New to Levo - Does anyone know if you can also take - Tramadol 50-100mg daily (when needed) and St Johns Wort with Levothyroxine please?

Hi I've just been given a prescription for 25m of Levo daily as my antibodies are so high and I need to bring my levels down so I can restart ivf. It was stopped last minute around a month ago.

Does anyone know if you can also take - Tramadol, St Johns Wort and Levo please?

I take Tramadol for my Endometriosis and pain (when needed but sometimes daily) and am considering taking St Johns Wort for depression. I'm feeling so low at the moment and have no energy. Have been trying for a baby for 5 years now and it just seems to be one thing after another. My clinic have prescribed Levo as my GP doesn't want to know. They won't advice on any other drugs and don't want to get involved. My GP/ Locum wouldn't even prescribe Levo and has simply told me to get on with things and it's sad I can't have a child but at my age I should give up.

If anyone can advice on this 'combo' I would really appreciate it. No one else to ask and I'd hate to start Levo and find out that either St Johns Wort or Tramadol have prevented it from working.

Many thanks xx

23 Replies


You can take anything while you are taking Levothyroxine but for maximum absorption Levothyroxine should be taken with water 1 hour before, or 2 hours after, food and drink, 2 hours away from other medication and supplements, and 4 hours away from calcium, iron, vitamin D supplements, magnesium and oestrogen.

What are your thyroid levels? The TSH of women planning pregnancy should be in the low-normal range 0.4 -2.5 otherwise conception can be difficult. Levothyroxine dose is usually increased by 25-50mcg when pregnancy is confirmed to ensure good foetal development.

Many thanks for clarifying that Clutter. Just feel like I seem to be taking everything and anything at the moment. My level was 4.25 but both my antibodies were above 400. I appreciate your reply x


Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

Thanks Clutter

Do they know what causes it, or how long I may have had it for?

Would anything have been making it worse. I just figured it was my job that was making me increasingly tierd, and the more pasta and sugar drinks I had the more tierd I felt. I figured my depression was due to the constant failed ivfs and treatment being postponed or other things they then said I had. I will try and go completely gluten-free. This is probably a stupid question, but I'm guessing that means I can't drink beer :) Seems I'm losing all my creature comforts x


Hashimoto's progressively destroys the thyroid gland reducing thyroid hormone and that causes fatigue. You could have had Hashi's for decades before it damaged your thyroid enough to cause hypothyroidism.

You can get gluten-free beer.

Hi, you may find that taking levo will help with your low mood anyway. You could give the new dose a few weeks first and try at johns wort if you don't notice an improvement. Low mood is a symptom of being hypothyroid

After looking at your other posts I can see that you have thyroid antibodies which means you have an autoimmune disease called Hashimotos. This is quite common and most people on this forum have it. I'd suggest you read as much as you can about it, I'm sure a few more experienced members on here will offer advice soon. You could post a new thread showing your results in the thyroid forum for more advice. Hashimotos can cause fertility problems in itself.

Thanks for everything Foxrabbit. I really wish I'd had these tests done a long time ago, but each clinic said there was no need and I looked ok etc. Would Hashimotos or thyroid cause a miscarriage or prevent implantation?

Thanks for posting. When a GP and fertility know very little about TFT and results and you can't go anywhere 'medical' for advise this website is an absolute Godsend. I guess I'll try the Levo when I pick up my prescription (been putting if off - worried about costs and feeling like it wouldn't help anyhow). Will just see how things go. Many thanks Foxrabbit - love the name :) x

I've been looking into fertility issues recently for my sister in law as I think she has a lot of hypothyroid symptoms and she's been struggling to get pregnant and has lost two in early stages too, and the answer is yes, it can prevent you getting pregnant and cause miscarriage. The endocrine systems are all intricately linked so issues in one like the thyroid can knock on to others like the adrenal glands and reproductive system.

When you say you are worried about costs what do you mean? Prescription costs? If so, and you are in the uk, if you are diagnosed as having a thyroid condition you get your prescriptions for free.

Do you have digestion issues at all? There is a big school of thought in the functional medicine world that a lot of autoimmune conditions are caused by food sensitivities and a lot of people on here are gluten free because if it. Most people find their antibodies reduce on a 100% gluten free diet. It's worth a go alongside the levo if you can.

Sorry, I didn't realise clutter had already suggested the gluten free bit!.

