I’ve been perusing comments in response to the UK’s Royal College of Physicians blundering and dark-age-constructed Diagnosis and treatment of primary hypothyroidism. And though all comments are quite good and worth your read, I was struck by the comment titled May Reality Intrude? by a man named Charles.
Charles explains that in 1999, his 67-year-old wife had RAI (radioactive iodine) and was then put on levothyroxine, a T4-only medication (aka Synthroid, Levoxyl, Eltroxin, Oroxine, levothyroxine, et al). And not long after, she complained of having depression.
He had an idea why after reading the New England Journal of Medicine about T3, and proceeded to buy her Armour off the internet. Without her knowing, he switched medications. Lo and behold, he states “she promptly returned to her usual sunny disposition”. Her physician knew nothing of the switch either, and found nothing to be concerned about in her.
Charles then explained how, at age 74 in 2007, she was near death thanks to an ulcer bleed. And to continue treating her hypothyroidism, the hospital gave her levothyroxine all over again. Back came her depression and a feeling of wanting to go home and die.
So Charles brought her Armour to the hospital, and though her physical state was depressing enough, her sunny disposition returned. And that happy spirit while still on Armour continues today after a full recovery.
And Charles pondered. If his wife had been in a NHS (National Health Service) hospital under the care of a so-called thyroid specialist of the NHS, would she have failed to obtain T3 and instead, sent to a psychiatrist as if her depression had nothing to do with her levothyroxine treated hypothyroidism–the very treatment that the Royal College of Physicians has a dogmatic love affair with?
He then concludes: My wife’s depression was obvious. Since she is equipped with much the same assortment of body parts and associated physiology as others, is it not likely that many levothyroxine-treated patients suffer from less-noticeable depression?
Well Charles, most any thyroid patient who decides to respond to this will tell you unequivacably YES, YES, YES. Because there’s no research, study or directive that is more profound and telling than the actual EXPERIENCE of patients all over the world with T4 treatment and depression…besides a slew of other side effects of continuing hypothyroidism on T4-only meds.
Did you have depression on a T4 med? Tell us about your experience in the Comments section of this post.
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*Scroll down to the June 2nd post and report your experience on the newly formulated Armour. It’s not a happy picture.
Christine said:
Jun 26, 09 at 6:45 pmI recently switched over to Armour and the first thing I noticed was my depression completely disappeared – like magic! Still working on the dosage to relieve the rest of the thyroid symptoms, but glad to not fell so desolate every day!
Lee Morgan said:
Jun 27, 09 at 9:27 amI was on Synthroid or many years (at least 8). I was on antidepressants (on and off) for many of those years. No matter how much I tried I always ended up depressed. Finally, I got on Armour Thyroid. While I still have many problems, constant depression is not one of them. I do believe that changed with the change in medication.
Lee Morgan said:
Jun 27, 09 at 11:40 amI was on Synthroid or many years (at least 8). I was on antidepressants (on and off) for many of those years. No matter how much I tried I always ended up depressed. Finally, I got on Armour Thyroid. While I still have many problems, constant depression is not one of them. I do believe that changed with the change in medication.
BTW I love your blog!
Chris said:
Jun 29, 09 at 7:42 amI was on Synthroid for ten years with constant depression that got worse every year. I even started to fantasize about leaving my wonderful husband and kids, completely irrational thoughts. I never took antidepressants, being a pharmacist, I’m familiar with their adverse effects. I started on Armour in April, and am feeling much more like my old self as I work on increasing my dose to my optimal level. Thank you to STTM for all the helpful advice.
Sue said:
Jun 30, 09 at 12:47 pmI cannot help but wonder if the Synthroid I have been on for the last 10 years is causing my depression. It has always been low grade until I am nearing menopause and now it is very bad. I do not know if it is from this Synthroid or declining and fluctuating hormones. I still have nearly all the hypo symptoms. This is all so frustrating because hypo and meno symptoms are so similar. I did have to lower my dose of Synthroid because of declining estrogen. This is all so complicated. Looks like there should be a doctor somewhere who can treat both.
