Hi, recently been prescribed paroxatine 20mg does anybody know if it's safe with levothyroxine 125mcg before I start the paroxatine
Paroxatine 20mg while on levothyroxine 125mcg - Thyroid UK
Paroxatine 20mg while on levothyroxine 125mcg
Written by
zeusmum2
To view profiles and participate in discussions please or .
Read more about...
31 Replies
•
Ryansmum1,
Yes, it is safe but make sure you take Levothyroxine at least 2 hours away from Paroxetine. drugs.com/drug-interactions...
Before starting an antidepressant, I would make sure you're optimally medicated on levo. Under-medication with cause depression, anxiety, etc. Far better to optimise your thyroid hormone levels than take an antidepressant you don't really need. 
How are your B12 levels ? - also Folate - Ferritin & VitD. If low you can suffer low mood and the Levo/T4 does not works as efficiently. Try to obtain copies of test results with ranges that you are legally entitled to have.
Thyroid tests should be - TSH - FT4 - FT3 and thyroid anti-bodies TPO & Tg.
The brain needs good thyroid hormones - especially T3 😊
Have you read about Kelly Brogan who with others believes that depression starts with the gut ....
Thanks for info, I've never been told anything apart from my thyroid levels are ok, Dr thinks my anxiety and depression are due to me losing my parents and only brother early last year and being a carer to my autistic son so I feel I need to try the paroxatine, I'm at my wits end to be honest, problem is I also have a fear of trying new meds after an allergic reaction to an antibiotic years ago, thanks for reply
Having been on this forum for over six years we read almost daily of members joining who have been told all is fine by their GP. On further investigation we find their thyroid results are shocking as are the vitamins and minerals.
We have to take control and get hold of those results. GP's are awarded funding points for prescribing AD's. Surely it would be better to obtain and share your results with members as trying to come off anti-depressants could be awful for you.
You are taking a good amount of T4/Levo - which is a storage hormone and has to convert into the ACTIVE hormone T3. That is the test and result you need.
Anxiety and depression are so often symptoms of an undertreated thyroid and low B12. At least make sure before you start AD's.
Lots of VitC could help your adrenals 😊 You are coping with lots - so getting the basics right would be good rather than putting on a sticking plaster 😊 Take good care ....
Thank you, I have an appointment at the Dr on Monday so I will ask for a thyroid blood test form as it's a while since I had one, I will also ask for my previous results in detail, many thanks for all your help
Dear Ryansmum1, first off I want to begin by saying that Iam very sorry for your loss. That alone is a very big stresser. I cant imagine how you must be feeling, and my heart goes out to you. The fact that you are also caring for your autistic son is also very stressful. I think that your Dr. was disappointed that you wouldn't take the medication that could possibly help you a lot at this time where you are feeling so emotionally and physically burdened. I have fought with the fact that I have to take Paxil. It took me a long time to accept that I need it in my life, in order to get on with my life. For you, it could be that given you have had such a blow emotionally caused by your great loss, that you need a little help with what you are going through. If your Dr. thinks it would help, and will follow your progress, then you might think about trying the antidepressant. But remember, if one isent that helpful, then another one might be better. You are the only one who can say if they are helping, and trying it out dosent mean you have to have it for life. I pray that you will be blessed with peace and comfort durning this time of sadness and challenge, xox littlebowpeep
Thank you, that's very kind of you, it doesn't help that the side effects of the paroxatine include raised blood pressure, and at the moment mine is 180 over 100 so I'm too scared of taking them, mostly because if anything happened to me my son has nobody else to help him, and it's not easy to get help and advice in my area, again thanks for your kind words, it means a lot
It's very common for doctors to prescribe anti-d's for people with thyroid conditions without bothering to first optimise both their thyroid medication and vitamin levels. Quite a few of us have experienced this approach and there isn't enough evidence to prove that anti-d's actually work.
You've been through a lot and it would be tough for anyone. so I'm really sorry and when you have thyroid disease that is not treated optimally then all of lifes challenges feel harder than they normally would. However, anti-d's might not get to the root of the reasons why you have symptoms and all medicines can have side effects. YOu must be a really strong person as you are a carer and also live with a long term thyroid condition. This proves that you are essential very strong emotionally so it's likely that your thyroid condition is not optimally treated and this is throwing you off balance and causing the anxiety etc.
Mainly doctor don't bother looking into the cause of our symptoms because it's too much trouble for them. It's easier to dish out anti-depressants for which they get paid extra. I think they even look for reasons to give patients anti-d's as it attracts extra funding for the surgery. If you really think you need them then that's your choice. Don't feel under pressure to try what the doctor says if you don't think they are the answer. Ask the doctor to run blood tests to rule out all possible physical factors. Once you go down the depression route then doctors simply ascribe all symptoms to depression/anxiety and it gives them a convenient get out not to look into symptoms.