Unfortunately most doctors don't have enough knowledge of the thyroid, let alone the balance between all the other systems to be able to help you. Websites like this are great for information and also try to read and research everything you can about the thyroid and reproductive systems to get to the bottom of your problems.

It makes me wonder why they don't suggest or offer TFT earlier before starting any ivf. I did wonder what was happening and whether it could have contributed. I was just told it was 'unexplained or due to my age'.

Yes, I was worried about prescription costs as I only work 1 day a week now (sometimes 2). My oh just picked up a prescription and it was £11 which is fine. Sorry, I panicked expecting it to be around £70 a week which was what I was paying for my ivf drugs.

I am not yet diagnosed by my GP as having a thyroid condition. The locum saw my blood results and suggested I go back to my 'private clinic' as she wouldn't give me a prescription. Am still waiting to hear if I can see a Endocrynologist. My clinic ended up giving me the prescription so I expected it to cost more.

Yes, have been having digestion and stomach problems for years but was always told it was prob IBS so just watch what I eat. A few people have mentioned 'Gluten Free' so I will take everyones advice thanks. I thought 'GF' was just for celiac but had never heard of Hashimoto or Thyroid before. x

Hi Music1 & foxrabbit - yes thyroid can cause fertility issues. Here's an important article

BTW I am on 125mcg Levo & 50mg of Tramadol for 5 yrs now, no issues. Hugs🌺

Thanks Boohbette17 I will take a look at the article. Encouraging to hear that I will be able to take both together with no issues. Many thanks for your reply and reassurance x

You're welcome Music1 , so glad your post caught my attention & wishing all good things for you!! Im in the US & got sidetracked in my day , I apologize for the delay to reply. HUGS🌺

Thank you for the article. It completely blew my mind. Heartbreaking to think that you can go through all that and it can still end in mc due to levels. I had no idea. After 3 failed, 1 mc and 1 stopped transfer with ivf, if someone on this site hadn't suggested I 'push' for this test I would have been none the wiser. My consultant clearly didn't seem bothered and was dismissive as soon as I enquired about it. Years of ttc and I just wonder if it would have made a difference had I known sooner. Thank you so much for your kind reply x

Very welcome love 😊

I don't take t4 but I do take T3. I also take 100mg Tramadol per day on my better days, twice that on bad days. I don't think my T3 is affected by the Tramadol.

Thank you humanbean. I think I'm taking the Levo to lower my TSH from 4.25. It was my antibodies that were up in there 400s I think. I only look at the 'red ink'. Neither my clinic or GP/ locum have advised or told me anything about the results, what they mean or anything. I've just relied on lovely, kind and well informed people on this website.

It's nice to know that someone else is taking Tramadol and Levo and the combination work. Many thanks x

I've recently taken tramadol and no problems but I did read a long time ago now not to take St John's Wort if on thyroid meds. Don't know why I'm afraid but I'm sure when optimally dosed your low mood will lift.

Thanks silverfox, I did wonder if this would be the case. A friend suggested 'anti depressants' but I was worried they may cause problems with the other 2 and then be difficult to get off. I thought St John's Wort would be a 'safer' option. Some other kind people have also suggested I try Levo for a while and see if that helps my mood. I don't think coming off 3 weeks of high dose ivf meds and being told that my transfer had to be stopped suddenly helped. Many thanks for your reply x

HelloMusic1, I am in the U.S. too. Amazing what Docs. do not know, or tell you. I was given Tramadol for a Fx wrist, did not need really, but read the insert, it was nearly an 8 & 1/2 X 11 page of side effects, none good!! You might look for group on Face Book, Stop the Thyroid Madness, also book same name. If you look on Amazon you will find a long list of books on the Thyroid. Very informative. Also, but very much not least, Look for Izabells Wentz's Face Book space, and her very well researched books and blogs and Exc. follow ups. She is a pharmacist, with training and resources. Plus a lovely person. Cured herself from Hashimotos. Offers books lectures and personal follow up. & Docs rec by patients. This forum, UK People, has been heaven sent for me in my despair, Thank you all. XXX Best to Music1. Look also at Body Logic, Docs who work with bioidentical Hormones. Located around the U.S. Knowlegable about the endocrine system.

Thanks VTUI, will start to do some research on this. I really appreciate your suggestions and help. Best wishes x

Hi Music1, pleased you can use the information. XO.

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