Laura said:
Jul 01, 09 at 3:58 pmWhen I was on Synthroid for almost a month after first being diagnosed hypo, I became very depressed. My doctor at the time was listening to me tell him about how awful I was feeling, and reached for his script pad and started to write. I was already mad at him for not wanting to increase the Armour he had switched me to (I felt so much better right away on just 15 mg of Armour and wanted more) so when I saw him writing I said “And I am NOT suffering from an acute Prozac deficiency.” He quit writing and put the pad away and suddenly decided I needed to see a rheumatologist for my CFS and fibromyalgia. I never went to him again, never went to a rheumatologist, but gradually got up to 180 mg of Armour daily and all problems went away. No depression, no CFS, no fibro.
Sam said:
Jul 04, 09 at 12:59 amI suffered from severe recurrent depression for about 20 years before my hypothyroidism was finally diagnosed. I am now on T4 and T3 meds although I had to fight hard to get the T3. My doctor decided it was not my thyroid problem causing my exhaustion and tiredness but a rare form of depression which causes tiredness but no feelings of depression! He was wanting to put my anti-depressant dose up rather than consider that it could be my hypothyroidism not being properly treated. I managed to persuade him to let me try T3 – I couldn’t get him to go as far as Armour. I actually don’t feel any better though. I did try to get him to look at adrenal fatigue but he ruled that out based on a blood test (calcium levels I think). So I have had the 24 hour saliva test done, and guess what! I have low cortisol levels. Just waiting now to see if I can persuade him at our next appointment!
It is interesting however that the T4 could be causing depression – so he could be right after all – but treating the symptoms instead of the root cause. I will be taking this info with me next time I go!
Tori said:
Jul 04, 09 at 12:46 pmI have a long standing history of being on and off antidepressants, and the entire time, I knew something else was wrong. The first time I was put on them was before I was diagnosed with hypoT, and I had a horrible time with the side effects. A few years later I was diagnosed hypoT, and ever since then my depression has come and gone over and over, and they kept wanting to prescribe antidepressants. Finally when I thought I had a good doctor, I told her I did NOT want any more drugs, and thought something wasn’t right with my thyroid, she told me to work out more, and eat better, and that was that. Then I called her again a few weeks later and told her I wanted to try Armour to change my thyroid treatment, as this might work. She didn’t even call me back, had her nurse call me, to tell me there would be a prescription waiting for me at the pharmacy of Effexor ..more antidepressants. That was it. I was DONE. I knew I was smart enough to know my body and that this was not how I wanted to be treated…it still brings tears to my eyes, because I was in the middle of my divorce, and all hell broke loose on top of my doctor not even listening to me. But here I am today, and I didn’t put up with their bull, and I’m getting better, on a dessicated thyroid med……..She also wouldn’t prescribe Armour because “ugh, you DO know it’s made from pig thyroids right??? I don’t believe in that”. HA
Jess said:
Jul 05, 09 at 10:18 amI’m thankful that I’m pro-active about my health and have the internet, because no answers have been forthcoming from the med professionals for the past 18 or 20 years since I was diagnosed w/ hypo (aka “hippo” which is how I feel.) Yes, there is the depression, currently on Effexor, and don’t dare go off, from what I’ve read and the way I feel. Also the ridiculous weight gain, resulting in my being 40# overweight. As a person who has always been active, and eaten a healthy fresh diet (w/ no fast, fried, little starch, sugar, 4 footed meat), and has no serious vices (wine, a very occasional beer or drink), when I look at my body, I feel it doesn’t belong to me. I’m embarrassed and disgusted. And the cement-brain, which others call brain fog…talk about embarrassing! I’m forgetful, which in my line of work is seriously not good, and it has made me an inadvertent promise-breaker w/ friends and family. It makes me seem irresponsible and self-centered. I can’t tell everyone “my thyroid made me not do it!” On top of everything…the fatigue! Eight hours sleep isn’t enough. I’m too tired to go dancing, which is great exercise. I used to salsa dance for 3 or 4 hours straight…now I get tired after one dance. Vicious cycle…carrying around 40 extra pounds could make me tired and depressed, but where did that come from in the first place? So, long story short, happy to stumble upon the T3 T4 discussion, as it looks like the solution for me might be T3 or some good ol’ pig thyroid tissue. Currently taking Synthroid that I now know is just T4. Thanks for this forum.
