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How T3 Thyroid Hormone Helps Reverse Depression [6 Tips to Start Taking Action]

Do we actually have a depression epidemic?

Or do we have an untreated thyroid epidemic?

After treating hundreds of depressed hypothyroid patients I tend to think it's the latter.

You see...

​I've found that treating depressed hypothyroid patients with the RIGHT kind of medication at the RIGHT dose almost completely eliminates (or at least significant improves) the majority of "depressed" patients!

And it's no wonder why so many hypothyroid patients are depressed.

These are just some symptoms that untreated thyroid patients deal with:

  • Hair loss by the clumps
  • Constant weight gain with no end in sight
  • Crushing and debilitating fatigue
  • Chronic pain over their entire body

​How can anyone stay happy with symptoms like these?!

And yet, when you go to the doctor you are told it's all in your head. ​

That's what I want to talk about today...

How using T3 Thyroid Hormone medication can help treat and REVERSE depression in hypothyroid patients.

Let's jump in: ​

More...

We are looking at Depression all wrong

​The main problem with addressing and treating depression has to do with how we look at it. 

We are told (Doctors and patients) that Depression is caused by an imbalance of your neurotransmitters.

Everyone would have us believe that if you are depressed you have low levels of a neurotransmitter called Serotonin in your brain.

And it's this chemical imbalance that causes all of your symptoms.

​I'm not going to go into why that's wrong because Kelly Brogan has done an amazing job - I recommend you check out her work here

Basically, ​60 years of research has proven that depression is NOT caused by a serotonin deficiency. 

Depression is NOT caused by a serotonin deficiency

(This is an image taken from her Website with quotes from Psychiatrists giving their opinion on the Debate) 

​So if depression isn't caused by a serotonin deficiency, then what causes it? 

What actually causes depression​

​You are made to believe that depression is caused by a single chemical imbalance, because then the treatment becomes very easy - a drug.

But that just isn't the case.

Like many other diseases, depression is caused by a number of different imbalances in the body.

​Depression can be caused by any of the following:

  • Hormonal imbalances (Including hypothyroidism, adrenal fatigue, low testosterone and estrogen dominance)
  • Food allergies or sensitivities
  • Imbalances of fatty acids
  • Emotional or physical stress
  • And the list goes on...

​In the real world depression is caused by a number of different factors and in order to treat the condition you have to find the root cause. 

​Based on my experience hormonal imbalances (listed as #1 cause above!) is the MOST common reason I see patients being depressed. 

And on that list is Hypothyroidism - so let's talk more about that. ​

Depression is a symptom of Hypothyroidism

Doctors are taught this in medical school for crying out loud. 

It's even listed on the Mayo Clinic main website as a symptom of hypothyroidism.​

List of hypothyroid symptoms including depression

​So why is it so overlooked?

Well, it boils down to a couple of reasons:

1. Doctors wrongly assume that if the TSH is in the "normal" range that your thyroid is fine.

Has this happened to you before?

You just know that something is wrong, but your doctor keeps telling you that your thyroid is "fine".

Eventually you start to think that everything is just in your head, or that maybe you're crazy.

​I can't tell you how many patients I find that are being under treated when it comes to their thyroid medication. 

Often times just putting them on the right type of medication or increasing their dose is enough to help significantly.

If you feel you fall into this category, read this post on how to accurately diagnose your thyroid problems. ​

2. Most Doctors don't know how effective and safe T3 medication can be in treating depression.

Let's provide some quick background on this so everyone is on the same page.

When I say T3 medication I am referring to giving someone the active form of thyroid hormone.

There are 2 ways you can get this kind of medication.

Taking it by itself (the medication is called Liothyronine or Cytomel).

Or, getting it in combination with T4 in the form of Natural Dessicated Thyroid.

​Almost every Doctor is willing to give you T4 medication (like Synthroid) but very few are willing to give you T3 medication (like Liothyronine or Cytomel). 

​Unfortunately most people (about 90%) do significantly better on some form of T3 medication. 

​Let's take a look at some of the studies showing the effectiveness of T3 medication in treating Depression...

Studies showing how effective T3 is in the treatment of depression

​Doctors pride themselves on being "evidenced based". Meaning, they like to base their treatment on literary studies that "prove" a treatment is effective. 

