Hypothyroid? or am I just a victim of anti-depressants side effects ?

[shond2015]

If you were prescribed Antidepressants prior to being diagnosed with hypothyroidism - you may well be interested in this post which relates to my recent appointment with a specialist Endocrinologist who is also the hospital's Medical Director. He has over 25 years of specialist knowledge.

After a fairly rapid weight gain of almost 2 stone, heavy perspiration at the slightest exertion, extreme fatigue, listlessness and general feelings of weakness, along with other symptoms such as freezing cod legs and body, brittle nails, body hair loss, abdominal bloating to the point of being bent double, I was diagnosed with Hypothyroidism. Over a period of 18 months I have been given a progressive increase of Levo, starting at 75mg up to my current dosage of 175 mg.

However, symptoms have not been not improving. On the contrary, I have been getting progressively worse. I used to have one or two days reprieve before suffering the debilitating symptoms if hypothyroidism. Now it is daily torture.

It is the stomach trouble that has caused me the most debilitating effects however, My GP has been quite helpful in the sense that he has organised various tests over this 18 month period. All tests (even the Ovarian Cancer Scan) have come back negative (thankfully) but with my symptoms becoming more and more debilitating, he finally organised an appointment with the Endocrinologist.

and what an eye opener!!!!

I saw the Endo on Friday -and...... I was amazed - no.....gobsmacked.....to be told by this specialist that after looking at all my blood test results over the 18 months, coupled with the fact that even on a high dosage of Levo, he was quite sure I wasn't suffering with Hypothyroidism at all.

I was totally thrown by this. I argued that I had all the classic symptoms and sufferings of hypothyroidism. He said that with his experience of 25 years he was fairly convinced that my symptoms were as a result of another drug I was taking - the anti-depressant, Sertraline. His argument for this I think was due to the progressively worsening symptoms I am experiencing coupled with the high dosage of Levo. In fact, he got his staff to bring him the latest Drug Classification book and read me the side effect symptoms from the anti-depressant pills (Sertraline) that I have been taking since November 2014.

If what he says is right, obviously it is a huge relief for me. But I am still flabbergasted and sceptical. He has taken another blood test to look for anti-bodies and has told me that if test proves positive, then I will stay on Levo but a lower dose - but if proves negative (I sincerely hope it does) then I have to be weaned off both drugs slowly.

Am going to make an appointment to see local GP this week so will let you know the results. e.g. Am I hypothyroid or just a victim of these drug companies. Fingers crossed !!

The reason I am posting this news is to warn others that you were taking antidepressants (before diagnosed as hypothyroid) and have subsequently been diagnosed with hypothyroidism - you could be suffering all the symptoms and effects of the condition but not actually be hypo. Shond2015

[shaws]

Your experience is not uncommon, I believe, and members have suffered in various different ways.

So many members are offered anti-depressants (usually after diagnosis) because they keep complaining of symptoms and the doctor tells them it cannot be that as the are 'normal' (meaning they are somewhere in the range for TSH. They are unaware we need it to be 1 or lower.

The never test Free T4 and Free T3 and I would ask your doctor or Endocrinologist to test these two and I'll give you a link but it may be preferable to have them yourself.

Liothyronine T3 is the only active thyroid hormone needed in our billions of receptor cells. Levothyroxine is T4 only and has to convert to T3, we may not be able to convert or aren't given sufficient to meet the needs of the patient.

So many people are misdiagnosed because the proper tests aren't taken. Doctors and Endocrinologists appear to not be trained adequately about hypothyroidism. The have been told only to diagnose when the TSH reaches 10 (in UK) whilst in other countries it is 3+.

Blood tests should be the very earliest possible, fasting (you can drink water) and allow about 24 hours gap between last dose of levothyroxine and the test. The reason being it may be in our favour as TSH is highest a.m. and drops throughout the day, which may mean a dose is adjusted unnecessarily and patient can never feel well.

If you can afford it we have some recommended labs which will do all the ones you need and it can be done at home (pin-prick tests) and members who've done so will also respond. Always get a print-out of your results with the ranges and post them if you have a query.