If you describe a list of symptoms here then people might be able to help you know whether they are hypothyroid symptoms or vitamin deficiencies all of which can contribute to anxiety or depression. If you'd like to post your latest blood test results we can help you interpret them and determine if you are on the right amount of thyroid hormone.
Hi, thanks for reply, I don't have my latest blood results as the doc has never told me them, he just said it was ok, I am going to ask for another blood test done though and see if I can get my previous results when I go to the docs on Monday, as for my symptoms they are high blood pressure it was 180 over 100, a feeling of fear constantly, my stomach is turning over all the time, heart feeling like it's racing, and I'm worrying about every little thing obsessively, and getting a feeling of being strangled in my neck, sounds strange but it's the only way I can describe it, I think the feeling of fear is the worst symptom
The feeling of fear can be a symptom of not enough thyroid hormone. When we don't get enough thyroid hormone then cortisol takes over to compensate and eventually when it runs out adrenalin is released. Adrenalin is the flight or fight hormone and it gives us the feeling that we need to fear something. I gradually became hypothyroid due to faulty levothyrxoine and got that feeling of fear, especially waking in the morning with a feeling of doom. When on the right medication and then optimising vitamin levels it vanished. Blood pressure can also rise when thyroid meds are out of whack. I've since gone low carb high fat diet which has also helped but it will only be any use if you're taking the right thyroid hormone. My heart rate also became very rapid due to adrenalin surges. It's all settled now. I'm not saying this is the case for you, I'm just saying it's a possibility and incorrect thyroid hormone dose can give a lot of symptoms that can be attributed to anxiety and so on. When you get your blood test results people here might be able to help you work out what's going on.
You could start by taking 1000mg of vitamin C a day daily to support adrenal function. Adrenal glands become stressed when releasing a lot of cortisol and adrenalin. Also, you could take magnesium which is calming. Neither are stored in your body so if you take more than you need your body excretes the excess. Magnesium citrate is fine but there are others. You can also take magnesium baths if you prefer. It's absorbed through your skin.
Magnesium choices
Thanks ever so much for taking the time to help, I think I might hold off taking the antidepressants until I've had another blood test, and get some vitamin c while I'm waiting
SlowDragonAdministrator
You are entitled to copies of your own blood test results under data protection laws.
You may be able to view test results online - ring and ask about this. If you can then apply for online access to your account. All GP practices are supposed to offer this, in reality very few have blood test results available online.
If not then ask for print out of recent tests. Pick up in a day or two. They may make a nominal charge for paper. (Maximum £10, should be lot less)
You need to know results for TSH, FT4 and FT3.
Do you also have high thyroid antibodies? You need to know. Did GP ever test these? If not ask that they are tested.
Essential to test vitamin D, folate, ferritin and B12.
Always get actual results and ranges.
Post results when you have them, members can advise
If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of all hypothyroidism in Uk is due to Hashimoto's
We see hundreds turn up on here, very under medicated. And GP's pushing antidepressants while Thyroid levels are still way off balance and hypothyroid symptoms being completely ignored
Read as much as possible, about hypothyroidism. If you have Hashimoto's (autoimmune thyroid disease) then read as much as you can.
Always take Levo on empty stomach and then nothing apart from water for at least an hour after. Many take on waking, but it may be more convenient and possibly more effective taken at bedtime
verywell.com/should-i-take-...
Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription.
All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results
List of hypothyroid symptoms
thyroiduk.org/tuk/about_the...
Feeling anxious and down are both classic hypothyroid symptoms
Hi, update, I went to the docs and he was horrible to me but eventually he gave me a blood test form, it says (TFGPRX) THYROID (ON T4) has he sent me for the right one? Also are most people only managed by their gp or do they have a specialist, I've only ever seen my gp. I refused to take the paroxatine, I think that's why he was so mean to me, hope you don't mind me asking but you seem very knowledgeable, where as I know nothing even though I've had underactive thyroid for over 15 years
I was prescribed paroxatene (prozac) some years ago and took it for a short while as the GP had told me so many times to take it I thought she wouldn't take me seriously until I did. I can't remember now what it did to me but it wasn't good so I soon stopped it. I know now that it was my thyroid all along but it took years to be diagnosed (privately). You sound as though you've had a dreadful time and I'm not surprised you're depressed. I wouldn't touch anti ds again myself, but sometimes they can help people over a crisis. I wouldn't go down that route until I'd explored all the thyroid/adrenal possibilities though. With the symptoms you describe it sounds as if you'd be better with a tranquilizer - but of course you won't be given any of those. Why exactly do docs think anti-ds are so much better?
