Underactive Thyroid

I went to the doctor with symptoms of depression and he prescribed Prozac. But he also took blood and there was some indication I might have a somewhat underactive tyroid gland. I had raised tyroid stimulating hormone (5.75) but normal T3/T4. Subsequently, I've had a negative thyroid antibody test result. So, does that mean the tyroid is normal? I presume so.

I have no problem with the diagnosis of depression and the Prozac seems to be working - I'm concentrating better, sleeping more normally and I don't wake up wanting to die. My wife also assures me that I'm a nicer person to live with.

However, is there a food or a supplement that might give the old thyroid a boost and me a bit more energy?

I've cut back on alcohol, which wasn't excessive anyway. I'm increasing my training (which I'm enjoying again) to get my weight down. I'm about 85kg - and 1.9m tall - but I run much better when about 79kg.

But I still feel tired and running sometimes still feels an effort. Suggestions?


  • Are you eating enough carbs? or getting enough iron in your food - a lack of both makes me feel really rubbishy and lethargic when I'm running.
  • Also oily fish (or fish oil capsules)
  • I think so. As a precaution I've started to take a daily mulitvitamin/mineral supplement (with iron) - I know there isn't much evidence that they work but so long as they do no harm then its worth a try.

    The only things I'm leaving out in an effort to lose weight are refined sugars, very fatty stuff (I love cheese) and cutting back on alcohol - I still like a few beers on Fri/Sat.
  • Yes, I like oily fish.
  • Kelp supplements may help if it is your thyroid, Ian. You can get them from Holland and Barratt and are about £3 or £4 pounds for about 3months supply (if you take the maximum dose a day). My blood levels were normal when tested (but they didn't have my levels from when I was well) but it didn't explain my extreme fatigue and odd joint pains. So I started to take kelp and gradually I began to feel better (whether it is psychological or not I don't know) - I still get days where I feel exhausted in the afternoons but not every day and they aren't as often either.
  • Not an expert but I thought that TSH more indicative of underactive (or over) than thyroxine.

    In which case why didn't GP suggest replacement - could you get it rechecked. I was underactive for years and suffered with depression/exhaustion etc

    As soon as treated I felt much better and can't say I've felt depressed since.

    I'd ask your GP
  • Get another TSH in a month or so. My result was borderline (8.7) - i had thought the lethargy, exhaustion, headaches, dizziness, needing to go to bed at 9pm etc were due to my marathon training. My antibodies were negative - they just record positive when they are over a certain level - . After a second raised TSH (5.8)and lowish T4 (12.8), I was started on thyroxine, and stopped feeling old relatively quickly, could run uphill again and my hair stopped falling out. Interestingly after about a year of treatment my TSH went up further, and I have had to increase the dose. I assume this is when my thyroid packed in completely. I wonder whether us runners get symptoms earlier (ie. at a milder thyroid underactivity) than more sedentary folk as we push our metabolism harder??
  • Ian - I'd expect your doc to run the TSH test again after about three months and if it were still raised and you were symptomatic start you on thyroxine. Depression is one of the major symptoms of hypothyroidism, do you have dry skin, hair loss, joint aches, shortness of breath or any of the other possible symptoms?

    SS - I like the hypothesis that runners are symptomatic at a lower level!
    If you think you can or you think you can't you're probably right.
  • Ian, I'm a GP and I'd repeat your TSH to make sure the high reading wasn't an artefact, and prescribe thyroxine for you if the second test confirmed borderline hypothyroidism.
  • i agree with velociraptor, i am a nurse, and also have hypothyroidism, if my TSH got that high i would feel like total s***e, last reading was below 1 on replacement therapy.

    Another blood test in a few weeks time is entirely sensible.

  • Cor Flateric, I want your GP, I couldn't persuade mine to run me that low!
    If you think you can or you think you can't you're probably right.
  • It took a little persuasion LMH, the slow heart rate of less than 60 with other symptoms finally persuaded him to allow a trial of an extra 25mcg, then repeated bloods.

    i was only subclinical originaly and the Docs debated wether to treat or not, 2 years down the line and i am on 125mcg.

  • Hi everyone
    I have an underactive thryoid following my first pregnancy (8 years ago) and now take 100mcg a day. I was so relieved when it was diagnosed and those 'magic white tablets' started working! After about 3 weeks I felt so much better and have had very few problems since. Hope you get your dose sorted quickly Ian and start to feel welll again.

    It seems to be the kind of illness that creeps up on you and it is only when you get better that you realise how ill you were, if that makes sense.