I doubt you'd not be hypothyroid as, I believe (and am not medically qualified) you would have symptoms of overdose.

Your GP should test B12, Vit D, iron, ferritin and folate as we can also be deficient.

thyroiduk.org.uk/tuk/testin...

thyroiduk.org.uk/tuk/about_...

The following - read about FT4 and FT3

thyroiduk.org.uk/tuk/testin...

On your dose, if you aren't converting properly, your T3 will be low.

[Clutter]

Shond2015,

What were your thyroid levels when you were diagnosed with hypothyroidism and what are they on 75mcg?

If those symptoms are due to adverse effects from Sertraline wasn't it suggested that you should switch to a different antidepressant or wean off Sertraline?

[shond2015 in reply to Clutter]

Hi there

In response to your question......No......simply because when I went to my GP almost in tears August 2015 with such horrid symptoms - he took a blood test...saw my thyroid levels were low and told me I had an underactive thyroid...put me straight onto 75mg. He obviously didn't consider for once, my symptoms may be side effects from anti depressants.

I am still unsure myself though .....only given this diagnosis on Friday afternoon. As I said in my post...still quite sceptical but if it turns out that my antibodies are negative...then it will indicate, apparently that I am definitely not hypo.

[Clutter in reply to shond2015]

Shond2015,

Negative antibodies does NOT rule out hypothyroidism, it rules out autoimmune hypothyroidism. It is your thyroid levels which indicate hypothyroidism so high TSH indicates primary hypothyroidism due to thyroid failure.

Some drugs induce hypothyroidism. If you had drug induced hypothyroidism you would need Levothyroxine until the drug which induced it was stopped. Sertaline does not induce hypothyroidism but it may lower thyroid levels. I can't believe your GP will have prescribed Levothyroxine and raised dose to 75mcg without blood tests confirming TSH over range.

[shond2015 in reply to Clutter]

its bloody incredible isn't it!

[shond2015 in reply to Clutter]

You know.....he read from this big drug definer book - and he ready out hypothyroidism. When I got back I took out the leaflet from the Sertraline back and searched for hypothyroidism - and you are absolutely right...it suggests it lowers the thyroid levels but I couldn't find anywhere where it stated hypothyroidism. I then thought maybe his book had a more thorough explanation than those in the drug packs? I am extremely perturbed now.

[Clutter in reply to shond2015]

Shond2015,

I was taking 200mcg Sertraline when I had my thyroidectomy and I was recovering on 60mcg Liothyronine for 3 months but became extremely unwell after I was switched to Levothyroxine. It wasn't Sertraline that made me unwell.

[greygoose]

After all I've read on here, this really doesn't surprise me at all. It would be funny, if it weren't so sad. And, you really do wonder how a man in his position can be so ignorant. Antidepressants do not cause antibodies, as far as I know. And, basing everything on a second test is a bit like playing Russian roulette with a bullet in every chamber. Antibodies fluctuate, and you never know when they're going to be high and when they're going to be low. And, even if they come back at the same level as before, that is no basis for reducing your dose. The man's a lunatic. Ask for a second opinion.

As Clutter says, do post all your blood test results, as it will be interesting to see exactly what was tested, and what the results were.

[shond2015 in reply to greygoose]

Hi Greygoose

The Endocrinologist isn't suggesting that the anti depressants are causing antibodies. He is merely trying to rule out hypothyroidism. He has said that if the antibodies are negative...rather than positive this will indicate that I am not hypo - apparently.

He also explained about T3 and advised that contrary to opinion on the thyroid site....that T4 will always convert to T3 - he even drew a diagram to show me.

As I've said. I am a little sceptical right at this moment and now have to wait and see what the tests will show.

If I am able to get a print out of all my blood tests over the 18 months...I will certainly put them on this site for you to look at.

[greygoose in reply to shond2015]

OK, but he is still totally wrong. If you have once had a result with high antibodies, then you have Hashi's, and will always have Hashi's, no matter what subsequent blood tests say. It doesn't go away. And, you will eventually becomes hypo, even if you aren't, now.