Dina7, Tranquillisers can be very addictive and have side effects too. SSRI's are supposedly safer but neither are any use to address thyroid imbalance as you need to address underlying cause. Adding more medication adds the potential for more side effects without treating underlying problem. It can be difficult to get off these additional meds.
We feel under pressure, as you say, to take medicine doc prescribes because of fear that if we don't follow their advice we won't be taken seriously but in fact the opposite is true.
If we take anti-d's then we're not taken seriously. We just get 'somatic' symptoms written on our notes, meaning, all in our heads, and all symptoms are dismissed from then on. Then it's very difficult to get doc to optimise thyroid treatment and take notice of symptoms.
Mostly women are affected by thyroid disease and I doubt men would put up with being tranquillised or thrown out of surgery with anti-d's so why should we. Our lives are just as valuable and we prop up half the world while working, caring for family, giving birth and looking after neighbours and generally underpaid for all our work. We deserve better from the NHS.
Sorry, I'm making the assumption you're female, if not then forgive my rant
Yes I'm female and love the rant! Trouble was I was so unwell, in so much pain and so frustrated with it all that I burst into tears in her surgery one day and knew I didn't stand a chance of anything but "all in my head" after that. I know tranquillisers are addictive, but aren't SSRIs very hard to get off of too? My beta blockers certainly are! I did have tranquillisers at one point and found taking the odd one extremely helpful which I certainly can't say for the prozac.
I wonder which years you were in so much pain and discomfort for? Did you know that levothyrxoine quality was badly impaired in the UK up until around the year 2015? If your pharmacy swapped you between formulations of levothyroxine it's very probable that you were getting hugely variable doses of thyroid hormone. In addition, even if you weren't swapped between formulations, the manufacuring methods of some levothyroxines were not adequate for the type of drug so you probably got batch differences no matter what levo you were on. As we know big changes of thyroid hormone up and down can make a big difference to how we feel. Some products were nearly 50% difference in efficacy between each other and were not interchangeable yet we were being told they were.
To understand what I'm saying read the 2013 MHRA report on quality and clinical considerations of levothyroxine. The unreliable products were finallly all recalled from the shelves by 2015. Reports on problems with levvothyroxine were arriving by 2005/6 I believe but the MHRA only investigated in 2011.
MHRA 2013 Review of Levothyroxine
gov.uk/government/publicati...
gov.uk/government/uploads/s...
This means doctors were telling patients they were fine and their symptoms were in their heads when actually they were being affected by the quality of the levothyroxine. This would not have been very apparent in people with thyroid antibodies whose blood test results can vary as a result of autoimmune disease but in those of us without antibodies, it gradually became clear that the levothyroxine was not working as it should as we became hypothyroid on very high doses and then overmedicated if the product were changed.
So you might have felt ill for years and not known why and as we now know, becoming hypothyroid can affect vitamin levels which adds to the problems.
It was long before that, and long before I was diagnosed as hypo. She did test me from time to time and told me my thyroid was fine ... this was before I even knew what or where my thyroid was!
Anxiety can be induced both by (external) factors and our response to them; and also by (internal) psychological & physiological disorders - and if we're really unlucky, by all in combination! If we are as fit as the proverbial flee, and are subject to an incident of trauma or stress, we can process it as no more than a niggly glitch in our otherwise untroubled life, or we can be devastated by it - and often there's no "apparent" logic to how we react, or necessary correlation with the scale of the stress. It can vary according to what else is going on in our lives at the time for instance. If we become ill and our body struggles or fails to maintain homeostasis we can be affected by the general stress of no longer being the healthy autonomous person we used to be, but equally the illness can of course directly impact on our psychological functioning, and in the case of hypothyroidism, thyroid hormone is directly linked to the regulation of important neurotransmitters for instance. From GABA to serotonin to norepinephrine, thyroid hormone plays a crucial role in their creation and regulation. When your thyroid hormone is not functioning properly, these neurotransmitters tend to go haywire, causing not only anxiety, but also panic attacks. This is made worse by the physical symptoms often associated with hypothyroidism, causing people to be constantly reminded of their ill health and becoming anxious about it .... When someone is under continued or great stress, or their reaction to it is exaggerated (that's not a criticism, just a statement of fact), for instance, there is a degree of cognitive impairment affecting their critical faculties, including their ability to judge the "real" nature of the stress and respond accordingly, and the invoking of a host of physiological and psychological responses including but not exclusively, the release of adrenaline, cortisol and noradrenaline. Hence people reporting chest pain or throat tightness. So for some, the ideal treatment might be both a short term course of antidepressants, or beta blockers or similar whilst also optimising thyroid treatment; whilst others might need solely the improvement in their thyroid treatment; and others still, simply the anti-d's. And it's not that one or other is innately right or wrong, but what's important is what is needed by the individual. Unfortunately evidence shows that many medics don't know, or chose to ignore the interconnectedness of thyroid dysfunction and anxiety & depression; or they're disinterested in or overwhelmed by the challenge presented by thyroid disease; or they're prevented from or disinterested in, prescribing other than Levothyroxine. Which is a long lead up to saying that being diagnosed as depressed isn't necessarily wrong or an insult as long as the full picture is understood; and that antidepressants are not the devil's spawn that they're sometimes made out to be in some thyroid fora, if they are prescribed for the right reason and with the right intention; and can be very helpful in helping someone return to a period of calm, and a reactivation of the higher brain functions rather than the stress-mediating neural systems retaining control ie in layman terms, getting back to being able to think straight. Unfortunately they're often used by Drs as a get out of jail card to get the thyroid patient out of their office.
