Zoloft(Sertraline) or T3(add toT4) or both? help please

[adin]

Hi, I had a difficult period last weeks perhaps because I was overmedicated(I was on 135mcglevo +1/2gr.ndt). I felt great for a period of time but then symptoms of overdosing have appeared in short time, insomnia(many nights with no sleep at all) , anxiety, shivering, hot face, sweating palms, nervousness. The fT4 was not so high (24.5->12-22.05) but it seems it was enough to make me sick. For about 3 weeks ago I reduced the levo dose to 125 and no ndt(fT4 now is 22 ; fT3 is 4->3,6-6,8 and TSH is 0.18) but the spaced out feeling, brain fog, anxiety(especially in the morning to 2 hours after I take levo and in the evening) and insomnia has not gone. Now my skyn and hair are so dry, etc. The doc. gave me sleeping pills(nitrazepam) and zoloft(setraline), she thinks I have depression. I decided to take only the sleeping pill, for now .

Now something weird is happening to me, one night i have deep sleep with dreams and wake up refreshed but the next night no( I sleep with CPAP ), strange pattern. When I try to fall asleep suddenly I startles (arousal or central apneas) and don't let me sleep. It seems that anxiety does not let me sleep though before I had no problem even if I was only on levo.

When I took ndt or T3 in combination with levo I slept like a bayby but in my stupidity I have not reduced the levo dose and I came to be overmedicated. Now I can not get out of this vicious circle and I do not know what should I do. If i will take zoloft my insomnia will be gone or just It will mask the my undertreated hypo symptoms. So I do not know what to do(I just know that I want my life back), take the zoloft, or should I try 5mcg T3 add to my 125mcg levo again or both ?

[puncturedbicycle]

I wonder if being a bit overmedicated has just made you feel pants and you need to reset - ? If you were adding ndt to your levo to feel better then I assume you don't feel well now because you're on levo alone. Does that seem plausible?

I guess I'd rather retrace my steps than add in a lot of other stuff. Can you bear to feel a bit under the weather while you go back to the combo that made you feel well, just at a slightly reduced dose? I'm not on ndt so not familiar w the dosing regimen, but if 135 levo + .5 gr ndt made you hyper, how about 100 levo +.5 ndt for a while, then if you're still flat you can always take slightly ore on alternate days until you feel better.

Your zoloft would take a few weeks to kick in anyway, so why not use that time to readjust your thyroid meds?

[adin in reply to puncturedbicycle]

Sincerely I am so confuse, I do not know where it comes from my unwell condition(so tired), it is from lack of sleep, or because I'm now only on levo. Also I am not sure that sertrlaine will help me. I'll want to try T3 and levo but I do not know what effect it will have sertraline in this combo.

[bluebug in reply to adin]

Don't take the zoloft as it can cause some of the side effects that you are trying to get rid off and takes weeks to work. The more drugs you add in the more side effects you risk suffering from.

[adin in reply to bluebug]

Yes i uderstand that but my doctor told me that apparently insomnia is linked to my depression(but i I don't feel depressed) and if i take zoloft then insomnia may go away. When I try to fall asleep suddenly I startles (arousal) and not let me sleep.

[bluebug in reply to adin]

You don't have insomnia you have sleep disturbances.

Loads of conditions including vitamin deficiencies, food interolances as well as thyroid disorders can cause it.

The fix in your case is to sort out your medication for your hypothyroidism.

Taking loads of drugs to go to sleep works in the short term but in the long term can cause other problems like addiction and masking of other more serious illnesses.

Also as you don't have depression you need to tell your GP like a broken record that you don't have it.

If the GP insists demand a referral to a physchologist or psychiatrist.

Do this twice. (If you are referred then take stuff on hypothyroidism with you to the appointment.)

If the GP refuses write a letter stating the appointments where you asked for the referral. (You must demand the letter is put in your medical notes.) Stating that if you had depression why was your request to see a suitably qualified specialist refused?

There is no physical test or physical examination that can prove depression.

So to get people normally women to go away without treating them properly some GPs tell the patient they are depressed and hand out antidepressants.

In your case the only treatment your GP could do is work out your dose of levo and if s/he knows you are self medicating to tell you to stop doing so.

[adin in reply to bluebug]

Sorry for misunderstanding, when I wrote about my doc. I referred to a psychiatrist who prescribed me Zoloft and sleping pills.

[Ruthi]

Sertraline is brilliant for genuine depression with anxiety - the best of the many anti-depressants I have taken in my lifetime. BUT I was genuinely depressed (sorted out by ditching the husband, but that is another story).