But, even if you aren't hypo now, it's best to take levo to support the gland during antibody attacks. And, ideally, you should take enough to suppress your TSH, in order to lower antibody attacks.

But, even you have no antibodies at all, you can still be hypo - not all hypos are Hashi's.

And, what's more, not all Hashi's sufferers have high antibodies. They are diagnosed by an ultra-sound scan. So, he doesn't really know what he's talking about on any level.

Also, I fail to see how anyone can prove with a diagram that everyone converts perfectly. For a start, that's just not true. Conversion can go wrong, just like any other function in the human body. Secondly, you can explain how conversion works in a diagram - perhaps - but to prove that EVERYBODY, without exception is capable of doing it? There's no way on earth to prove that.

[Angel_of_the_North in reply to shond2015]

T4 converts to T3 if all the co-factors (like B12) are present in high enough amounts and you don't have a gene problem or something else that prevents it. Unfortunately, many people do seem to have something that prevents the conversion.

[shond2015 in reply to greygoose]

You know.......these GP's and Endocrinologists have all the theory and they certainly know what and how the body should respond. What they don't seem to get is that the body doesn't always behave just as the theory books suggest. He made me feel quite stupid to be honest - and I actually said to him.....your making me feel as though I am a hypochondriac. he laughed and said if he thought I was, he would be asking lots more questions.

He told me that he would be writing to my GP to advise that I am not Hypothyroid and that I would need no further referrals.

Ask me whether I liked him or not!!!!

[shond2015 in reply to shond2015]

then again........Better not!

[greygoose in reply to shond2015]

But, that's the whole problem, they don't have all the theory, and they don't know how the body should respond all the time. Some of the stories and explications I've heard would stand your hair on end! They are really, very ignorant, about most things. They just pretend they know - perhaps they even believe they know - but they don't. I asked one doctor about the purpose of lymph. He put on a superior face, as if I was an idiot, and came out with some made up yarn. What he didn't know, was that I did know the answer to that question, and was just testing him. He failed. But, I didn't tell him, no point. He wouldn't have listened, anyway.

That doctor obviously wanted to make me feel small and stupid. And, when I asked him for something for the pain, he sneered at me and said 'any idiot can go into a pharmacy and buy a packet of aspirin'. I didn't argue, I was in too much pain. But, just goes to show what was going on in his head. I've seen so many like that. There was, once, a doctor that I adored. We were on the same wave-length. But, his ignorance just took my breath away! I had to leave him before he killed me! lol

[shond2015]

I couldn't agree with you more .....I think doctors are a lot like teachers...they think they know everything and we are the ignorant ones.

My professional career was about recruiting the top notch commercial pilots for the top airlines. I can't tell you how many times I interviewed pilots who had all the right certificates and had passed all their flying exams - both technical and physical - but my god....I wouldn't have given them a job with BA for all the world!

With respect to my experience on Friday.....I have to tell you I did try to stand my ground in respect of my symptoms being side effects of Sertraline. I told him that the side effects he was reading out to me were applicable to most drugs. He just ignored me. I actually don't think he was listening to me. I so wish I had taken my phone in the consulting room and recorded the meeting.

Just want to thank you all for your responses and replies. I will let you know the next instalment to this saga! making an appt to see GP for results next week.

[banshishi]

i agree that sertraline could be why you are having symptoms but it doesn't mean your thyroid status has changed, just the drug is masking any recovery you may or may not have been experiencing on the thyroid treatment. I would be inclined to ask to stay on thyroid treatment and wean off sertraline. I can sympathise with you in terms of sertraline, the worse year of my life was spent suffering on that stuff which is why whenever my drs mention antidepressants to me they get told to insert them in a sunless area!!

[shond2015]

thanks very much for your reply and I can completely empathise with you. I had no idea that these drugs actually did give off such awful side effects - to tell you the truth I always thought that the warnings were simply there to cover the medical scientists! Even though I was told to stay on both drugs (sertraline and levo until I have seen my GP with blood results, I haven't taken a Sertraline since my meeting with Endocrinologist). The side effects of stopping sertraline will be minuscule compared to the symptoms I am having to endure at present! I like your response to being offered the drug! might use it myself in the near future!