Depressed with Hypothyroidism

Depressed with Hypothyroidism

I have been treated for 18 months now with depression and an under active thyroid. Frankly I can no longer tell the symptoms apart. 125mg Levothyroxine and 40mg Citalopram. I am so tired I fight to stay awake from early afternoon. Testing as within normal range, so apparently no need to do anymore for me. Just ordered Armour and hoping for some improvement.

The picture was taken when I used to feel normal and healthy.

32 Replies

Hi Holly

If you can get a print-out of your latest thyroid gland blood test results complete with the ranges and someone will comment upon them. What is normal to the GP, may not be normal for us.

These are links which may interest you.

Hi there... At the beginning I was treated with Citalopram too...they seem to give me the yawning disease..I just could not stop- best find out the true picture of T3 FT4 as normal TFT hides alot of secrets of the true thyroid function...and as I found out alot... B12 can really affect mood..x best of good to hear how you get on with I am wanting to step down this road too..once I have a private consultation with a full picture of my thyroid as my results are normal...but I am far from feeling normal....

I just want to say that when someone changes to a NDT, some may be disappointed that it doesn't work as they hoped. Keep in mind that there are a few others which may suit better so don't be despondent and hopefully the first one you try will work wonders.

Unfortunately many of us who have been down the low thyroid road know more about clinical depression than we ever wanted to. Quite often it is because of two basic problems. When doctors use the TSH to determine the proper replacement dose this quite often leaves us underdosed and still hypo. They treat the lab test and ignore the patient. The average normal dose pre TSH test was two to three times the average normal dose post TSH test. Secondly, for many people a combo of T4/T3 either syn or NDT quite often works better than just T4. You also need to check the basics such as B12, ferritin and so forth. As Shaws suggested please get a copy of your lab results and post for comment and make sure your B12 and other are where they should be. PR

PS Have you checked your adrenals with a 4 sample stress test? PR

Hi PR4NOW Is the 4sample stress test a saliva test? If so, where is the best place to get one done & any idea on the cost. Have had one done before which clearly indicated an adrenal problem. As symptoms are worse need to have another done. Many thanks.

Sorry, I fumble-fingered or fumble-minded on that. Yes, a salivary adrenal stress test with at least four samples is what I meant to say. Usually this is done initially when considering thyroid treatment as if you have adrenal problems and don't correct before thyroid treatment you end up feeling worse. It generally isn't used after supplementing with HC or similiar because the values obtained are much higher and more difficult to analyze. I have read of one doctor here in the US who has written about how to read the values if you are supplementing if I can remember who it was. Another commonly used method to check adrenals is temperature and pulse. Janie Bowthorpe has written about this on her site. This is a good place to start.

Also the RT3 Group talk about this. Home page

Page on adrenals

Paul Robinson's CT3M is another way to address adrenal problems however everything else needs to be in line first so it is just the thyroid-adrenal axis left to fix and even then if the adrenals are way out of whack some people need to start with some HC first and then graduate to the CT3M method. Paul's site had much more as well as his book.

Unfortunately for many of us we end up balancing a few hormones to get everything back in shape. You also need to look at estrogen ( or oestrogen as you say in the UK ) and progesterone, are they in balance? Birth control pills and HRT can cause problems because they are synthetic estrogens and synthetic progestins which do not do well in the human body. Sometimes women also need to look at testosterone, you have less than men but you do need some.

Usually you start with the thyroid-adrenal axis and try to get that in balance first.

The most common problem is not enough Syn T4 or Syn T4 does not work as well as NDT or T3 in a person's body. In some depression cases T3 can be much more effective as others have commented. We are all different and it is always the case of finding out what works best in your body. It is a pain that we have to do this with so little help from doctors but the end result is worth the effort. You also need to make sure B12, iron, ferritin, D, and so forth are where they should be. Please get you blood test results and post for comment. PR

Thank you again, Did do a 7 day temperature chart which clearly indicated an adrenal problem. The NHS however only measure adrenals by the cortisol blood test (long & short synatchen as well) None of these matched the saliva test which they do not accept because they do not do them except on children in some areas of the country. Have also done the eye sensitivity test, sergant's white line both confirming adrenal insufficiency along with Dr Wilson's questionnaire. None of which the NHS accept. So how are sufferers supposed to procede? My Vit D result was 54 (range 50-250nmol/l) Research tells me that 50 is adequate for bone & general health!!! IReally? What is the optimum level? surely this is where we should all be or try to get to.

