Antidepressants

[eagleeye]

Hi I’ve been to see the nurse for a diabetic check up and she told me I had anxiety, I’ve an underactive thyroid and she told me to see the doctor for some medication do you think antidepressants would interfere with my thyroxine .

[lamornabuck]

if you are prescribed an SSRI which is often the case, that means you will be accumulating serotonin in your system bc SSRIs are selected serotonin reuptake inhibitors.

Dopamine is the opposite of serotonin and is an essential part of the thyroid system as dopamine tells the pituitary gland to instruct the thyroid to make t4 that's why tyrosine is recommended tyrosine is made into dopamine in our bodies

so if you are serotonin dominant it may impact your thyroid

also SSRIs can be difficult to withdraw from and sometimes have bad side effects as shown on the excellent despatches documentary the other night

I am no expert but I would try to find a natural way to ease your anxiety which is probably due to your health issues

channel4.com/programmes/dis...

[MaisieGray in reply to lamornabuck]

When you write that "dopamine tells the pituitary gland to instruct the thyroid to make T4" I'm assuming you mean by increasing production of TSH. However, from the albeit limited amount I've read about dopamine's role in that, it seems to have an inhibitory role in the regulation of secretion of TSH, not the opposite as you imply (if I'm reading you correctly). I've read that dopamine itself decreases plasma levels of TSH, and in some instances inhibits TSH secretory response to TRH; and conversely, that a blockade of dopamine receptors leads to an elevation of circulating TSH. Am I misreading what you're saying?

[shaws Administrator]

Anxiety is one of the many symptoms and to relieve any of them we need a dose of levo - or if that doesn't work - a combination of T4/T3. Doctors are apt to give us 'additional' prescriptions for the 'symptom' rather than an optimum dose which relieves it.

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

Levothyroxine is T4 alone and is inactive. It has to convert to T3 (T3 being the active hormone needed in the millions of T3 receptor cells -brain and heart contain the most).

Therefore we need to be a good converter of T4. Link below.

Liothyronine for Depression: A Review and Guidance for Safety Monitoring

ncbi.nlm.nih.gov/pmc/articl...

[SeasideSusie Remembering]

Surely it's not a nurse's place to tell you that you have anxiety and ask the doctor for medication.

As Shaws has said, anxiety (if you do suffer from it) is a symptom of hypothyroidism. Before you do anything else, please post your current thyroid test results, including reference ranges, for

TSH

FT4

FT3

And it would be a good idea to also have results for

Thyroid antibodies

Vit D

B12

Folate

Ferritin

[Lora7again in reply to SeasideSusie]

Nurses are not Doctors.

[shaws Administrator]

You should have both Free T4 and Free T3 tested before taking anti-d's as you may have low T3 which can cause these unpleasant smptoms.

Extract:

"Why You Need a Thyroid Gland

T3 and T4 travel in your bloodstream to reach almost every cell in the body. The hormones regulate the speed with which the cells/metabolism work. For example, T3 and T4 regulate your heart rate and how fast your intestines process food. So if T3 and T4 levels are low, your heart rate may be slower than normal, and you may have constipation/weight gain. If T3 and T4 levels are high, you may have a rapid heart rate and diarrhea/weight loss.

endocrineweb.com/conditions...

[MaisieGray]

Unless the nurse is qualified to diagnose (unlikely) and qualified to diagnose mental illhealth (even more unlikely) she has no business diagnosing you with anxiety nor indeed anything else. Clearly though, and more importantly/worryingly, she seems unaware that anxiety can be a symptom of thyroid dysfunction, including being under-medicated when you are hypothyroid. Anxiety meds have their place for those who need them, but the first thing to ensure before even considering taking an antidepressant or whatever she had in mind, is that you are optimally medicated for your thyroid, with FT4 and FT3 at the right levels for you. Do you have your latest test results to post here?

[m7-cola in reply to MaisieGray]

I totally support this argument. The first and most important step is to check you are ‘optimally medicated for your thyroid’.

[NWA6]

The thing is, who’s place is it to ‘diagnose’? She’s only offering advice, she can’t actually write a prescription for anything. Maybe her wording was quite correct but at the end of day we get advice from all sources and TBH none of us have had good experiences with Dr’s who are supposed to be qualified.

That said, I would avoided anti depressants at all costs. Test for the meet medication first and you may need an increase but you may also need counselling to help you deal with anxiety.

[humanbean in reply to NWA6]

Some specially trained nurses can provide prescriptions for some conditions. I realise that is a very woolly statement that isn't informative. I got a prescription for antibiotics a few months ago written by a nurse for an infected finger.

I would agree that a nurse shouldn't be getting involved in diagnosing mental health conditions. And I would want to check my thyroid, adrenals, nutrients and diet before I would consider taking anything prescribed by doctors for depression or anxiety - and even then I would still refuse! I hate the fact that they are so keen to prescribe drugs which are not only addictive but are absolutely life-destroying for some people when they try to come off them.

Intermittently, I eat a low-carb diet, and eat more fat and protein as part of it. It makes a big improvement in my mood.

[MissGrace]

I do agree with some of the other comments on here that you need to wary of what this nurse has said. You went for a diabetic check up - not a mental health one. The very fact you say ‘and she told me I had anxiety’ sounds back to front to me. Surely you should have been telling her you felt anxious? Do you agree with what she said?

We all feel anxious at times. It’s not an illness to feel anxious - at times it’s common sense and the correct reaction to events. Medication is for those with debilitating dysfunctional anxiety. Anxiety appears to be the ‘in thing’ at the moment and I worry about the number of diagnoses and labels flying around for something that can’t really be tested for or confirmed. I would never deny that there are people who need all kinds of help and support for anxiety and other issues. I would question what seems like a rather flippant diagnosis though. My opinion is to limit medication as much as I can, but that’s me and not everyone is the same.

Hypothyroidism is always surrounded by a load of mental health codswallop to tell us it’s all in our minds rather than trying to titrate our meds properly to get us well. It goes hand in hand with the worshipping at the altar of that unquestionable dictator of all things hypo: TSH.

🤸🏿‍♀️🥛

[Angel_of_the_North]

So the nurse was qualified as a psychiatrist, was she? I doubt you need antidepressants and they will interfere with thyroid meds and make them work less well. You are more likely to need a levo dose increase.

[Clarrisa]

I don’t think healthcare providers fully appreciate how anxiety provoking just coming to see them in the first place is for many patients. There even is a “White Coat Syndrome” condition for those who can be quantified by elevated blood pressure readings.

Anxiety manifests itself in so many individual ways. We could have some lower vital signs from hypothyroidism alone right(?), that could become elevated to “normal range” upon seeing them.

The classic way to diagnose high blood pressure is measuring it on three separate occasions after the patient has sat quietly in a quiet room for a spell. How many healthcare providers just jump to the anxiety conclusion after the patient’s very first meeting? What are the patient’s like outside of the medical setting discussing matters other than their healthcare? Snap diagnoses are enough to induce anxiety in anyone as far as I am concerned.