Sudden Depression

Katty · Jul 18, 2014

So, I'd been feeling pretty good- warm and calm and mostly upbeat.
Then the last couple weeks I started to get irritable and cranky and even a bit depressed.
I changed from NDT to T4/T3 combo about 5 weeks ago. T3- 12.5mcg (taken in bites throughout the day), and T4- 56.25mcg (at night). I know the ratio is a bit more than 4:1. I felt pretty good with this for about the first 1.5-2 weeks or so. Then I slowly started getting irritable and depressed. I thought the new meds were maybe making PMS symptoms more severe for some reason, causing me to be irritable before menstruation (which I'm not usually). But then these depression symptoms have persisted even past menstruation into the first half of my cycle.
Not sure what's going on here.
-Are the new meds pushing my metabolism higher, making me need more calories or more vitamins/minerals?
-Is the ratio of meds somehow causing this issue? If so, how?
-I also started increasing my Vitamin A while on these new meds. I was on about 20,000iu and then the last couple weeks I went up to 70,000iu (it did seem to help my acne a bit). I thought maybe the Vitamin A was the cause of the depression. But I didn't take any Vitamin A the last 2 days and I'm still experiencing the depression symptoms. (Maybe it takes longer than 2 days to get the Nutrisorb A out of my system?)

Any thoughts?

jyb · Jul 18, 2014

70K seems like a huge lot for Nutrisorb A, even for a normal oil based formula...

If it's a sudden change of mind, maybe its dopamine related. Amino acids like BCAA are pretty powerful at changing that, whether in a good or bad way. Gelatin seems always safe, BCAA seems interesting but careful to dose it like on the threads with tyrosine.

tara · Jul 19, 2014

I don't have experience with supplementing either Vit A or thyroid. I think all the fat soluble vitamins, including A, can stay in the system for quite a while. And I think more thyroid hormone burns through more calories.

SQu · Jul 19, 2014

For the first 3 of the 4 months I've been on thyroid, whenever hypo symptoms reappeared, which in my case took a day or two because that's how my body responds to T4, I lowered T4 in relation to T3 and it would fix it. I can't take much T4 and currently take half as much as T3. For me the ratio is really vital, and I won't drop T4 entirely but I do take just a little. Perhaps that is something to consider?

Katty · Jul 19, 2014

Thanks for the responses everyone!

I'll look into the amino acids. Anyone know if the BCAA are easy to digest for most people? I'm fine with gelatin in things like gummies and marshmallows, but mixing the hydrolyzed into drinks causes bad digestive problems for me.

I was thinking Vitamin A does take a while to get out of the system-- so maybe that's why the depression is sticking around. But the acne seems to be getting worse without taking the Vitamin A every day... seems so unfair that the bad effects of it stick around, but the good ones don't :roll:

... if that is what is going on.

sueq, yes, maybe I should lower the T4. Funny, I'm ok with constantly messing with the dose of vitamins, but it makes me more nervous to change up the thyroid amount for some reason.

Katty · Jul 20, 2014

sueq said:
For the first 3 of the 4 months I've been on thyroid, whenever hypo symptoms reappeared, which in my case took a day or two because that's how my body responds to T4, I lowered T4 in relation to T3 and it would fix it. I can't take much T4 and currently take half as much as T3. For me the ratio is really vital, and I won't drop T4 entirely but I do take just a little. Perhaps that is something to consider?

Forgot to ask: how much do you lower it each time? My T4 pills are 75mcg and I take 3/4 of one per day, which is 56.25mcg. If I only take 1/2 the pill, it will be 37.5mcg per day, so almost 20mcg less. Is that too low to cut? Might be a pain to try to cut 1/4 of a pill into another 1/4, etc.
Do you also increase the T3 when you cut the T4, or just do one at a time? I'm not sure how to know when I need to cut T4 vs when I need to increase T3.

SQu · Jul 21, 2014

I dropped it by the smallest amount I could, and then checked my symptoms and pulse regularly over the next few days or weeks, but mostly I would feel a difference almost immediately. I tried not to also raise my T3 at the same time. My aim was to make tiny adjustments as seldom as possible, only taking action when I was clearly going downhill. And otherwise aiming to get in as close to a month or more at one dose. This seldom happened because also we were going into winter.
Other times when I seemed to be not getting much from the dose but also not getting much worse (like this last few weeks) I waited for a while before concluding that I was getting more hypo, and then raised T3 by a few mcg at a time. By then my T4 was quite low and I thought it was about right. (I want to take some T4 to 1. lower TSH and 2. not get into unstable high adrenalin state on T3 only like I did at the beginning.)
I really watched for adrenalin signs and aimed to keep pulse at about 90. But in actuality it only really hit 90 for a short time just after a T3 dose. The rest of the day it would be more like 80. I aimed also to keep blood sugar level especially at bad times of day (afternoon and night time). Not succeeding with the night time thing yet though. I also took it in divided doses with food about every 3 hours or so, by then pulse would be lower again.
So, to summarize, I dropped by as small an amount as I could divide a tablet into, only one thing at a time, and tried to stay at that level as long as possible, changing only when I felt I was deteriorating again. I watched for not overshooting with T3 by keeping a close eye on pulse and adrenalin signs and by snacking to keep blood sugar as level as I could. This has worked reasonably well for me and I think I minimized the classic signs of over/undershooting on dose by keeping adjustments small and watching for symptoms.
Still got a long way to go myself, though.