As for B12, mine was at 1900? Was on B complex at the time & I learned that complex masks a B12 result so will have to do that again. How many get B5 (for adrenals) done? Very few I suspect. Progesterone low, aldosterone low but within their "Range". A range to me is just an indicator of how near or far someone is from the optimum level. Why oh why cannot they see this?

....lots of great advice above. Just glad you are connecting the two conditions and hopefully you will soon be well. Lovely pic btw.....

I agree with Marz about the pic – hopefully you'll be back to your vivacious-looking self once you find the right (effective) combination of meds. All the best!

I am just stunned at the support, knowledge and openness of the people on the site, you are real! thank you, thank you

dont ever forget ......theres more of us tha ther is of them.....and the best way of tackling a problem is 'TO EXPERIENCE IT 'that way you know the pitfalls before it affects you most people on this site can attest to -----which makes it so valuable to those of us ...for the advice ,knowledge and above all EMPATHY that does not come from anywhere else the way we [me and the other half ] both love the pic

I am on 175 Levo and 40 Citalopram. Have been for years and still feel lousy. Sometimes I just wish it wast time to go from this earth. I don't bother with doctors anymore, they never listen, it would cost them too much!

Doctors will always prescribe an anti - depressant before proper thyroid medication simply because they get paid at a higher rate. If you are taking any anti depression meds please remember to leave a good few hours between taking your thyroid meds and them. My sister has just been through a huge crash period simply because she took her anti - panic attack meds at the same time as her NDT, since she has taken her NDT at night and her anti - panic attack meds in the morning she has done much better.

My husband was treated with 125mg levo for his hypo and 40mg Citalopram for his depression. It was only when he was treated with T3 that his depression went. He had a hard time getting off Citalopram because of the side effects but he did manage it. As already suggested you need to post your blood test results to get more advice.

best wishes

Many thanks, I now feel more armed to face my GP. I have always liked her but she obviously hasn't listened to me as she just refers me for another T4 count then says it is fine. When it feels that going anywhere or doing anything is a specific and exhausting act of sheer will something is wrong and in our case just the effort to force the medical profession to act feels overwhelming. I hope to look back at some point in the future and be able to really understand the grey fog I am living in, once I am out of it!

Hi HollyTired,

Sorry that you're having these problems. I don't take Citalopram but I do take Seroxat 20mcgs which has worked very well alongside my thyroxine. Without the anti depressant, my depression is very bad but with it......I'm fine. I just wondered if you consistently take the same make of thyroxine or do you switch brands? It is always advisable to stick with the same brand or make. If so, what make or brand are you taking?

Also as others have already said, submit you're blood results because there are some people here who are very good at interpreting them. If you are being told that you are in range, you may be right at the top of the range and therefore still have room to up your dosage.

Might I suggest that you phone your GP receptionist and ask for the results of your last blood tests, including the ranges and then post them.

Please don't give up just yet. There are a lot of people here who are ready to help you find a solution!!


Forgot to mention.......I leave 4 hours between taking thyroxine and Seroxat. So I do thyroxine in the morning and Seroxat at lunchtime.


I am at the top of my range so won't prescribe further Levothyroxine.

I'd just like to make a comment not necessarily an answer, but I find it quite alarming how many of the people on here who are hypothyroid are being give antidepressants. I know it can help the depression short-term, but all mood-enhancing drugs can prove extremely difficult to stop taking even though it was probably not the right treatment in the first place.

Truth to tell I know that it is absolutely none of my business who takes anti d's and who doesn't. I am not being in ANY way judgemental, but I just want to express how I feel about these very potent and dangerous drugs. As a thyroid patient over many, many years I have been offered these drugs, and in my Overactive days I was also offered Valium.

I have always resisted most strongly for four reasons:

1: I know I have a physical illness which is causing my symptoms. I want that illness, not the symptoms, to be addressed.

2: I believe I have a addictive personality judging by my careless use of alcohol as a teenager. (I hasten to add I nipped it in the bud before it was out of control!)

