Thyroid hormones’s primary role is to increase the metabolic rate of every cell in the body. In simple terms, thyroid hormones make everything faster. For example, this includes the rate at which nutrients are metabolized, neurons communicate, hairs grow, or wounds heal. In addition to increasing the metabolic rate of every cell, thyroid hormones also increase blood circulation, which itself also promotes healthy joints, tendons, skin, hair, and nails.
Thyroid hormone deficiency can produce a hypometabolic syndrome that manifests as depression, fatigue, slowness, brain fog, weight gain, or poor circulation.
It is no coincidence that thyroid hormones are one of the most studied augmentation agents in the treatment of depression. Thyroid hormones stimulate monoaminergic neurotransmitter systems (serotonin, dopamine, noradrenaline) and therefore improve energy, mood, and motivation.
If thyroid hormones improve, antidepressants and stimulants (including coffee) are much more effective and sometimes dosages need to be reduced, or can be phased out completely. Even in non-depressed people, supplemental thyroid hormones tend to improve mood and make the mind “quicker”.
(Of note, in general, many hormones do have potent effects on monoamine transmitter systems. However, monoamines can be high even if hormones are low, and monoamines can be low, even if hormones are high.)
Personal experience
A couple of years ago, I found out that my thyroid hormones are at the lower end of the reference range. After lifestyle interventions did not help (presumably because I was already at my healthy baseline), I decided to take them despite no proven deficiency from a TSH-based reference frame. I do not fully replace my endogenous production but only “supplement” with them.
I had been taking low doses of thyroid hormones for about six years and supplementing with thyroid hormones, in particular a low dose of T3, improved many aspects of my general health, energy levels, sleep, and life enjoyment. I could also work for longer and with more stable energy.
Whenever I stopped taking them, I felt more tired after waking up, my mood and general sense of well-being took a hit, and I needed to drink coffee or take other stimulants to maintain a similar level of functionality, my sleep duration increased, energy levels decreased, and I was cold for a couple of weeks. I also got more infections (which I rarely get).
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After a few weeks, things seemed to gradually get better, though, all things considered, I found that, for me, life was a little bit easier and better if I supplemented with low doses of thyroid hormones.
I recently stopped taking them because the addition of metreleptin to my regimen boosted my thyroid hormones from the low-normal to the high-normal range and I felt that the additional T3 dehydrated me and made me a tad more restless. Time will tell whether I go back to thyroid hormones or not.
Signs & symptoms of low thyroid hormones
- needing a lot of sleep
- being tired in the morning after waking up
- getting easily tired at rest
- over-reliance on caffeine
- puffy & pale face (especially in the morning)
- a lowish heart rate
- an inability to lose weight
- having low energy levels
- dry skin & hair & nails
- poor wound healing
- frequent infections
- cold hands and feet
- poor concentration
- slowness in thought
- brain fog
Diagnostics
When it comes to determining hormone function, a blood test is not enough. Just as important are signs & symptoms (and some doctors claim, perhaps rightfully, that signs & symptoms matter a little more than lab values when it comes to diagnosing hormone deficiencies).
- Blood test: TSH, fT3, fT4 (optional: reverse T3)
- Vital signs: low body temperature, low heart rate, a small difference between systolic and diastolic blood pressure
- Presences of symptoms (see above)
Intervention that worked for me and friends
- Thyroid replacement therapy: Desiccated thyroid or T4/T3 combination therapy – the T3 needs to be taken at least twice per day, ideally trice. Ideal doses and regimens need some trial & error.
- Avoid: eating too many cruciferous vegetables as they contain goitrogens; only looking at lab values for diagnosis or monitoring treatment
Sources & further information
- Opinion article: Dr. Linder – Thyroid hormone
- Website: Wikipedia – Thyroid hormones
- Scientific article: The Link between Thyroid Function and Depression