This is why most Doctors love to prescribe medications. 

Medications can be compared to a control or "placebo".

​If the medication is superior to the placebo, by a certain margin, then it is considered to be an effective treatment. 

​The interesting thing is, we've done these studies with T3 medication. 

Take a look at this study:

Depression treated with liothyronine

​This study showed that adding Liothyronine or T3 medication to an antidepressant (in this case Sertraline) is more effective in treating depression than using an antidepressant alone. 

Another very interesting point is that adding liothyronine did not increase the number of adverse events! (which is what more doctors are scared of when prescribing liothyronine).

​And this isn't the only study to show that adding T3 medication can help improve mood and reduce symptoms of depression. 

​Another study showed that adding Liothyronine or T3 medication to T4 only medication resulted in "improved mood and neuropsychiatric function". 

​Or how about this study - which showed that adding liothyronine or T3 medication resulted in better mood AND decreased weight! (Maybe that's part of the reason people weren't so depressed!). 

​The list of studies showing how effective T3 medication or Liothyronine is in treating depression continues to grow.

But this begs an even bigger question:

Is Liothyronine a new amazing treatment for depression, or do we just really have that many under treated hypothyroid patients running around?

How I look at Depression in my office

Remember that depression is a symptom, it is NOT a disease entity!

It's a sign that something inside of your body is out of balance.

It could be related to hormonal imbalances, nutrient deficiencies, poor diet, emotional stress or due to a number of other reasons.

The treatment for depression shouldn't always be an anti-depressant!

This is ​how I look at diagnosing and treating depression in patients who see me in the office:

1. ALWAYS properly evaluate the thyroid!

And I don't mean just looking at TSH.

You will need a complete thyroid panel, including all of the following tests:

  • TSH - Anything > 2.0 is a problem
  • Free T3 - Should be in the upper 1/3 of the reference range
  • Free T4 - Should be in the upper 1/3 of the reference range
  • Reverse T3 - As low as possible, anything > 15 is a problem
  • TPO antibodies and thyroglobulin antibodies - Both should be as low as possible
  • Sex hormone binding globulin - Optimal in females = 70-80, optimal in males = 20-30

Don't just get these tests but make SURE that they are in the "optimal" range!

​Don't settle for "normal" labs if you feel like crap

​Another important step in here is to make SURE you are on the right type and dose of thyroid medication. 

If you are currently being treated but still having symptoms of hypothyroidism then you may need a different medication or higher dose.

This article will show you how to properly test your body to see if your thyroid medication is working. ​

In my clinic I've found that most of my patients do better when T3 has been added to their medication in some form. This could be from liothyronine or from NDT. ​

2. Look closer at inflammatory markers in the blood

Inflammation in the body causes and is associated with Depression

​Because of this make sure your doctor is looking for inflammation in your body. 

I recommend the following tests:

  • Erythrocyte sedimentation rate
  • C reactive protein
  • Homocysteine

​It's more important to find the CAUSE of the inflammation than just knowing that inflammation is present, but ordering the right tests is a good place to start. 

I've found that a common instigator of inflammation in many patients is the hormone insulin.

Which brings me to my next topic...​

3. Pay attention to hormonal imbalances

Hormone imbalances in the body can directly cause depression, or can indirectly cause depression by increasing inflammation.

That's why it's absolutely critical to order ALL of the following hormone levels:

  • Testosterone - Low levels are associated with depression
  • Insulin - High levels cause inflammation
  • Estrogen balance - Too much or too little can cause depression
  • Thyroid hormone - This is a MAJOR driver of depression when low
  • Progesterone - Too little leads to estrogen dominance and can indirectly lead to depression

​Not only will imbalances of these hormones lead to depression, they can also lead to weight gain and other problems such as joint pain, acne and other chronic diseases!

That's why I check these hormone levels on EVERY patient. ​

4. Find and treat social stressors or emotional trauma

EVERYONE ​is dealing with stress - whether they admit it or not. 

The issue is that stress causes high levels of cortisol and cortisol can lead to depression and weight gain.

​While it may not always be possible to eliminate social stress from your life, it's important to be able to manage it. 