Katty · Jul 21, 2014

sueq said:
I dropped it by the smallest amount I could, and then checked my symptoms and pulse regularly over the next few days or weeks, but mostly I would feel a difference almost immediately. I tried not to also raise my T3 at the same time. My aim was to make tiny adjustments as seldom as possible, only taking action when I was clearly going downhill. And otherwise aiming to get in as close to a month or more at one dose. This seldom happened because also we were going into winter.
Other times when I seemed to be not getting much from the dose but also not getting much worse (like this last few weeks) I waited for a while before concluding that I was getting more hypo, and then raised T3 by a few mcg at a time. By then my T4 was quite low and I thought it was about right. (I want to take some T4 to 1. lower TSH and 2. not get into unstable high adrenalin state on T3 only like I did at the beginning.)
I really watched for adrenalin signs and aimed to keep pulse at about 90. But in actuality it only really hit 90 for a short time just after a T3 dose. The rest of the day it would be more like 80. I aimed also to keep blood sugar level especially at bad times of day (afternoon and night time). Not succeeding with the night time thing yet though. I also took it in divided doses with food about every 3 hours or so, by then pulse would be lower again.
So, to summarize, I dropped by as small an amount as I could divide a tablet into, only one thing at a time, and tried to stay at that level as long as possible, changing only when I felt I was deteriorating again. I watched for not overshooting with T3 by keeping a close eye on pulse and adrenalin signs and by snacking to keep blood sugar as level as I could. This has worked reasonably well for me and I think I minimized the classic signs of over/undershooting on dose by keeping adjustments small and watching for symptoms.
Still got a long way to go myself, though.

Thanks so much for the detailed reply! I dropped my T4 dose today by a bit... I do seem to feel better, but I imagine one day is too soon to tell.
I need to work on keeping blood sugar up. I think I do better in the morning. But I don't eat enough in the afternoons between lunch and dinner. It's like I have a mental block to preparing more foods for some reason. It would help if I could tolerate milk, because I'd love to sip on chocolate milk all afternoon.

gummybear · Jul 21, 2014

I can sometimes get quite low when my prolactin is high, zink is usually mad good with lowering prolactin. Just doing something that is utterly satisfying usually makes it much better also. Having a walk in new enviroment, playing with a dog, annoying a cat the possibilities are endless.

SQu · Jul 22, 2014

I feel it immediately. Maybe you are too.
I also have a mental block in the afternoons! I'm usually driving then, and even before I often can't think of what to have for lunch or just have something i know is too small. Maybe because I cook breakfast for the family and dinner but lunch is usually just me and I'd rather have a break and ignore the faint hunger pangs. I run on adrenaline then crash by about 5 and get grumpy and aching. A bad habit for years. I'm getting better (cheese works as a quick easy meal) but the other day when I underate I was shocked to find my pulse was over 100 though I did not feel wired.
Gummy I stopped Zinc because years of it might have whitened my hair, but I find salt lowers prolactin very well.

gummybear · Jul 22, 2014

sueq said:
I feel it immediately. Maybe you are too.
I also have a mental block in the afternoons! I'm usually driving then, and even before I often can't think of what to have for lunch or just have something i know is too small. Maybe because I cook breakfast for the family and dinner but lunch is usually just me and I'd rather have a break and ignore the faint hunger pangs. I run on adrenaline then crash by about 5 and get grumpy and aching. A bad habit for years. I'm getting better (cheese works as a quick easy meal) but the other day when I underate I was shocked to find my pulse was over 100 though I did not feel wired.
Gummy I stopped Zinc because years of it might have whitened my hair, but I find salt lowers prolactin very well.

Yeah zinc is good at displacing copper that's why I only use it after blowing a load

Katty · Jul 22, 2014

gummybear said:
I can sometimes get quite low when my prolactin is high, zink is usually mad good with lowering prolactin. Just doing something that is utterly satisfying usually makes it much better also. Having a walk in new enviroment, playing with a dog, annoying a cat the possibilities are endless.

