Hello All, I am on 100mg Levothyroxine been to the doctor today regarding symptoms [exhaustion, anger, confusion] and although she suggested two weeks ago to stop taking antidepressant Fluxotine as it was not working she seems at a loss at what to do and now suggests taking a drug called Amitriptyline, I googled it and it doesn't seem like a good drug to me, what do other people think about this.

Last blood test results were:

Serum TSH 4.98 mu/L [0.27 - 4.2]

Serum free T4 level 11.4 pmol/L [11.0 - 20]

Basically the doctor is saying to me there is nothing else to be done regarding hypothyroidism, no increase in Levo etc, no other treatment other than antidepressants

28 Replies

Hello Tom

Are you depressed? Did you take the prozac & do you think it worked?

Have you ever googled a good drug? (sorry that's just me being obvious)

I was prescribed amitriptyline for various reasons which I can't remember (my daughter just to gain weight.. grr) we never took it... OK once prescribed for fatigue & joint pain... (which was actually low Vitamin D)

anyway your TSH of 4.98 is over range & FT4 11.4 is only just in range (low). SO You need more thyroid hormone - if I can see it then it must be darn obvious!

Doing my homework I see you've been vitamined already - PLEASE don't ignore vitamin/mineral advice - it's usually why you're hypo in the first place!!!

So If your doc won't increase your dose to allieve your symptoms (and ignore your blood tests) you still have options...

- Believe your doctor to be acting on your behalf & do nothing for you (peril)

- take more Levo and see if you feel better - explain later (slight peril)

- Buy your own & take your health into your own hands (mild peril)

Not sure if you're male or female regarding anger, not sure of the difference!

you could rethink/divert & use your anger to help yourself..

J :D

fellow sufferer & not medically qualified

Hello Spareribs, thanks for your reply, for me the prozac made absolutely no difference to me, whether I was taking it and when I stopped I felt exactly the same, I suggested the doctor increase the dose and she said if it didn't make me feel better then it wasn't working for me so I should stop. My doctor really doesn't want to increase Levothyroxine at all for some reason, not even by 25mg, she told me not to buy T3 off the internet when I suggested it. she tells me my Hypothyroidism is under control and now she is thinking I may have ME/CFS that's why she is thinking of .Amitriptyline. I tell you I am just about at the point of giving up all tablets and just drink red wine and eat garlic

Doctor is a sadist and ignorant - ignore. ME and CFS are what is called "dustbin diagnoses" - in other words a last resort of lazy doctors who don't want to treat you as there is no cure. You are so obviously undertreated I can't see why your doctor won't raise your meds. You can buy extra levo on the Internet, not just T3 (many of the same places).

When you are adequately treated for your thyroid you will not be in need of harmful drugs. Also your B12 and VitD need to be optimal and not bumping along the bottom of the range.

The vital clue to the puzzle is missing - the FT3 test. Which Docs seem loathe to do - but quite happy to think you have depression without a test. Could you have your FT3 test done privately ?

Thanks for that Marz, I must get the FT3 test done, I tried doing it via finger blood drip into a pot at home but did not get enough blood. I will have to go somewhere to have it done. Tom

Hello Hippocampal, they said I didn't send them enough blood, I thought there was enough in the pot but they said not. Tom

Hi, you are obviously undermedicated. Both your blood test results and your symptoms are indicating this. If your GP is not willing to increase your Levo dose, I'd recommend you change GPs until you find one that listens to you! My GP didn't listen either and wanted to give me antidepressants so I decided to self-medicate (I wasn't converting T4 to FT3 and I switched from Levo to T3) and then switched GPs. My new GP eventually prescribed me T3.

If your GP is rubbish (sounds like it!) then look for another one!

Btw. I'm taking 5HTP, it's a natural substance, precursor to serotonine, and it got rid of all my depression symptoms, no side effects. I'm happy as pig in sh*t 😃 I take a 100mg capsule every evening.

Hope you feel better soon!

Hello Amazon, thanks for your reply. I will take on board what you say and try to follow what you have done, i have got some research to do. Tom

Hi there. I was offered amytriptiline for my pain. I hose not to take it but that's because I am opposed to taking too many meds if at all possible. What a lot of doctors don't tell you is how and when to take medication which I think can help alleviate a lot of symptoms. I take my levothyroxine in the middle of the night with a pint of water so it's taken on an empty stomach. I just leave it by the bed so it doesn't disrupt my sleep too much. I also do Pilates which helps lessen muscle aches and pain. I notice a huge difference when I haven't done any for a week or two. Taking your meds on an empty stomach is key I think so it gives your levothyroxine a chance to work. My tiredness and grumpiness certainly has gone although I still need to go to bed before 9.30 each night👎

I m afraid I still don't understand my results and what they mean!