That's why it is so important to practice techniques that help lower cortisol and calm down the body, like: yoga, meditation or daily spiritual prayer. ​

5. Replace and replete nutritional deficiencies

Some very basic nutrient deficiencies can lead to or make depression worse.

It's important to check these on every patient because we live in a world where food doesn't have the same nutritional value that it once did, and we are more stressed than ever (causing further depletion of antioxidants in our body).

​If you have depression consider supplementing with the following:

These are just the basics, but they can certainly help get you started. ​

6. Consider advanced therapies like Neurofeedback​

Sometimes it can be VERY difficult to treat depression.

And in these cases it's sometimes necessary to pull out the big guns.

In cases like these I like to use a special therapy called neurofeedback (in addition to all of the above).

Studies have shown this to be an effective and LONG LASTING treatment for depression. 

And my in office cases would agree.

What is Neurofeedback?

Neurofeedbac​k is a special therapy designed to balance and recalibrate your brain waves. 

Special leads are placed on the head and brain waves are measured (alpha, beta, theta and delta waves).

​Once these waves are measured your brain is then compared to a data base of over 100,000 other brains. 

The computer algorithm then designs a treatment to "balance" and "recalibrate" your brain waves to match the controls.

Treatment consists of 20 to 40 sessions where you are placed in front of a computer monitor with a movie playing.

​When your brain waves are congruent, the video will play - when your brain isn't the movie will shut off. 

Each time this happens it retrains your brain to communicate with itself and recreate those pathways that have been loss.

This process happens as many as 70,000 times over the course of treatment!

Talk about some serious brain exercising...

​Neurofeedback when combined with the above treatments can be VERY powerful for treating depression. 

​Using this sequence and combination you CAN take back your life and recover from depression. 

You don't have to suffer from Depression forever

​If you've been suffering from Depression and you aren't sure what to do - use the steps above!

  • Check your thyroid function and if necessary try some T3 medication!
  • Look for inflammatory markers
  • Get tested for hormonal imbalances
  • Practice techniques to help reduce your stress
  • Replace your nutrient deficiencies
  • And consider neurofeedback

Now it's your turn!

​What have you tried for your depression?

What worked and what didn't?

Leave a comment below and I will answer!​


Dr. Westin Childs
 

I'm Dr. Childs and I write these posts. I'm a physician that specializes helping patients lose weight, have more energy and FEEL better. My practice focuses on hormone imbalances, thyroid issues and weight loss resistance. My goal is to provide the BEST information out there on the internet that is both actionable and trustworthy. Get my free ebook: Hashimoto's Diet Guide here. You can also find more about my personal journey back to health here.

Click Here to Leave a Comment Below 25 comments
Janel Clarke - March 25, 2016

Good article.. thanks! I am taking the time to give some feedback as suggested because I read the entire article and found the information to be relevant. Over the years I have tried everything, although I have had to figure most of this information out for myself. First diagnosed in 1994 as hyperthyroid (Graves), given radioactive iodine which resulted in a hypothyroid condition. After 15 years, I finally stumbled upon the need for Cytomel after moving and finding a different doctor. Although I was experiencing a great deal of muscle tension in my body and for many years there was no answer for that, so I suffered. Two years ago I made the decision to take Armour Thyroid but forgot to insist on taking the Cytomel as I assumed it was unnecessary as the more natural treatment would provide all the T3 that was needed. After 2 years of roller coaster lab results and a different doctor that was willing to work with me; we both realized I needed to start taking Cytomel again. I have since added a chiropractor (because yoga and Occupational Therapy were not helping the muscle tension) and slowly I realized I needed to find a doctor that was trained in Funcitonal Medicine. Of course there were many years of “major depressive disorder, recurrent” that came and went depending upon D3 levels and other nutrition. I found 5HTP and upgraded my diet substantially. This all has occurred through trail and error on my part. Without a clear understanding from the medical community I have experienced a few hospitalizations and a great deal of wasted time, energy, and quality of life even though I was motivated to whatever I needed to do.. I just did not know what to do. I hope I am now on the right track with finding someone that is more informed through an approach with functional medicine. Although, I have finally realized that blood lab results are not clear indications at all and so has my regular family physician. We have both seen the proof on this, and I will be following my symptoms much more closely as an indication of what is occurring instead of just ignoring them or putting up with them as an inconvenience. It helps to know what the symptoms are pointing towards. Thanks, JC

Reply
    Westin Childs - March 25, 2016

    Hey Janel,

    Thanks for sharing your story. I find that what you’ve experienced is really not that uncommon at all. Managing thyroid medication can be tough, but like I tell all of my patients – it’s just one piece to larger puzzle. I’m glad you have a family physician that recognizes that the current system doesn’t work for everyone, and I think that most Doctors probably realize this – they just don’t know what to do. But good for you for sticking to it and figuring it out. Keep up the good work!