3: I do not want to create a new problem to add to the ones I already have, i.e. tiredness from the drug - I am tired enough already, thank you, and what can I gain from being more so - I still can't do anything but thanks to the drugs I no longer care?

4: I am certain that the doctor is offering these drugs because he can shut me up and send me away while at the same time getting some extra points for another 'depressed' patient. (And what do points mean? PRIZES!)

Please forgive my cynicism, but have had a battle with my GP for a year and finally he has agreed to increase my Levothyroxine to where it was before I was 'depressed'.

Now, my 'depression' is disappearing gradually and so is my agoraphobia.

I am sure that the majority of those with hypothyroism AND depression would not need to take antidepressants if their thyroid condition were optimally treated, be it with Levo or T3 or NDT, whichever is the best for that individual.

This long comment (sorry) is really to encourage those who are diagnosed with both to be really, really insistent that the thyroid condition be sorted as a priority, since the price of not doing so is the quality of life.

One thing which really bugged me when I thought about it last night was that at no point has my GP said that my having an under active thyroid and depression could be linked in any way. When I have talked in general terms about not being able to separate the two symptoms she has just been a little vague!

No surprise there then!

It is utterly mindboggling that 100 years ago they discovered the connection between mental problems (depression, anxiety, paranoia and, in my case, hallucinations!) and the health of the thyroid. as I said on another post, they have gone from the 20th century back to the dark ages when it comes to the thyroid.

So sorry you have had such bad treatment and poor diagnosis. Hopefully with the support and confidence you can find here, yoiu will be properly treated and start to get better. Hugs Marie XXX

this is because they just do not see the link. I have been told it's all in your mind and that was before i was diagnosed and put on T4 only meds then it just got worse, I just got fatter felt so ill, you know whats coming next "your bloods are normal" go away. I ended up at Dr Peatfields clinic, he put me on Amour, I improved , my GP wasn't at all pleased, then i didn't see my GP for two years even he had too could see the improvement in me i felt grate. Dr Peatfield then had the GMC after him and the clinic closed. I had to find another doctor this time it was Eagle Clinic again the GMC went after him. I finely found Dr Skinner sadly he died , he got me back on track but now I am now without a guiding hand my GP can see what I have been doing to help myself and I am still on Amour but I had singles in October and virus after virus gone down hill ever since. I have to admit I am scared of what comes next as the depression is not lifting, I have refused antidepressants they do not work on me just make my life worse.

What I need is a GOOD Dr who knows about Hashimoto's disease etc so not much hope for me!

I have had thyroid problems since 2001 although my doctor didn't informe for 11 months by which time I had a breakdown and a major depressive episode. I was on anti-depressants and eventually the psychiatrist discovered I was hypo. I managed eventually to get off the anti-depressants. But hey ho I developed a neurological disorder called peripheral neuropathy. There are various drugs for this, but I have not been able to tolerate any except Cymbalta an anti-depressant which has been found to reduce the painful sensations in neuropathy. It does reduce the pain by about 25% but I have to take another anti-depressant at night to enable me to sleep. This results in me being sleepy all of the time. My GP refuses to increase Levo, the neurologist says it is not related to being hypo but does not know the cause. I am quite convinced it has been caused by being under medicated and by having HRT. I am trying to find a private endo to try and find if thisis the case. The neurologist told me the peripheral neuropathy is a progressive disease and it will only get worse.

Look at this short anwer:

I think you are being quite poorly treated for symptoms rather than the true illness. Yout GP might listen if you were to get this book from either or even Amazon: 'Understanding Thyroid Disorders' by Dr Anthony Toft.

A consultant psychiatrist I saw years ago said there was a link.

Regardless of its type e.g. synthetic T4, T3 or NDT, thyroid replacement hormone cannot undo clinical depression caused by an under active thyroid. However you must have adequate thyroid hormone or you will continue suffering the trigger for the depression. A bit of a catch-22 but not one that cannot be managed.

The link between under active thyroid and clinical depression is well established knowledge. In fact I was reading in an old nursing text book from 1992, that thyroid hormone replacement cannot cure clinical depression caused from underactive thyroid. A separate treatment is needed to restore function. And this link and treatment plan was kindly and explicitly told to me by my GP who is exceptional in every way and has an interest in both hypothyroidism and clinical depression.