Hi tom210. I was on 50mcg Levo and also on Amitrpytyline for so called (diagnosed) Frybro. Let's just say the Amitrpytyline did not suit me. I did nothing but sleep from the meds and while awake I felt ill. I stopped the Amitrpytyline and realised it was not for me. I still felt ill and had the fog, exhaustion, pain etc. I found this forum (see my very first post), and they guided me. Now I am on 75mcg and take the B12 and B complex ( as per the advice on here) and no Amitrpytyline . I don't believe I needed it in the first place. I feel so well now in such a short space of time. I'm not telling you avoid the Amitrpytyline, I'm just letting you know my experience. You will get advice here on how to proceed, take note - it worked for me.

All the best

Would you kindly tell me what dose of Amitriptyline you were on? I was prescribed 10 mg, then 25 mg for PHN (Pain after shingles) low doses but even that has to be tapered off slowly. Difficult to get doc. appt. so am weaning off myself. Ami. worked well at first and helped with sleep but I don't want to become "hooked" Thanks

Hi I can't remember the dosage, only that it was 2 tablets at night. It used to wipe me out and I slept for Queen and country. I didn't like the effect when I woke up - I did not feel 'refreshed'. But I still didn't feel well. I had confusion, I was like a zombie. Not good for someone who does accounts for a living! I took myself off them ( I think I had a light bulb moment). Once they were out of my system I knew it was the right thing to do, but still did not feel well. My b12 had a low reading so have been taking B12 and I am convinced this is helping me to feel better. I too have had shingles, and appreciate the pain you have. If I still have the box at home I will look up the mg and get back to you.

Good of you to take time to reply, a lot of what you say rings true with me. I am a bit sorry to have taken the Ami. but would have swallowed anything to get relief from shingles . I am a wimp and maybe should have braved it out . Too late now but I've learned a lesson, it is also kind of you to do a search for box - hope you find as I would love to know, Thanks

Doxepin cream (tricyclic antidepressant cream) is the best treatment of PHN alongside with acupuncture. I had shingles 8x so unfortunately I have quite a lot of experience with this :-/ Most GPs don't even know about Doxepin for PHN... I hope you feel better soon! Work on your immune system (probiotics, lactofermented foods, avoid gluten and grains!) and you'll have less chance of getting shingles again! I haven't had it for about 7 years now!

I have never heard of doxepin cream and the websites I looked at seemed to be more interested in selling Viagra Eventually found a site but cost absolutely beyond me. Think I'll just keep on with the aqueous calamine! Good of you to share your story and advice - can't imagine having shingles 8 times!!!

foxglove To dry off the blisters the best thing one can do is mix bicarb with a bit of water to get a thick paste and put that on. It's very soothing too and dried off my blisters in 2-3 days. Are you in the UK? My GP prescribed me the Doxepin cream so it was free! I hope you get well soon!! PHN sucks!

Do you actually think you are depressed or is this their diagnosis.?

I was given amytriptaline once in response to my m.e symptoms it made me very ill and I never took it again. It is a particularly nasty anti depressant. I was given it for sleep, I wasn't depressed I was ill.

If your GP won't help have you condsidered self medicating perhaps adding in some t3? Your t4 is very low and your tsh still not optimal.

I got my thyroid optimal myself and then convinced endo to prescribe, so I always think it is better to take things into your own hands rather than suffering at the hands of an ignorant and unhelpful GP, then if what you do Iimproves your health you tell them straight what you are doing and ask to see an endo. Who may well be as stupid and useless as your GP but on the evidence you have gathered of how much better you are may actually prescribe what you need.

Can I just say that many people with rheumatic diseases take Amitriptyline with good effect - it is rarely used to treat depression these days. It isn't addictive and is used to help people, sometime children with bed wetting issues as it helps with bladder control. It is used mostly for people with chronic pain of all kinds. I'm not saying it's a great drug for all - it made my eyes very dry and gave me heart palpitations - but at the low doses it's prescribed at now it isn't "a particularly nasty antidepressant" although some may find it nasty in the way it affects them.

