thyroid + anxiety

[Sofie007]

After 3 years of taking levothyroxine (+ tiny bit of cytomel) I went to see a private endocrinologist. I have always been an anxious person but with levo it’s through the roof. He said my anxiety has nothing to do with thyroid and he prescribed an antidepressant. I know my anxiety is from before levo but I know and feel it is way worse with levo. He is also very against cytomel. I was so looking forward to meeting this doctor. I feel a bit lost.

[Andypandy30]

Hi with my increase doctor prescribed diazepam as anxiety was so bad have you tried this .I'm afraid to take it

[Sofie007 in reply to Andypandy30]

Hi Andypandy, no I haven’t tried it. I’m sorry you feel so anxious. I wish I had a solution. How much levo do you take? And is your T3 level good? I suspect, but not sure, that my anxiety is high when T3 is low

[humanbean]

He is also very against cytomel

This kind of comment from doctors is very, very annoying. While your endocrinologist was saying this to you he had T3 flowing through his veins and, assuming he had no thyroid disease, he had enough T3 for his needs. The majority of people who suffer from hypothyroidism are female. I am convinced this attitude to T3 is at least partly caused by misogyny.

Another couple of points...

In the UK there have been zero deaths recorded at all for which T3 has been given as a cause, since the government started collecting records in 1967 (57 years ago). And in the same period there have only been 23 deaths from levothyroxine. So thyroid hormones simply aren't dangerous compared to many drugs regularly prescribed by doctors.

One of the commonest arguments used against T3 is that its bad for the heart. But the research doesn't bear that out. And in fact many people with heart failure do better with good levels of T3. I think that the doctors that are scared of T3 are comparing hypothyroid patients with hyperthyroid patients and the latter do have extremely high levels of T3 which can be dangerous. But hypothyroid patients don't want really high levels of T3 - they just want enough to keep them feeling well.

I have always been an anxious person but with levo it’s through the roof.

This is a personal anecdote so might not apply to you. I was anxious and depressed for decades. I also had problems with low iron and ferritin (iron stores), and frequent anaemia.

Doctors would (very rarely) prescribe a couple of months worth of iron supplements for me, and then wouldn't re-test or prescribe more iron pills.

In 2013 I discovered several things I hadn't known before. Firstly, I could buy prescription-strength iron pills in the UK without a prescription from pharmacies. Secondly, I could test an iron panel by buying the test online and using a fingerprick sample of blood which was returned to the lab by post then I was sent the results by email.

That was it - for the first time ever I could treat my own iron/ferritin/saturation levels without begging or pleading with a doctor.

It took me nearly two years to get my ferritin up to mid-range. My serum iron hardly budged. I decided just to aim to keep my ferritin at mid-range. I was testing an iron panel regularly to be sure I didn't overdo it because excessive iron is poisonous. If I stopped taking iron it kept dropping very rapidly. I took a maintenance dose of iron for another five years after getting my ferritin to mid-range. After that time my serum iron started to rise so I stopped taking iron altogether once I was happy with all my iron results.

I realised at some point that my life-long depression and anxiety were disappearing. I have no problems with anxiety any more, and my depression has dramatically reduced.

So - iron worked to eliminate my anxiety. I've read that some people need to optimise their B12 and folate in order to have the same effect. I'm sure there are other vitamins and minerals that have effects on depression, and low nutrients are very common in thyroid disease.

[phronsias in reply to humanbean]

"The majority of people who suffer from hypothyroidism are female. I am convinced this attitude to T3 is at least partly caused by misogyny." Im a man and can tell you that I was passed from GP to GP for years ,and was made to feel "It is all in your head" Its not a man or woman issue its a person not being believed and you are made to believe you are the problem issue. We are all in the same boat at the end of the day,

[humanbean]

I forgot to mention...

I couldn't tolerate Levo until I had got my iron and ferritin levels fixed, and had to take T3-only. After seven years of taking iron I finally found I could tolerate Levo for the first time. I now take Levo and T3 daily.

Another point...

Iron supplements aren't addictive like so many of the drugs prescribed by doctors for anxiety and depression. And when you stop taking it there are no withdrawal effects.

[Sofie007 in reply to humanbean]

Hey humanbean, thank you for the reply. I’m sorry you had to go through years of mental health struggle. I think my iron is fine but will check again. How sure are you that it was iron for you and not something else in your life? I have no clue, I’m just wondering and investigating because I like to do that.

[humanbean in reply to Sofie007]

I'm very sure my iron and ferritin were responsible for my anxiety and depression. The benefits I got from taking the iron supplements happened in conjunction with taking the supplements.

It took me a long time to feel better with thyroid hormones and the timing of feeling better and taking the thyroid hormones was different to the benefits I got from the iron.

I didn't know that improving my iron and ferritin would reduce my anxiety and depression. I actually hoped that it would reduce my breathlessness and increase my energy levels, which it did to some extent. But the improvements in my iron and ferritin, and the tolerance of Levo were a welcome bonus.

I'm not suggesting that anyone take iron to very high levels. I'm suggesting that the very low levels that some people have need to be fixed to bring them into an optimal range. These are described in these two links :

rt3-adrenals.org/Iron_test_...

This next link is about hair loss in thyroid disease but also makes a suggestion about the optimal level of ferritin for people with thyroid disease - I've quoted the relevant paragraph after the link :

thyroidpharmacist.com/artic...

Normal ferritin levels for women are between 20 and 200 ng/mL. According to some experts, ferritin levels of at least 40 ng/ml are required to stop hair loss, while levels of at least 70 ng/ml are needed for hair regrowth. The optimal ferritin level for thyroid function is between 90-110 ng/ml.

[FallingInReverse]

I had zero mental health issues, zero depression, zero anxiety … until I went totally hypo.

When this happened I was so aware of this foreign uncomfortable feeling - so very aware that it had nothing to do with my situation and entirely to do with my blood chemistry.

I share this because you mention that you have always had anxious feelings but you can feel the difference now.

I deeply believe one of the most important things for me in my journey is knowing that difference. Because it’s helped me tease out what the hypo has caused and therefore what treating the hypo will fix. So for me, I am acknowledging these anxious feelings when they pop up, but really see them as intruders, separate from me, that treating my hypo is remedying. It helps me be patient as I optimize my thyroid hormones.

That being said - a very common thing to think that it’s the Levo CAUSING xyz symptoms.

Very/most often it is the HYPO that is causing… but because the hypo is correlated and overlapping with needing Levo, it feels like the Levo is causing it. But it’s the underlying hypo in actuality.

Now - antidepressants are not inherently bad. When we need them we need them. It’s just also important when you have suboptimally treated hypo, that you recognize that that too is contributing - either through low T3 or also in the 6-8 weeks periods when you are increasing your Levo dose.

Sorry this is a bit long winded.

Lastly - have you shared your current TSH, Free T4, Free T3, and key vitamins B12, folate, D3, and ferritin ? Each of these play a part in optimal thyroid health that will help alleviate at least some of the intensity of your depression/anxiety over time.