    Reply
Melissa - March 25, 2016

Very good information!But Will this information still work for a person who had a Thyroidectomy,and has pituitary problems with a empty cella!! And is Armour thyroid and synthroid a good combination together for treating hypothyroidism and exct..

Reply
    Westin Childs - March 25, 2016

    Hey Melissa,

    Yes the information still works for those without a thyroid. The body must still convert T4 medication into T3, whether it is produced by the thyroid or provided through medication. Generally I wouldn’t recommend a combination of synthroid + armour, but it might work for some people…

    Reply
Stephanie - March 25, 2016

Hi Dr Childs,
Thank you, this is helpful information.
I was diagnosed with Hashimotos in 2014. When I was diagnosed, I was experiencing hyper symptoms and my TPO was 12. I went to see an endo for treatment and within a few months, my TSH went up to 5. My endo felt that I may swing back into normal range, which it did, so she didn’t want to prescribe any medication. Because I have all the symptoms of hypo… dry hair and skin, depression, weight gain, and fatigue, I went to see another endo in hopes that she would would treat me. She gave me a very small dose of Synthroid (1/2 of 25mcg). She feels that I may have Graves Disease. Is it possible to have Graves Disease, and have hypo symptoms? Can it be treated with T3?

Reply
    Westin Childs - March 25, 2016

    Hey Stephanie,

    Sometimes symptoms of too much thyroid and mimic symptoms of too little thyroid hormone – it all just depends on the person. In your case it would be worth looking at TSI antibodies (the antibodies for graves), to see if you really have it. In general, I have a hard time believing you have too much thyroid hormone in your body with a TSH in the 5 range.

    Reply
Gill - March 29, 2016

Hi
I suffer with severe depression an have been prescribed mirtazapine, venlafaxine, quitiapine tablets. I have also been prescribed 100 micrograms of thyroxine for an underactive thyroid. I have put on an enormous amount of weight 3 1/2 stone to be exact. I have also had an operation called a discectomy the removal of discs on my spine replaced with cages, screws an metal plates. I also have nerve damage in my shoulders, 2 blown discs and arthritis in my spine. So my exercise levels are quite non existent. I do house work etc an go on my exercise bike a little. Can you please help me or give me some advice please as I feel my GP can do no more.
I have read all of your information you have provided an found it really interesting. Could you maybe help me a little please ?
Thank you

Reply
    Westin Childs - March 29, 2016

    Hey Gill,

    With that kind of degenerative disease I would look at your insulin levels. Also, your weight gain is likely from the anti psychotic medications that they put you on (not the levothyroxine), they have a known side effect of weight gain. http://www.ncbi.nlm.nih.gov/pubmed/17474816

    It will be tough getting the treatment you need through your GP. I would look for a doctor that practices functional medicine near you.

    Reply
Keenan Willoughby - August 29, 2016

I found this article to be very helpful, now to get a doctor that will listen! I have hashi’s which has caused the hypothyroidism. I’m on Levo 112mcg. My dosage was 125 mcg but after blood work it was determined I was on the lowest end of my tsp level. I felt the best I had felt in years on 125! Now at the 112 the constipation, fatigue and weigHt gain has come back! I feel terrible! I’m going to ask about the cytomel.. Thank you

Reply
    Dr. Westin Childs - August 30, 2016

    Hey Keenan,

    It’s a good sign if you were able to feel better on the synthroid, but it certainly wouldn’t hurt to ask about the cytomel as well.

    I’m glad you found the article helpful!