Nanaedake in reply to
There is no firm evidence that SSRI's actually help with serotonin dysfunction or any of the other neurotransmitter dysfunctions mentioned as I understand it, at least the scientists cannot measure it, I believe.
Littlebowpeep in reply to
Hi nomoreT3, just a quick note. I have had a battle with accepting anti-ds, but finally understood that they help me get on with my life. No, they are not the Devil's spawn, but you do have to find the right one that will work for you. And its a highly personal individual choice, they are not for everyone, but if you need them, be easy on yourself, mabey its just to get through a very rough patch in your life, or longer, but the bottom line is they are there to help when mabey nothing else will. When all the thyroid tests come in, and everything is as it should be, sometimes a person just needs a little more help, thanks for listening, littlebowpeep
No problem
Always ask your pharmacist for interactions
helvellaAdministratorThyroid UK
ryansmum1,
Trying to find out what is known about interactions, I found the case report below. Do note that it is the first such case - but will be far from the first person taking both.
Reversible Paroxetine-Induced Symptomatic Hypothyroidism
M. Takahashi 1 , E. Sawayama 1 , T. Sawayama 1 , H. Miyaoka 1
1Department of Psychiatry, Kitasato University School of Medicine, Sagamihara, Japan
Abstract
Paroxetine is a selective serotonin reuptake inhibitor (SSRI). SSRIs are widely used as antidepressants and have rare but severe adverse effects [1], particularly on thyroid hormone [2]. We present the first case, to the best of our knowledge, of reversible paroxetine-induced symptomatic hypothyroidism.
Rest of paper freely available here:
thieme-connect.com/products...
That's very interesting. It may not be as rare an adverse event as it seems because adverse events are often not reported or investigated.
Nanaedake,
The biggest factor seems to be that no-one looks for these issues.
I'd like to think that every medicine has been tested for interaction with thyroid hormone (howsoever caused). That is, it should be part of the standard list of things that are looked for. I suspect it is not looked for, though it could be that we simply cannot see any of the results of such research. Far too much is locked away on pharmaceutical company archives.
I've reacted badly to nearly every medicine I've taken since being on levothyroxine. That includes necessary NSAIDS and antibiotics. I suspect that once on Levothyrxoine then anything that affects the stomach bacteria causes lack of proper levothyrxoine absorption or interferes with how it's taken up into our cells. My theory is that if people take T3 as well as LT4 some of this effect can be mitigated but on LT4 only we haven't got a chance.
Not what you're looking for?
You may also like...
Coming off 125mcg levothyroxine conpletley
year ago after giving birth I had to go on levothyroxine 125mcg. My thyroid was so low they...
Was taking 150mcg of Levothyroxin, got lowered to 125mcg. Why?
i was taking 150mcg of levothyroxin and my doctor just told me after i stopped birth control that...
Rapidly rising TSH while on levothyroxine - New here :-)
drastically) hence started 50mcg of Levothyroxine.
I was tested for Hashimotos prior to starting...
T3 with 125mcg thyroxine
carry on taking 125mcg of levothyroxine and start the t3. Any advice on dosing would be helpful?
Hypothyroid symptoms while on Levothyroxine
depression.
Results:
14/08/2019 - Before treatment with 50mg levothyroxine
TSH - 7.3 (0.2-4.5...
Related Posts
I'm on 125mcg levothyroxine but I have recently been adding a further 25mcg without Drs knowledge.
Does anyone takes Levothyroxine like me? Monday to Friday 125mcg and Saturday and Sunday 100mcg?
185mcg Levothyroxine did nothing. I take 125mcg levo now and 75mcg liothyronine.
First bloodwork results while on levothyroxine - input please!
Can I take milk thistle while taking levothyroxine?
