I first started Levothyroxine in 2018 at 25mcg, then 50mcg where my doctor left me. As soon as I started taking Levothyroxine I developed anxiety and depression. After 9 months I stopped taking it and felt so much better and my mood lifted completely. Fast forward. Started taking Levo again 3 years ago and as soon as I got to 50mcg daily the anxiety and depression started and I've been living with these symptoms ever since. It's so bad that I don't want to do anything but force myself to walk each day to try and improve my mood. Is this a side effect of Levothyroxine? I have just this week started to take 75mcg Levo + 10T3 (previously taking 50/75 alternate days + 10 T3 daily).
Before diagnosis the only symptom I had was tiredness, no anxiety or depression at all. I only became ill after taking Levothyroxine.
21.2.25 - Blood tests on 50/75 Levo and 10T3 (followed protocol but blood test was 11.30am)
TSH 0.18 (0.27 - 4.20)
T4 13.7 (12.0 - 22.00)
No T3 result. Doctor is going to repeat bloods to include T3 on 1 April.
Ferritin 28 (13 - 150)
Folate 3.6 (over 2.9)
B12 473 (over 178)
I'm supplementing with D3/K2, B complex, gentle iron, omega 3.
Am I intolerant to Levothyroxine or under medicated? Even with dose increases I have never felt any improvement in the anxiety and depression. I take anti anxiety medication and anti depressants but they don't make any difference.
I'm so grateful for this group and read up every day to learn as much as possible and have read other posts of Levothyroxine making people feel worse and wonder if I am one of them.
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When taking T3 its essential to test a full hyroid panel of TSH, FT4 & FT3. Suggest you buy your own tests to be able to monitor your own levels to get well if NHS wont.
75mcgs Levo + 10mcg T3 is a fairly low dose and your FT4 is showing you are under replaced. You may well need 100-125mcgs Levo in the end.
I doubt you are intolerant of Levo, just not got vitamins right yet or optimally replaced with Levo + T3.
Thank you for replying. I've been taking the Vitamin D 2,000 and Omega 3 for 3 years but have just started the Igennus B complex and iron after these blood results. Will buy the Three Arrows you have recommended. i really do hope I'm under medicated as am really struggling with the depression, nothing seems to help. With such a low TSH it will probably be hard to get my GP to increase my Levo dose. I had to ask for a trial to take 75mcg. Vit D was on the blood request but wasn't done. I'll ask again when I have the re-test.
Most people need a minimum of 3,000iu of vit D+K2.
You probably need the full dose of Igennus B complex to get 400mcgs folate, thats 2 tablets a day.
What have you tried diet wise?
Many Hashi people need strictly gluten free. Others need to remove dairy as well.
Some benefit from removing processed foods from their diet. Sugar and carbs can be an issue for some too.
For sure your FT4 is too low and on T3 most peoples TSH would be almost non existent. Yours at 0.18 is relatively high, showing you need more thyroid hormone.
Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.
It’s possible to have low ferritin but high iron
Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test
If taking any iron supplements stop 3-5 days before testing
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement as well as a separate vitamin B Complex
Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.
If Vegetarian or vegan likely to need ongoing separate B12 few times a week
Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose and may need 2 per day and/or may need separate methyl folate couple times a week
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-6 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12 if last test result serum B12 was below 500 or active B12 (private test) under 70
It sounds like I need to get separate B12 and Folate to top up the B complex and thank you for the recommendations. I shall increase the Vit D spray to 3,000.
Lastly you need to know if your hypothyroidism is autoimmune by testing BOTH TPO and TG antibodies
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)
NHS only tests TG antibodies if TPO are high
20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis
In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)
Retest thyroid levels and vitamins 2-3 months after increase in dose Levo
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)
T3 ….day before test split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
Randox FULL thyroid test including both thyroid antibodies just £31
I wonder about my cortisol too as I have fibromyalgia and the rheumatologist advised that fibro causes a dysregulation of the HPA axis.
My only adverse effects are the anxiety and depression and I also cannot get out of bed even sleeping for 12 hours. I've never felt so ill for so long as after taking Levo.
I have never been able to tolerate T4, not even in NDT. My symptoms were as humanbean describes them, like coming down with flu, just a general all over feeling of not well. Plus fatigue and weight-gain.
And I struggled for several years - can't remember how long exactly - trying different doses - got up as high as 200 mcg. I optimised my nutrients, I took hydrocortisone for my low cortisol, I tried adding T3 - didn't help. I tried NDT and that was even worse! I got up to six grains and still felt like death. But depression and anxiety quite definitely were not part of my symptoms.
You are most definitely under-medicated at the moment, and depression and anxiety are hypo symptoms. And the fact that you didn't have those symptoms before starting levo means nothing. It's quite common for new symptoms to appear when you start taking levo - especially when the dose is too low - and 25 mcg is a very low dose, I really don't understand why doctors insist on starting people on it when they're over 60. But that's doctors for you!
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Advice please re dr reducing dosage
Should I take T3
Need some help!
Recent bloods .. help 
Has anyone had dramatic mood changes when starting levothyroxine?