Yes, I think I do need zinc. But it seems like a lot of Peaters don't necessarily supplement zinc. Can't get oysters at the moment but I eat my weekly liver.
I was doing the feel-good activities when this depression came on-- taking walks in the sun, etc. I really think this onset of depression was not environmental because I was feeling better mood-wise until I switched up my thyroid meds. Unless you're saying the thyroid meds made my prolactin go high.

sueq said:
I feel it immediately. Maybe you are too.
I also have a mental block in the afternoons! I'm usually driving then, and even before I often can't think of what to have for lunch or just have something i know is too small. Maybe because I cook breakfast for the family and dinner but lunch is usually just me and I'd rather have a break and ignore the faint hunger pangs. I run on adrenaline then crash by about 5 and get grumpy and aching. A bad habit for years. I'm getting better (cheese works as a quick easy meal) but the other day when I underate I was shocked to find my pulse was over 100 though I did not feel wired.
Gummy I stopped Zinc because years of it might have whitened my hair, but I find salt lowers prolactin very well.

Yeah, I might be slipping into some adrenaline in the afternoons too. I feel like I already put so much effort into cooking and eating the right foods, I don't want to be bothered to have to find more food for afternoons now.

Katty · Jul 30, 2014

Maybe this should warrant a new post, but I'll try here first.
So I lowered my T4 about 1.5 weeks ago. Depression still much better. =)
However, I started to get really tired and achy. Also, I'm not as excited to eat as I was a couple weeks ago. It's not horrible, but food isn't going down quite as easily-- like my body doesn't seem to want the foods I'm eating, even though I know I need fuel. Nothing in my routine has changed- not doing any more physical activity than usual, diet and calories are pretty much the same.
Does this mean I might need more T3?

One other symptom... Occasionally I will start to feel kind of loopy. Not exactly dizzy, just like I have a mild headache and like I feel off, maybe a little slow or something. Hard to describe. It's possibly related to bowel issues?? In which case, I might think serotonin is at issue, but I'm not certain. Haven't really dealt with this feeling before, but it's come up several times in the last few weeks. Today it has lasted longer that normal. Can't figure out if this means I need more or less thyroid meds, more or less food??

gretchen · Jul 30, 2014

You might also try getting more sun, either by sitting near a window or getting direct exposure.

I've always tended to keep the blinds shut but now keep them open and also use 100 watt bulbs. Seems to help a little.

Katty · Jul 30, 2014

gretchen said:
You might also try getting more sun, either by sitting near a window or getting direct exposure.

I've always tended to keep the blinds shut but now keep them open and also use 100 watt bulbs. Seems to help a little.

Hey Gretchen-
Are you referring to the initial problem of depression and getting more sun? I really think the depression was from too much T4, so that has subsided. And I walk 1-2 miles in the sun every day. But I appreciate your response!

visionofstrength · Jul 30, 2014

There are two ways to choose from. One is to take the t4/t3 combo (approximately 40 mcg:10 mcg ratio), with meals, 4-6 times a day.

The other is to take one t4/t3 combo once a day, and to nibble pure t3 - no more than a few micrograms an hour.

The problem is that neither of these is a cure-all, and can easily make matters worse. Once your metabolic process is halted by some kind of stress, then you may suffer very serious side effects from the t4/t3, including depression. The most common stress that impairs metabolism is shortage of sugar. RP tells of first noticing this some 35 years ago because his heartbeat became irregular when he took t3 without also having sugar.

It's also possible that you have endotoxemia from any of a staggering number of anti-thyroid foods that you may be eating, or from a lack of certain of the amino acids (those found most abundantly in milk).

A couple things:
Can you save a cronometer.com entry for what you eat each day (it's free)?
When waking, can you check:
your body temperature,
pulse, and
the color of your urine?

These are all good indicators of what you may want to do going forward.

Katty · Jul 30, 2014

visionofstrength said:
There are two ways to choose from. One is to take the t4/t3 combo (approximately 40 mcg:10 mcg ratio), with meals, 4-6 times a day.

The other is to take one t4/t3 combo once a day, and to nibble pure t3 - no more than a few micrograms an hour.

The problem is that neither of these is a cure-all, and can easily make matters worse. Once your metabolic process is halted by some kind of stress, then you may suffer very serious side effects from the t4/t3, including depression. The most common stress that impairs metabolism is shortage of sugar. RP tells of first noticing this some 35 years ago because his heartbeat became irregular when he took t3 without also having sugar.

It's also possible that you have endotoxemia from any of a staggering number of anti-thyroid foods that you may be eating, or from a lack of certain of the amino acids (those found most abundantly in milk).

A couple things:
Can you save a cronometer.com entry for what you eat each day (it's free)?
When waking, can you check:
your body temperature,
pulse, and
the color of your urine?

