Still experiencing symptoms even when bloodwork is in range

[taylor_TheSaltyT]

My names Taylor and I've been diagnosed with a hypothyroid condition for 17 years. About a year ago, I was also diagnosed with Hashimoto's but have been on the same medication, generic synthroid (levothyroxine), for almost the whole duration. In 2020, I was told by my psychiatrist that I had severe depression and moderate anxiety and I've battled this for as long as I can remember. I have seen that medication can help regulate the thyroid gland, but feel the symptoms of depression and anxiety still persist even when my level are within the normal range. I've had other lasting symptoms of cold intolerance, dryness in my skin and hair, cold intolerance, poor hands and feet circulation, brain fog, but I mostly want to address my depression/anxiety. I'm due for my 6 month follow up soon and wanted to seek advice on where I should go moving forward. My previous endocrinologist shut down the idea of Amour pretty quickly when I asked. Should I be trying different medications to see if my depression/anxiety resolves? If so where should I start? Any recommendations would be greatly appreciated as I feel like I've been let down by my medical doctors and have been dismissed because of my previous "normal" blood work levels. Please help me!

[gimel]

Please post your thyroid related test results and reference ranges shown on the lab report.  Also what is your thyroid med and dosage?  And last for now, if tested for  Vitamin D, B12 and ferritin please post those results as well.

[taylor_TheSaltyT]

Unfortunately I don't have my previous labs on hand at the moment, but I plan on getting the workup done  soon. My current thyroid medication is Levothyroxine 112mcg. I believe I've been tested for Vit D, B12, and ferritin in the past and it was ruled out, however I will see if it's necessary through my doctor to test for that too. Once I have all the results, I'll post back in the chat. Thanks so much for your quick response!

[gimel]

Taking 112 mcg of Levo is typically not enough to relieve hypothyroid symptoms.  Note the following link to  a paper co-authored by Dr. Hoermann, a retired Endo from Germany, with vast knowledge and experience about thyroid issues.

https:/www.hindawi.com/journals/jtr/2018/3239197

If you scroll down and look at graph c, on the Y axis is the Probability of having hypo symptoms.  As your usage of T4 goes up, the probability of symptoms goes down, but will approach zero symptoms only if there is adequate FT3 levels.  The three curves for FT3 are as follows:  The red line is FT3 at about 8% of its range.  The green line is FT3 at 39% of its range.  And the blue line is FT3 at 57% of its
range.  So you can't eliminate hypo symptoms without having adequate levels of FT3.   And your 112 dosage is nowhere near enough to provide adequate FT4 and fT3 levels.  

I you want to read more about this, have a look at my paper in the following link.  Dr. Hoermann is a co-author.  In the paper you will alson find that Vitamin D is very important and needs to be at least 50 ng/ml. B12 in the upper part of its range,  and ferritin should be at least 100.

https://thyroiduk.org/further-reading/managing-the-total-thyroid-process/

[taylor_TheSaltyT]

Thanks for the information! I was unaware the dose I was taking could be too low. I'll definitely read that literature you sent me to identify precisely what I need. Here are my my current lab results taken on Oct 2021:
THYROID LABS In OCT 2021- TSH 4.320 and T4 1.42. TPO 165. TSI < 0.10. ACTH 32.7 and Cortisol 16.8. THYROID ULTRASOUND: No nodules (10/19). and, no h/o nodules. Currently on T4 112 mcg QD. TSH 0.575 and T4 1.64.
I am trying to make an appointment to be seen asap for current labs. I do not have the other lab work you previously mentioned about the vit. d, b-12, and ferritin.

Thank you!

[gimel]

Please understand that everyone can be different in the thyroid levels needed to relieve symptoms, so there are no specific levels to target.   Levels have to be adjusted as needed to relieve symptoms for the specific person.

When u see doctor make sure they test for Free T4 and Free T3, not total T4 and T3. Also push to get tested for D, B22 and ferritin.