This is my second reduction of levo and its affecting the dose of the nortriptyline. As the levo dose reduces so does the nortriptyline. It's giving me withdrawal type symptoms. Hot flushes chills muscle twitches tingle hands and uneasy tummy feeling. A normal reduction of levo without the ith med has never given me these symptoms. Usually have felt well agrin quite soon after reducing. At moment feel awful. These symptoms started 4 days after reducing levo which correlates with timing to experience w/d from nortriptyline. Wish I had known that each med enhances effects if each other. Going onto nortriptyline made me HYPER after being on it for 18months. My levels were gradually getting lower and lower. I don't function well on TSH below 2 and so going really low gave me anxiety symptoms. Hence blood tests and on results a reduction.