These are all good indicators of what you may want to do going forward.

Thanks for the detailed response! The depression is basically gone now since lowering the T4, I'm assuming your other suggestions are for the new questions? Like the loopy feeling I'm getting and/or the tiredness?

I take my T4 at night, then nibble T3 throughout the day (I probably don't nibble the exact same amount each time). I stop nibbling the T3 around 7pm.

I log on cronometer... which amino acids in milk are the ones that I need to make sure I have enough of? I think I'm getting enough carbs... usually at least 250 grams per day.

Body temp and pulse upon waking are high-- oral temp in 1st half of cycle is around 98.0-98.2, and in second half it's around 98.6-98.9 upon waking- temp stays high throughout the day (though I do sometimes get chilly fingers, so maybe I should do some more temp readings just to be sure). Pulse is pretty much always 90 throughout the day... for some reason I have a really hard time finding my pulse first thing on waking- but when I used to be able to find it occasionally, it was around 85-90. Pulse right before bed is closer to 85.

Urine is usually a strong yellow, though occasionally it gets a tad lighter. Since switching from NDT to T4/T3, I think I'm retaining a bit less water and urinating a bit more (but not excessively).

visionofstrength · Jul 30, 2014

Katty said:
... which amino acids in milk are the ones that I need to make sure I have enough of? I think I'm getting enough carbs... usually at least 250 grams per day.

Body temp and pulse upon waking are high-- oral temp in 1st half of cycle is around 98.0-98.2, and in second half it's around 98.6-98.9 upon waking- temp stays high throughout the day (though I do sometimes get chilly fingers, so maybe I should do some more temp readings just to be sure). Pulse is pretty much always 90 throughout the day.

It seems t3/t4 has raised your temp and pulse, but there may now be side effects from needing more nutrients to fuel your higher temp and pulse. For example, 100 grams of protein would be a minimum for your temp and pulse, and so would 120 grams of sugar, or the equivalent, say, the juice from almost two pounds of ripe oranges.

If you'd like to get toned at the same time, just limit your fat to a tablespoonful of coconut oil. You'll see the pounds melt off.

Can you compare your readings from your cronometer to mine (below)? If you can try to be about 80% of my protein and sugar totals, you may be ready to reduce the t4/t3 - and eventually keep your metabolism high even without t3/t4.

Katty · Jul 31, 2014

Hey vision, really appreciate your thoughts!

visionofstrength said:
It seems t3/t4 has raised your temp and pulse

Actually, I've been on the T4/T3 for about 6 weeks, but when I was on the NDT my temps and pulses were the same. Even before I was on any thyroid meds my pulse was always about 90. And temps may be more consistent now, but they were never much lower. I suppose I actually feel warm more often now-- Yet even with good temps and pulses, I have lots of hypothyroid symptoms.

visionofstrength said:
but there may now be side effects from needing more nutrients to fuel your higher temp and pulse. For example, 100 grams of protein would be a minimum for your temp and pulse, and so would 120 grams of sugar, or the equivalent, say, the juice from almost two pounds of ripe oranges.
Can you compare your readings from your cronometer to mine (below)? If you can try to be about 80% of my protein and sugar totals, you may be ready to reduce the t4/t3 - and eventually keep your metabolism high even without t3/t4.

So I'm only 5'1 and I'm female. 80% of your total calories is about 2400. I've been gaining weight on about 1850 calories. Do you think increasing my calories that much would be problematic?

Protein is my biggest macro problem. I'm getting close to 100 grams of protein every day, but it's a struggle. Milk and whey cause really bad acne for me. I seem to do a bit better with greek yogurt and some cheese, so I eat those every day. Also have a problem digesting gelatin. If I make gelatin gummies, those seem to digest ok, but I have trouble getting in more than about 5 grams of protein per day with gummies. I can't really digest hydrolyzed or non-hydrolyzed gelatin when mixed into drinks, even when fully dissolved. Even a teaspoon per day of the hydrolyzed causes digestion pain.
So I eat a lot of white fish (and the weekly liver), but there's only so much white fish I can swallow. You're getting 200 grams of protein-- 80% of that is 160 grams... can't imagine getting anywhere near that.

Also, whenever my carbs get higher than about 55% of total calories, I start waking up in the middle of the night around 2-4am-- probably adrenaline surge.

So I'm not quite sure where to start tweaking first.

visionofstrength · Jul 31, 2014

Since your depression is gone, and kudos to you for that! I'd like to start a new thread about these various tweaks you're thinking about, that I hope may be of interest to other women who visit this forum. The Getting Ripped with Dr. Ray Peat! thread has so far appealed mostly to men.

If you saw a thread here, Getting Sexy with Dr. Ray Peat! Would you click on it?

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