I cannot help feeling that its not the right thing in this case - what you need is to optimise your medication. I'd go back to where you started from and then go more gradually as you make the change.

I suppose its silly to ask if they tested FT3?

When my adrenals got upset by messing around with my dosing, I too had good and bad nights. I took the saliva cortisol test and my levels were high throughout the day - I think I just slept some nights- at least for a while, because I was exhausted.

What worked? The biggest thing was going to bed when I was tired (which was usually inconveniently early) so that I was going WITH my body clock, rather than trying to force it into the rhythm I wanted. I also used a lightbox all through that summer as soon as I woke - but right now you could just sit in the garden first thing. I also took Rhodiola in the morning, ashwagandha in the evening and gave up caffeine altogether.

[puncturedbicycle in reply to Ruthi]

All good ideas.

adin, I also think with your meds going up and down, this feeling awful and having trouble sleeping is a side effect of your levels rising and falling. I felt terrible - hair-raising anxiety! - when I tried to wean myself off levo (to try ndt). I couldn't hack it at all.

When your levels stablilise you may feel much better. And while the sertraline may help, it will take up to six weeks to see the effects. Just so you know, if you try it, it may not help for quite a while. You don't have to be depressed to take zoloft - it is used for anxiety as well - but if/when you being to feel better you will be faced with the choice of whether or not to come off it in case it's your thyroid meds that have sorted you out.

Do what you feel you need to do and try not to stress about it, but if you can stick it a little longer you may feel much better just sorting your thyroid meds.

[adin in reply to puncturedbicycle]

I really do not know what to do, I have an anxiety indeed but I don't know if the sertraline will help me. I think this anxiety is induced by levo and I'm afraid that it wan't be gone only with levo.The main question remain, I was able to sleep if I will take sertralina?

[puncturedbicycle in reply to adin]

adin I think there's no way to know unless you try it.

I used to take fluoxetine (different drug, same class of drug - ssri) and I found it made me feel drowsy and calm, but a lot of folk find it makes them restless and anxious and they have a hard time sleeping. It is an individual experience, like thyroid trouble is.

Either way, your thyroid meds need adjusting.

I do appreciate that when you feel anxious and desperate for relief it's very hard to relax and make decisions calmly. I'm so sorry you don't feel well. Treat yourself well. Do something you enjoy to give your mind some rest: watch a film or go for a walk or a swim, eat an ice lolly, be good to yourself.

Please try not to worry about your decision, just take a little while, an hour or so, write down the pros and cons, make a decision and then leave it. Don't obsess about it or make yourself a nervous wreck. Make your decision, reward yourself for doing it, have a rest, then act on it and consider it done.

I send you my very best wishes and hopes for improved health. Keep us updated. x

[adin in reply to Ruthi]

Thank you for your reply, sorry but I don't understand what is mean "lightbox all through that summer as soon as I woke " ? my fT3 is 4 -(3,6-6,8)

[bluebug in reply to adin]

A light box is often used by people who have SAD in the winter due to shortened day light hours. It makes them feel "normal" instead of depressed due to the lack of sunlight.

Some people have alarm clocks which mimic sun rise to them get up and feel "normal" when they do. Again these are used in winter due to lack of sunlight.

One issue with being prescribed anti-depressants is that no-one has clearly bothered to work out whether your depression is due to events in your life or due to chemical imbalances in the brain. Being hypothyroid and not being adequately medicated causes the former, and as it is a chronic condition then it is not surprising if you get depressed. This is probably why the psychiatrist said you had depression.

Oh and your ft3 could be higher it should be around 5. This is why puncturedbicycle and others have indicated you should try start again to sort out your thyroid hormones. However this time come and check with others on here what dose you should take and when, then double check before taking it.

BTW it just occurred to me due to it being summer so the weather is hotter and it is lighter outside you are going to naturally sleep less. As someone who also has sleep problems and I actually know other people who have sleep problems as well it would be far better for you to learn to "manage" the problem then take drugs and worry about not sleeping. If I can't sleep I get up go to another room and watch gardening or stately home programs on Youtube. It does get bad when you haven't sleep properly for days. In my case I have had to take time off work, which I don't get paid for, after not sleeping properly for 3-4 days as it is not safe for me to drive. One of my friends' mainly works at home so he avoids this but he suffers from chronic pain.

[Glynisrose]

Zoloft is an anti -depressant and as such negates your thyroxine.

[bluebug in reply to Glynisrose]

Yep.

If you scroll down to table 5 on this link it indicates how it can muck up your thyroid hormone levels - aafp.org/afp/2012/0801/p244...

Though the rest of the article is mainly junk.