    Reply
Lyn - August 30, 2016

Hi,

I was so happy to come across this article about using T3 for depression, something I’ve had great success with in the past. Maybe you can steer me in the right direction for my future. I was diagnosed hypothyroid 20 years ago after the birth of my daughter. I was actually diagnosed by a psychiatrist! I knew something was wrong, weight gain after losing all my baby weight, sluggish and bad depression. All my doctors chalked it up to “just being exhausted from having a baby and a toddler.” I know my body, and I knew that wasn’t the reason, but I didn’t know what was causing all these symptoms. I started seeing a psychiatrist for my depression who told me, before I put you on any medication, I want you to have your thyroid checked. Low and behold, I was hypothyroid. Normal TSH, but low Ft3 & Ft4. He put me on a combo of Synthroid and Cytomel and with a week I was feeling GREAT! My GP agreed to continue me on this combo and for about 10 years I was doing great. I lost my health insurance in 2004 and had to start going to a clinic where they would only prescribe Synthroid. My depression and other symptoms came back, not as bad, but I carried on. Fast forward to a little over a year ago, I became very sick. My depression was back, and I started having crazy new symptoms. Terrible joint pain all over my body, so bad Id cry myself to sleep. I found a WONDERFUL doctor who diagnosed me with Hashimotos. I told her my history and ask if I could go on NDT. She agreed, and put me on Naturethroid. She also tested for everything you listed above, as well as 24 hrs cortisol. Besides the Naturethrpid, I am also on compounded BHRT (Biest, Progesterone, Testosterone and DHEA), Omega 3’s, a good B complex (after a few months of B12 shots), D3 5000 mgs a day, Mag glycinate, NAC, selenium, Vit E and an Adrenal support supplement. My ESR, C reactive & Homocystine were high as well and I am now seeing a Rhuematologist. I meditate and practice Qi Gong on a daily basis… Yet I can’t shake the depression!! We tried the Synthroid/Cytomel route again, but it made me sick to my stomach this time, so now she just upped my Naturethroid from 11/2 grains to 2. I take 1 1/2 at 7 am and the other 1/2 at 1pm. Also my blood work always comes back very low TSH, but also borderline low Ft4 and low Ft3. Is there ANYTHING you can suggest, that we might be missing? My Dr. Is a DO and practices integrative medicine. She is very open and truly cares about getting to the root of her patients problems. Sorry this was so long, any advice would be appreciated.

Reply
    Dr. Westin Childs - August 30, 2016

    Hey Lyn,

    Unfortunately there could be 10 things you are missing, the easiest place to look for now would be at the reverse T3 level. If it is elevated then NDT or the combo of synthroid + t3 would likely be insufficient to treat the cellular demand your body has for T3.

    Reply
      Lyn - August 30, 2016

      Thanks so much for getting back to me so quickly. My Rt3 has been falling between 14 and 16. I’m not sure if that is good or bad. What you said about not getting enough T3 at the cellular level, did you mean I should possibly be treating with t3 only? I’d also like to mention my sugar and cholesterol are good, and I’ve lowered my antibodies through diet and healing my gut. I’ve been so frustrated because my current psychiatrist just wants to keep pumping me with different antidepressants, and I refuse to take them. I’ve been on so many through the years without any good results, and I know how much better I felt when I was first diagnosed hypo and put on the t4/t3 combo.

      Reply
Lourdes - October 4, 2016

Hi Dr. Child I recently had my tsh, my t3 & my t4 tested my reults came back with
t3 0.66 s that low
my t4 7.49 is that normal
& tsh 0.82
is all this normal or not

Reply
crumpelstilzchen - October 19, 2016

I really like this article a lot. I have been diagnosed with Hashimoto’s and am, consequently, hypothyroid. The doctor who finally, after I suffered for over a decade, took the time to check everything and diagnose me, found the right dosage of Thyroxin for me. Then an other doctor went by TSH only and almost halved the dosage (cold turkey)with terrible consequences after a couple of years. I have been arguing with doctors ever since, especially about my fT3. While my fT4 is in the upper range or higher than “normal range”, my fT3 is in the lowest possible “normal range at 3.7 (normal range 3.7 – 6.9). But, of course, because everything is in normal range, there is, supposedly, no problem with the thyroid hormones. That means my exhaustion, tinnitus, lack of appetite, consistent weigh gain, muscle/joint pain/stiffness must be depression (despite two psychologists and one social worker not seeing depression at all), no matter how much I insist that I AM NOT DEPRESSED (but probably eventually will be under these conditions). With hypothyroidism and depression sharing so many symptoms I would like to see my fT3 elevated by T3 supplementation before going on antidepressants. Should it not work, I can always take them later. But so far no luck convincing a GP(or endo, for that matter). In fact, even the mention of the huge gap between fT4 and fT3 is not well received, let alone suggesting to raise the fT3. In the meantime I have been off work for three months and feel like total crap most of the time. I have located a doctor who practices functional, integrative medicine and will fly out to see him in November. God, I hope he can come up with something. This is no life. Anyway, thanks for the article. It helped me to keep my confidence that I’m not completely out to lunch. I am already following the recommendations concerning diet, supplements, stress reduction etc. So that, too, was great confirmation that at least I’m doing my part to finding a solution.

