?

[shelly2shoes]

Hi ... I was taking 125mcg Levothyroxine for many years but when I had a Heart Attack my Cardiologist suggested that my dose might be too much, I was very reluctant to lower the dose as I had been coping with life ''just fine''. I remember ''one GP'' telling me I had classic sub clinical hypothyroidism to which I didn't reply. I know I have Hashimoto's & I aslo know my Thyroid looks like an old walnut, so I don't think I make ANY THS. Over the past 2 months I have suffered extreme anxiety that is effecting my daily life & night times are a nightmare. My last THS result was 0.65, the nurse said it was at the lower end of the scale. The nurse said they will check my levels again so I have booked a blood test on Thursday next week, that's the quickest appointment I could get. Can anyone help here please by sending me by responding to this message. Thank you for taking the time to read this ... very much appreciated.

[Rapunzel]

Hey Shelly. I'm Rapunzel100(atleast)shoes. What you have to do here is recognise that you know more about your body than any medic. How you feel is the most important thing. It's such a pity you didn't come and pose your Q at the time your cardiologist suggested lowering your dose.

First of all, he may have heard a whisper that suppressed TSH results in atrial fibrillation. This is an ancient source of tribulation which has been discounted - the original study 'confirming' this had a subject group of aged people who rarely left their beds. Not you? Not me, either.

Stuff blood tests. The fact that you're feeling so unwell is doubtless not helping your heart. Suggest to your GP that having done fine on your Levo dose for so long, this reduction is an abberation, which your GP probably went along with, as it was suggested by a consultant. Pft.

You have to make up your own mind. In your mocassins, I would forge on with my original dose. The blood test being suggested is moot. In any event, I hope that you have the earliest appointment - don't take any supplement with biotin in it for the week beforehand, and fast overnight - only water - until your test. Don't take your meds before the blood test, as this will cause a false result.

With this wretched condition, you will sometimes have to fight for your right to party. This is one such event. Good luck, hun.

[Buddy195 Administrator]

Welcome to the forum shelly2shoes, as I think this is your first post.

So we can offer better advice, can you share blood test results (with ranges in brackets) for:

FT3

FT4

in addition to TSH supplied.

Plus any antibody and key vitamin tests (ferritin, folate, vitamins D and B12)

If your GP is unable to complete all the above (eg if TSH is within range, some surgeries may not be able to access FT4 and FT3 tests), you could look to do this privately, as many forum members do, for a better picture of your thyroid health:

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

Increased anxiety has been the worst symptom of having a thyroid condition for me and it is always worse if thyroid medication or key vitamins (ferritin, folate, vitamins B12 and D) are not optimal.

A patient to patient tip for blood tests….. always have the earliest blood draw, preferably before 9am as TSH will be at its highest then. Delay taking your daily dose of Levo until after the blood draw.

[Sparklingsunshine]

If the NHS is only offering to test TSH, the least important number, then it might be worthwhile getting a private fingerprick blood test, which will test FT4 and FT3 as well as TSH.

Once on Levo the TSH result is unimportant, but medics still attach far too much emphasis on it and as you have discovered, dosing based on TSH is a mistake.

Also medics will blame everything heart related on you having too much Levo, whilst conveniently forgetting that low FT3 levels also negatively impact the heart.

[SlowDragon Administrator]

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

and especially after any dose reduction

What vitamin supplements are you taking

Are you taking any other medications well away from taking levothyroxine

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)

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

Post all about what time of day to test

healthunlocked.com/thyroidu...

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65

(Doesn’t include thyroid antibodies)

monitormyhealth.org.uk/full...

10% off code here

thyroiduk.org/testing/priva...

[greygoose]

TSH is not a thyroid hormone, it is a pituitary hormone. So the fact that your thyroid looks like an old walnut has no bearing on the TSH.

TSH doesn't do much, anyway. I doesn't cause symptoms. It's just a message from the pituitary to the thyroid to make more or less thyroid hormones - T4 & T3. If you are on thyroid hormone replacement, your pituitary has decided that there's enough thyroid hormone in your blood so it has reduced production of TSH. That is the way it works.

So, don't worry about low TSH - although doctors do but they know nothing about thyroid - just worry that that is all your doctor tests because it is a very poor indicator of thyroid status. As the others have said, it's the actual thyroid hormones you need testing, to see how high or low they are.

[BenLabrador]

Your anxiety may be, in part, due to your body ringing an alarm bell that it doesn’t have enough T4 and T3. T3 comes from conversion of T4 unless you take natural desiccated thyroid which has it. It’s worth checking your T3 and T4 levels and for the DI02 genetic mutation which affects how you convert. I have the mutation, don’t fully convert and need T3 to help me feel well and less anxious.

[Astlebridge]

I have also been anxious and slightly depressed,I am certain it’s all to do with by b12

[Rapunzel in reply to Astlebridge]

What are you doing about that, Astlebridge ? I take a B12 supplement but sometimes levels are so dire you need B12 injections for a while...or forever!

[Astlebridge in reply to Rapunzel]

I was going to post on here for advice ,I recently had a private b12 jab and I am taking b12 compound and magnesium tablets,I could do with advice about more jabs and vitamins and also about further blood tests

[Rapunzel in reply to Astlebridge]

Put your concerns in a new post, and our vitamin and evrything else royalty will respond. Honestly useless hijacking someone else's post...you wll get much more advice, pertinent to you, if you post rather than respond to someone else's issues. It would be helpful for respondents if you could give a little more information ( what you take, incl thyroid meds, latest test results for everything, always include ranges, which are important) on your profile. You'll find that you have more useful information doing this. Good luck!

[Titian]

I got extremely anxious and physically shaky when my TSH dropped to 3.6. The doctor lowered my medication and it solved the physical problems that I was experiencing.

[Ruby1]

Do make sure you tell the doctors about your increased anxiety and how you think this may be related to your lower dose.... and ask for it to be raised again, at least as a trial. My doctor was very accommodating about this, though I know I was lucky. Sadly he's retired now, and who knows what the next one is like!

[momindenver]

A small shrunken thyroid gland (<5 ml) suggests atrophic thyroiditis, in which TSH receptor blocking antibodies are present (not easily measured though). Often these patients need a lot more T3 to feel well.

[Rapunzel in reply to momindenver]

Heya momindenver

I have a wizened thyroid, I've been told. Can you direct me to more info concerning atrophic thyroiditis, or is this just Hashimoto's by another name?

[momindenver]

facebook group Thyroid Patients Canada Support has more info. Here is an article about the founder Tania Smith, who has atrophic thyroditis:

healthing.ca/wellness/hypot....