And there are other things you can do to help yourself with depression as well as medication. My doctor recommended learning meditation because it helps the autonomic nervous system a key biological system that can be damaged by being hypo but not repaired by hormone replacement. She also recommended reading 'The Compassionate Mind'. She said and I quote: 'I think we're still a hundred years away from understanding how these autonomic nervous system mechanisms work, but in my experience there is a link with depression and they can be helped. Modern medicine ignores the psychology of it, but that doesn't mean we need to'.

There is no shame in having clinical depression induced from under active thyroid. And there is no shame whatsoever in getting treatment to sort it out. There is however permanent ill health if you suffer from both these conditions and use only one type of medication to fight the onslaught of these two hellish armies. And that goes for both ways around.

Please check with your pharmacist about your anti-depressant medication. It may inhibit some of the efficacy of the thyroid hormone replacement meaning you need a larger dose to counteract the off set. You can check with your pharmacist as your doctor may not know. Sertraline is a good example of an anti depressant drug that may produce this thyroid replacement dose offset, meaning your thyroid dose may need to be larger to get the same benefits as your previous lower dose. If you come off the drug, then your dose thyroid hormone should be reduced.

This is an excerpt re depression:

It takes but little reading of the psychiatric research literature, however, to show that Guttler’s pronouncements about depression in the two paragraphs above are wrong. Studies show that not just "any thyroid medication"[5] relieves all hypothyroid patients’ depression. The studies also show that hypothyroidism can cause depression despite patients being on T4-replacement and having "normal" TSH levels.

Consider a report by three psychiatric researchers from the Department of Psychiatry, University of Toronto.[33] They studied nine thyroid disease patients on T4-replacement who were depressed. The purpose of the study was to see whether adding T3 would improve the patients’ depression. The depression of seven of the nine patients (78%) decreased by at least 50% after they added T3 to their T4 dosage.[33,p.16]

A stubborn defender of "adequate" T4-replacement such as Dr. Guttler might argue that the patients in this study (depressed on T4 alone) simply weren’t taking enough T4. But this wasn’t true. As the researchers noted, the TSH levels of all nine patients showed they were taking what Guttler would consider an "adequate" dose of T4: "All nine patients," the researchers wrote, "had [TSH] levels near or below the lower limit of normal for our laboratory prior to the addition of T3, indicating at least adequate T4 replacement therapy."[33,p.17] (Italics mine.)

It’s noteworthy that eight of the nine patients in the study had thyroid disease before they got depressed. This suggests that thyroid disease caused their depression. It also suggests that "adequate" T4-replacement failed to prevent them from developing hypothyroid-induced depression.[33,p.16]

The results the Toronto psychiatric researchers reported are far from solitary in the research literature. Other psychiatric researchers also report that T4-replacement often fails to completely relieve depression caused by hypothyroidism.

Hi Holly, and everyone else who's left a comment. It's so refreshing and helpful to hear that i'm not the only one suffering with depression and an underactive thyroid. With everyone's helpful comments i'm now armed when i visit my GP tomorrow to find out if she's fully aware of the link between depression and underactive thyroid. I've been on 125mg thyroxine for years, but also Citalopram since 2006, which i've tried to cut down gradually, 10mg per year. Resulting in taking 10mg for most of last year. However two weeks ago i had another meltdown so now back up to 20mg Citalopram. I feel your pain Holly and i hope we get some respite soon :)

Hugs, Kaz xxx

This is a webinar done by Mary Shomon and Dr. Holtorf. If you haven't watched it I suggest watching the whole thing. At the bottom left of the black outline you see a start and pause symbol, next to it is the volume symbol. Just above them is a white circle that moves to the right as the video plays. You can drag it to the right to start anywhere in the video. Starting at about 45 minutes Dr. Holtorf talks about treatment options and depression treatment options.

I think you'll find the info of interest. PR

If you haven't read his websites they are full of info.

Thank you so much. I've listened to the webinar which has helped me list all my symptoms for the visit to my GP today.

HI HollyTired, it's been 4 years since this particular post of yours regarding your depression. How are you today in January of 2017. I hope well. I would love to hear if you found any resolutions to your depression as My sister is suffering and I am trying to find an answer for her. Thank you for your reply.

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