Lisa G. said:
Jul 09, 09 at 8:24 amI’m 42, divorced, single mother and only parent to a child with special needs. I live in Colorado. I have been diagnosed with hypothyroidism and have been on Levothyroxine for several years now. I’ve seen my health deteriorate over these past several years as well. I never knew that I could still be experiencing symptoms until a couple months ago. I had gone to see a psychiatrist but they told me that I was so mildly depressed, they felt I didn’t need to continue seeing them. However, they did prescribe meds. The meds did nothing for me. I contacted my primary care dr. at the time and he said “if you just exercise 30 mins a day, you’ll feel as good as you choose to feel”. I fired him and changed drs. Meanwhile my symptoms, both mental and physical have persisted, things like extreme fatigue, not being motivated to do very much at all(definitely not exercise), joint pains, anger, mood swings, irrational emotional reactions, you all know the things I’m referring to. I KNOW it’s not just a mild depression. I KNOW there is a link to my thyroid there somewhere. I’ve persisted until my primary care dr. is doing an assortment of tests. I suggested a T3/T4 treatment regimen. She said if all tests come back in the normal range, I should consider Prozac. I think I will insist on a referral to an endocrinologist before I go that route. I’m now thinking my adrenal levels and cortisol levels are off. It shouldn’t have to be this tough for us…but it is. I just wish drs. would make more of an effort to educate themselves about thyroid problems.
a story to tell said:
Jul 19, 09 at 7:40 amI had a total tyroidectomy 9 years ago (at age 25) for a toxic multi nodular goiter with suspicous cells. I was put on Synthroid afterwards and have routine TSH levels WNL. 4 months after surgery I began complaining to my endo. dr. that I was always tired, having a brain fog, headaches, dry skin and hair and simply just not feeling like myself (TSH, Free T3 and Free T4 all WNL). I am a nurse and knew better but allowed her to put me on an anitdepresent. This of course did not help either. I also had a cortisol challenge and 24 hour cortisol urine test after demanding this from my PCP. It was all WNL also. I had begun to think I was simply just crazy. My Endo. Dr. acutally told me that I just was so used to being hyperthryroid so long that I could not adjust to being “Normal” and it was just going to take more time. I have seen many specialists over the last 9 years with no real improvement. My newest symptom to this cascade of Feeling BAD daily is that i am now getting body aches in all of my joints. I did try armour about 6 months ago and did titrate the dosing as described but it hasnt helped either. Today I ordered the iodoral testing kit and medication since every symptom listed is consistent with my complaints. ANY SUGGESTIONS as to what to do next would be appreciated!!!! I used to be a outgoing, fun loving, easy going girl who was full of energy and excitement for life and I just feel BAD. Also note I AM NOT IN NEED OF DEPRESSION MEDICATIONS (this is not my problem) I NEED TO KNOW HOW TO FIX THE UNDERLYING CAUSE OF THIS CHRONIC FATIGUE AND SLUGISHNESS!!!
(from Janie: go to the following page: http://www.stopthethyroidmadness.com/talk-to-others)
Janie said:
Jul 22, 09 at 8:39 amFr0m Kara: just tested my Armour and it’s the new formulation. And yes, I’ve been having drier skin and bouts of depression. I was diagnosed hypoT seven months ago; Kaiser put me on levothyroxine, and for the three weeks I took it, I was miserable. Although I had largely learned how to not get depressions (more on this below), on T4 I found myself crying and miserable for a couple days, then I’d be overadrenalized, shaking and unable to think straight for a day or two, then back to depressed, and so on, over and over. Kaiser was terrible – the endo (from the UK, I learned later) wouldn’t even make an appointment with me. I found a GREAT doc here in San Diego, who started me on Armour and hydrocortisone, and I have been slowly getting so much better. So yes, I had some bad depressions on the T4 meds. Before about four years ago, I used to be apathetic and depressed for a week at a time, and terribly moody. I found (I’ll skip the long story) that I’m hypersensitive to CAFFEINE. Oh boy, did I fight that… I loved my mochas. But through trial and error, I found out that even trace amounts of caffeine or theobromine (think tea & chocolate) had the effect of making me miserably apathetic and depressed for two to three days. I now avoid even decaf things and (damn damn damn!) chocolate. My husband & friends help me when I start gazing longingly at fudge… because they have to put up with me if I eat it! Yes, it’s that bad (sounds stupid, doesn’t it). But it’s SO nice to not be so depressed. Others have found the same thing with caffeine; one even wrote a book on it. Here’s a couple websites with her writings: http://www.successfulschizophrenia.org/stories/whalen01.html http://www.doctoryourself.com/caffeine_allergy.html I hope to someday get to enjoy chocolates and mochas again, if my thyroid treatments fix that part of me.
