Hormonal and thyroid augmentation

Domain IX · Biomedical, neuro & digital

What it is

"Hormonal and thyroid augmentation" is not a psychotherapy. It is a group of prescriber-delivered medical strategies: adding a thyroid hormone (liothyronine) to an antidepressant when depression has not responded, and using hormonal treatments (mainly oestrogen-based therapy) where depression or…

Format

• This is not a phased therapy; the framework below describes the medical pathway as the guidelines set it out and where the therapist fits at each point. Session counts are not defined by any source; the psychotherapy runs on its own schedule.
• NICE NG222 lists further-line options to be discussed and decided jointly, including adding or switching to psychological therapy, changing antidepressant, adding group exercise, or combining therapy with medication. For combination treatments it advises considering referral to, or consultation…

Evidence status, as the guide reports it

• For perimenopausal major depression, the NAMS/NNDC guideline keeps proven antidepressants as front-line treatment, calls CBT "a reasonable option" on preliminary evidence, and says oestrogen therapy has antidepressant effects in perimenopausal (not postmenopausal) women, while noting estrogen "is…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• early relapse signs; route to the prescriber.
• the client deferring entirely or feeling pressured; return to values.
• attributing all improvement or setbacks to the medicine; review both.
• the client minimising symptoms to avoid a change; normalise reporting.
• letters that recommend a specific medicine; keep to observations and questions.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.