I think that in comparison to the more modern anti depressants and my experience of the mental health system I stand by my statement that as an anti depressant it is a particularly nasty one. I have a friend who is a nurse who describes it similarly. We can only use the term nasty in relation to how something effects us, what else is there to gauge something by?

My point is that most people who take it aren't prescribed it as an antidepressant because, at the kind of doses it was used for this purpose, it was unsustainable. So it may have once been a particularly nasty antidepressant at say 80mg or more, but most people take a fraction of that now - 10-30mg - some to very good effect indeed. I have tried all the relevant antidepressants for RA and nerve pain and have found ones like duloxetine very scary to try and come off. I did have adverse effects after three years on Amitriptyline so had to stop taking it. But I know many people who use it for pain and swear by it.

It is the least powerful of this antidepressant family and I wouldn't put anyone off trying it.

Hello Sulamaye, thanks for your reply, I will hold off the amytriptaline for the moment and try to get some T3, if the doctor won't prescribe it I wii get it off the internet. Tom

I was left on amytriptyline by my pants GP and eventually completely stopped as it was useless and the side effects were extensive. Having made many changes to my regime over the years I happened upon Kelly Brogans 'A mind of your own': an excellent discussion of alternative drugs for mood, sleep etc and an extensive coverage of diet and supplements. As said above your GP is falling into the 'prescribe anything to shut her up' stage of treatment. Its much easier to do that than to actually investigate the problem fully and really listen to you.

It is used in low doses as a muscle relaxant and to aid sleep. One of the side effects is a dry mouth. It will also increase the effect of painkilling medication. It doesn't suit everyone, but some people do find it helpful.

I had a very bad time taking amitriptyline and put on a huge amount of weight. As others have said you need an increase of thyroid medication.

I agree that you are very under medicated for your thyroid. I can't think what to suggest apart from being really firm with your GP or finding a better one.

Back in the days before my hypothyroidism diagnosis was confirmed, I had the "depression" thing.....anger, nasty spiteful short fuse, depression in the fact that I just simply didn't want to leave the house and participate in anything. I had a few things going on in my life too so my GP put me on Citalopram which probably had a sort of placebo effect for a couple of weeks and things then got very strange; phantom smells, suddenly freaking out on a walk in the woods for no reason at all and a few other strange things. GP thought maybe SSRI's was not the answer and put me on a tri-cyclic AD, yes Amitryptaline! More commonly used now for chronic pain relief but he thought it would be good because it would also help my dreadful insomnia (another symtom of hypo-t). It did the job admirably, I'm afraid I cannot remember the dose I was on.

Things rumbled on, I put on weight. After a full blood panel ordered by the nurse because i had a gouty toe the results came back with a TSH of around 28 and low T4. Bingo! Put onto Levo and have now levelled out to a TSH of under 1 with reasonable FT4.

For you....and I would place a bet with a lot of money on need your Levo increased. You probably don't need AD's at all it's all part of the symptoms of being hypo thyroid!

The info given and advice on here is correct. I came off the amitryptaline by way of weaning off over a couple of months, don't stop it sharply.

If your doctor cannot see that you need your Levo increased or at least try it and titrate you properly and thinks this is all about clinical depression and the handing out of antidepressents then change doctors because she appears to be out of her depth. Maybe I'm harsh but can she not see that you are over-range and with levels like that you will not be "well".

Doctor is wrong. Your FT4 is low. And who knows how your FT3 is, since your doctor only takes TSH and FT4. However, note that your TSH is over both the AACE range (0.3-3.0) and the Functional Medicine range (1-2). Do you have access to another doctor who is not stuck in the TSH-T4 rut? The very least you should do is up your levo.

Anti-depressants are a dead-end. I did not tolerate any of them well. Don't forget that BigPharma ADs are substances that are foreign to your body chemistry. T3 is a better AD than any of them.

Might be better just to treat your hypothroidism adequately. I'd be %&*!@ angry and exhausted if I was left with those results. Confusion could be low B12 or just hypo brain fog.

TSH should generally be under 1 and FT4 (and FT3) in the top quarter of their ranges. Change your GP, that one is never going to make you well. TUK has a list of GPs and endos with more of a clue. If you can't change doctor right now, try and demand a referral to an endo.

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