Lisa said:
Jul 22, 09 at 4:30 pmIt is such a relief to have discovered your web site.
I have been so sick and depressed and was ready to give up any hope of ever feeling normal again.
I have been on here for hours and I cannot thank you enough
for creating this site.
I was diagnosed with Graves disease last January and then had the radioactive Iodine after which I crashed and burned to Hypo, Put on Levothyroxine 4 months ago and feel awful. I traded in Hyper symptoms for all this Hypo stuff. Anyway, thought I was losing my mind alone until I stumbled on here. My DR is history as of Now. He insisted there is only ONE way to treat my illness.
I have already located a DR from the Armour site you listed and will be in his office next week to try dessicated thyroid. I am now so FULL of hope.
I can’t wait to read your book.
Thank you to everyone on here for all that you have shared.
Kerrie said:
Jul 22, 09 at 6:49 pmHi there – I am a little different to the others that have commented here – but have experienced depression because of Thyroid Medication. I am Hyperthyroid and have been taking neo-mercazale an anti-thyroid drug – when the amount was slowly increased until I was taking 12 to 13 5mg tablets per day – i quickly became HYPO and in turn depressed. Over the past 12 months or so I have see-sawed between HYPO and HYPER. The most significant symptom I notice is when HYPO (caused by too much ATD) I feel depressed – it is such an obvious turn that I know exactly when I go over from hyper to hypo even before the doctor has tested me and adjusted Medication – my aim is to get off and live without this medication eventually – I have changed my diet and have noticed a significant improvement in symptons – I have kept a blog for people who may be interested at http://gravesdiseaseanswers.blogspot.com/……Kerrie
e. said:
Jul 28, 09 at 8:32 pmI was diagnosed with Hashi’s 5 months ago and put on Synthroid. At first I thought the synthroid helped because my headaches went away. My digestive problems grew worse and I still was exhausted early in the day after waking! Yesterday I asked for Armour and was given a RX for Nature-throid. I am hoping and praying that things will get better for me. Thanks to this site for providing me with the valuable info I need to make informed decisions!!! God Bless You!!
John S R.Ph. said:
Aug 04, 09 at 12:08 amI take some issue with general statements about levothyroxine. There are many statements being made that there is nobody doing well on Levothyroxine. That is simply not true. Keep in mind that the body produces levothyroxine from the thyroid gland. therefore Levothyroxine really is a bio-identical hormone just like bio-identical estradiol, estriol, progesterone and testosterone. Many people then don’t convert Levothyroxine to Liothyronine. There are many reasons that this happens including nutritional deficiencies and medications.
In my practice I show a list of hypothyroid symptoms to all thyroid patients that I talk to. I do this after asking them how well their thyroid is controlled. Everybody says that the Doctor says their thyroid is well controlled. I then show them the symptoms. I find that about half of the people I show report no symptoms from the list. I would conclude that these patients are being treated with Levothyroxine.
That being said however, can anybody imagine a treatable disease being treated successfully only 50% of the time. I’m amazed at the many Doctors are willing to say “You know you are getting older, you’ll just have to live with it” or “You are fine because that is what your lab value says.” Start saying to them “Does the lab value have any symptoms?” IMHO
(from Janie: John S R.Ph., I will beg to differ with your first and second paragraph. It would be interesting to find how many of those 50% you claim reporting no symptoms are on anti-depressants, and it would be interesting to find out what the cortisol levels are of those who claim no symptoms, which I’ll bet are climbing slowly but surely, as well as a hefty amount of adrenaline. Finally, it will be interesting and sad to see what is going to happen to those so-called asymptomatic 50% who stay on an inadequate medication, because where they think it’s not getting them now….it WILL later.