Reply
Donna Willis-Radebaugh - January 1, 2017

I am a female, age 70. I have been treated for hypothyroidism for over 30 years with levothyroxine alone. I have also had ongoing depression which has not resolved or improved measurably with Prozac and now Effexor XR. My GP has only drawn TSH levels and now considers that I am overmedicated because of an elevated value. Over the last several months, she has reduced my dosage from 125 mcg, to 112, to 100, to 88, and now to 75 mcg at six week intervals followed by labs. Over the last two years, I have lost about 10 pounds by eating smaller more frequent meals. I am a nurse and am beginning to feel that I need a specialist to evaluate my thyroid function. What kind of specialist should I consider, outside of the obvious endocrinologist. I am intrigued about your comments on the addition of T3 to my drug regimen and would like a practitioner to consider this.

Reply
    Dr. Westin Childs - January 1, 2017

    Hey Donna,

    If you feel T3 might help your situation I would recommend you find someone who understands these advanced concepts otherwise you run the risk of simply being under dosed or under treated when you make the transition.

    Reply
Lisa - January 17, 2017

Hi Dr Child’s

I am doing a lot of research at the moment and found your article very interesting. My 15 year old daughter has been in a psych ward for the past 6 weeks. She was diagnosed with Hypothyroidism when she was 11 and has been on 50mg of levothyroxine since then. She has regular bloods and i’m always told “she’s fine, no change to dosage” She has been suffering with anxiety for a number of years and it just go worse and worse until she had a breakdown 8 weeks ago. She has been diagnosed with Anxiety and Depression. She had been doing CBT for anxiety before she landed in hospital and they are continuing with that treatment but it’s not working for her. Nothing seems to work. She was prescribed Olanzapine when she had the breakdown and she is still on that. They have started her on Sertraline now as well. They decided not to take her off the Olanzapine until the sertraline has kicked in as they were worried about a relapse. I am convince that her Thyroid is playing a part in all this. Also note that at the time of her breakdown she had not taken her Levothyrosine for about 4 weeks. What should I be looking for in her blood results? I have requested a copy of the results as I am unsure as to what tests were actually carried out. Sorry for such a long message but i am desperate to help her and battling against “converntional” thinking on the psych ward. Thank you.

Reply
Lou - January 21, 2017

Hi
I’ve had hashimoto’s diagnosed for about 2 years now they started me on levo which I didn’t tolerate made me very depressed… they lowered the dose and gave it to me in liquid form….even the smallest dose I had trouble with .. so I changed to ndt by self medicating..felt so much better no more suicidal thoughts but over time despite being on 3 grains I started to feel shocking again and my tsh started to rise again.. originally I had a tsh of 64 and a tpo of greater than 1300…I was fatigued..I hurt all over my moods were horrendous..I didn’t even like being with me …and massive weight gain..iv just recently been to see a 5th endocrinologist who told me to stop everything for now and that he would prescribe cytomel … I have them in my kitchen BUT I’m so scared to take them for fear of my suicidal mood swings getting even worse than they r now … iv lost my partner because of them .. so a few words of encouragement might go along way if u don’t mind …oh and ty for being 1 of the doctors who seems to understand …TIA

Reply
    Dr. Westin Childs - January 21, 2017

    Hey Lou,

    The single best thing you can do is to find someone who can trust to help guide you through this. There won’t be an “easy answer”, but through a combination of lab work and testing you should be able to improve your symptoms significantly.

    Reply

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