    My next challenge is to get my dose increased because I am expecting my third child and feel that my energylevels are falling again and I am slowing down mentally and physically(more than I would expect for pregnancy). just don't feel right (and it is not just being pregnant!)I have had a blood test and it is in the 'normal range'. so no joy so far.

    I have read that in USA they automatically increase thryoxine by 1/3 at the start of pregnancy, whereas here you have to wait to get ill ( and risk developmental delays etc with babe)it seems before this is addressed...I am quite worried about this and feel rather powerless. Can anyone help?

    Sorry to ramble and hope you all continue to feel well/get well soon.

  • LMH, I'll happily run people slightly biochemically "overtreated" if they're feeling well and don't have any signs or symptoms to suggest that they're thyrotoxic :o)
  • Sequin, that's interesting! I don't know the answer to your question and shall have a rake through the literature on the subject because it's an issue that's bound to arise in my own practice at some time.
  • Thank-you Velociraptor! Really appreciate it. Aren't we lucky to have a GP on the forum!
    (The book I read it in is called 'Pregnancy and conception over 35' by Dr Laura Goetzl published by DK page 19!)
  • Wow! Playmates! Thank you so much for all the help and advice. That's really useful.

    I don't really have any other symptoms apart from the depression, tiredness and feeling that I'm having to work very hard when I run (but that may be due to the extra 6kg I'm carrying - I eat like a pig when I'm low).

    My skin was getting rather strange on my forearms - a bit rough looking and dry but that may be due to the Prozac or the sun. My heart rate is usually fairly low - it can drop to 40 when I'm completely at rest but I just thought that's because I run about 50 miles a week normally.

    I'll give it a few more weeks and call back in on my GP to see whether he wants to repeat the test. After all, the Prozac is working so it might just be that.

    Yes, and we are very lucky to have doctors and nurses on the forum. Thank you all again.

  • Not just doctors and nurses, by the way, but people who have been through similar things and care.
  • I agree Ian. Thanks to everyone. So good to get support.
  • I was told by my endocrinologist that he likes you to run with TSH quite low (ie bordering under treated) because overtreatment risks osteoporosis.

    I was however bumped up to 200mcg prior to conception and throughout pregnancy.

    I managed to stay on that dose for 4 yrs until they spotted it :-D
  • Interesting Mrs P - did you request the increase in dose or did your dr suggest it? Hope you don't mind me asking! I just wish I could have 125mcgs...
  • I requested it because again my endocrinologist had said (several years before) to go back to him if ever I was preggers as I would need an increase.
  • I should add 175mcg is my normal dose (You can imagine how ill I felt before replacement)
  • V'rap - I'm not that far away, what do I have to do to get on your list:-)

    I've had to fight for the best part of three years to get to the 100mcg I'm on now - and only got that after my lovely GP diagnosed me as having CFS (despite me marathon training) and referred me to the CFS clinic who talked to me said 'your thyroxine levels are too low, what's the problem?' and wrote to my doc to say the same. All of a sudden I wasn't a depressive looking for an excuse and whingeing all the time but someone who needed double the dose I had been kept on for two years! I'm still only 1.67 so room for manouvre but I don't feel bad enough to fight again just yet.

    Ian - do you find that you're mentally tired too, a kind of foggy brain? Difficulty remembering things or concentrating?
    If you think you can or you think you can't you're probably right.
  • I'm tired much of the time. But that could be due to depression or a (hopefully transient) side effect of Fluoxetine. I had a lot of trouble remembering and concentrating (and sleeping - early morning waking: 3am etc - plus 'flight into sleep' - due to anxiety). But since the fluoxetine started working that seems a bit better.

    I'll give it another week or so and if the tiredness is still troublesome I'll pop back to the GP for a bit of a review. I'm very lucky to have a triathlete for a GP so at least he hasn't said 'don't run so much'.
  • Post script. After about 12 months on Prozac I've now been off it for about 4 weeks and I feel absolutely fine. I've no symptoms. I'm optimistic, energetic, sleeping and eating normally. Training is going well and everything in the garden is rosy (finished the FLM in 3:29 despite contracting a cold the week before). I know there is some controversy about Fluoxetine (Prozac) but it helped me as did an understanding GP - and the forum of course. I'm a psychiatric nurse by trade but this was my one and only excursion into mental illness (that I'm aware of anyway!). It has been an interesting lesson. I would now say to anyone - go and get treated. Its much better than the deep lager therapy that I used to do and much better than being grumpy with the kids all the time.
  • Lovely to see you Ian and to have such a positive result. I'm a student psychiatric nurse! Great FLM time too.
    If you think you can or you think you can't you're probably right.
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