And by the way, the body does produce T4. But the body also produces direct T3, as well as T2, T1 and calcitonin. And for any doctor to claim that giving a patient no more than a thyroid storage hormone is “adequate” is curious and dumbfounding to me and a huge and growing body of thyroid patients who have found out the truth.)
Rebecca L said:
Aug 04, 09 at 10:35 amHi there,
I was finally diagnosed as Hypothyroid about 6 months ago, after years about 10 years of on and off illness and depression.
My current GP isn’t very helpful for finding solutions to all my symptoms claiming I should except severe fatigue, weight gain, and severe constipation as part of ‘growing older’. I am thirty two. Or if I do not go into the appt armed with my own ideas for treatments he tries to pass me off onto specialists…to for my colon or to check for sleep apnea.(I am trying a new doc this week)
I did manage to have this GP prescribe 5mcg of cytomel for the T3..starting out at the lowest dosage. From what read the T3 meds, unlike the T4 meds, should show change within days. I just started taking it today, and so can not determine any effects.
I am still struggling with on and off various hypoT problems. Mainly being the severe fatigue, listlessness/depression, constipation and weight gain (about 10-15 pounds)
My energy levels fluctuate. For the past 3 weeks I have put myself on a strict diet and exercise regime hoping this would help. I have always been a very healthy eater: eating mostly whole foods, very little processed foods, mostly organic fruits and vegetables. I am lacto-ovo vegetarian consuming about 1500-1800 calories a day. I dropped down to consuming 1200-1400 calories a day and increased my exercise from 4-5 days to everyday 45 minutes to 1hour and half. I have barely lost any of the weight that I gained. Though I have noticed better energy levels and more regular bowel movements.
In regards to depression, I strongly believe it is due to low energy and poor health and the frustration which accompanies these issues. I have been on various anti-depressants in the past which I think have had short and long term undesirable effects. I have not taken any sort of anti-depressants in 6-7 years and would only consider them again as a very last resort.
I wanted to suggest anyone who has fatigue and depression problems to have there B12 checked. I have had chronically low b12 (even though i eat eggs and take b12 supplements) for at least 7 years. I have noticed I feel tremendously better (lots of energy and no depression) when my b12 levels are in the 800-1100 levels. In America acceptable levels of B12 in lab tests are from 200pg/mcl-1200pg/mcl. In Japan they diagnose and treat for B12 deficiency , anyone with levels below 550. The more I read about B12 levels, it sound like they should be above 500. If your levels are low, often times sublingual b12 vitamins can increase your levels. For me I get B12 shots and take the sublingual vitamins. If you do notice your levels are low, I would try to insist your doctor give you a shot of B12..you will notice a difference in energy and mood within the day or in the next few days.
I also agree with Janie on her 7/22 posting…I feel remarkably better when i cut out the caffeine. I still eat chocolate and drink decaf but i may try to cut this out as well. I am a recovering caffeine addict…I used to drink ridiculous amounts of espresso and miss it terribly but it will be worth it to avoid depression and fatigue.
I would also recommend to try to cut out wheat and gluten from your diet. Many people with hyoT have problems digesting this kind of food. It isn’t easy to do, but I feel much better without wheat and gluten than I do with it.
I have also very recently cut out all goitogenic foods. This was an arrow through the heart and made me want to spit nails. Not only could I not enjoy coffee or a piece of toast but I read that I should not be eating broocoli, cabbage, cauliflower, strawberries, peaches, kale, collard greens. In a way, it is almost difficult to get to 1200 calories with all the limitations in my diet.
I am hoping that with some medication tweaks that I will be able to consume a more normal diet. But I have also come to accept that if such restrictions help me, then I am willing to accept them with an open heart.
It is just frustrating when I still feel unwell and continue to have weight issues when i am working so hard to be healthy….