Sertraline and levothyroxine

[Byern2018]

Hey, if I stop taking sertraline do I have to resduce my levothyroxine dose then? I have heard sertraline affects TSH that it will be increased with it? My biggest expectation is that I could stop taking levothyroxine, anyone with this experience?

[MaisieGray]

Sertraline is known to increase TSH and decrease FT4, but whether you would need to reduce levothyroxine as a result of stopping the sertraline is not something that can be guessed at, and is individual to you and your circumstances ie what were your thyroid levels and dosage before the sertraline, what happened as a result of starting it, and what are your levels immediately before, and after stopping. When you last wrote, greygoose asked you for more information in order to help you, but you didn't respond; and without that info members are in the dark. Regarding stopping Levo, if your thyroid gland is failing, and not producing the thyroid hormones you need, you have to replace them with exogenous thyroid hormones. Some people can develop a temporary form of thyroid dysfunction such as post-partum or post-virally for instance, but even these can often result in permanent dysfunction. In most cases, Levothyroxine or whatever form of thyroid hormone is taken, is for life.

[Byern2018 in reply to MaisieGray]

Thanks for replay. I just take 25 mcg and 75 mg sertraline. My levels are normal Tsh 1,5 (0.5-8)

Free T4 16 (10-22) high TPO. If I stop sertraline I will test Tsh after 2 monthes and see if I can stop Levo it would be nice!

[Hidden in reply to Byern2018]

"If I stop taking sertraline do I have to resduce my levothyroxine dose then?"

It is more likely the other way around! 25mcg Levothyroxine is a tiny, starting dose. An increase in levothyroxine is likely to mean you will need LESS sertraline and may eventually be able to come off it altogether. Hypothyroidism itself can cause depression. It seems likely you are undermedicated - even if your test results are "Normal".

I have heard sertraline affects TSH that it will be increased with it? My biggest expectation is that I could stop taking levothyroxine...?

Why do you want to stop taking thyroxine??? If your TPO antibodies are high that means your immune system is attacking your thyroid by mistake and gradually destroying it. Again, 25mcg is too small a dose for most people with this condition. It needs to be increased gradually until you feel well, or as near as possible. Your aim should be to reach the right dose of thyroxine so that you don't need sertraline any more.

The problem with antidepressants is that they are likely to decrease your thyroid hormone levels. When that happens, your TSH is likely to rise because TSH is Thyroid Stimulating Hormone - it tries to get your thyroid to increase production.

"Tsh 1,5 (0.5-8)

Free T4 16 (10-22)"

What about T3? That is the most important test because T3 is the hormone that actually works. For some reason it is also the one that tests often miss out. Your FT4 is only half way in range, it probably needs to be higher. Most doctors don't realise that our levels need to be optimal, and optimal for US, not just in range. Many, or even most of us need T3 and T4 near the top of the range, even if TSH is driven below range. (as in my case). Sadly, most doctors are not taught that.

[Byern2018 in reply to Hidden]

I had something called subacute thyroditis and I think my thyroid will "selfrepair" maybe I just have to give it time. I think my high TPO are a result after the thyroiditis, sorry for bad english. I just want to try without medication,(feel bad) give it the best natural help but, maybe it will be destroyed anyway, the time will show. And I will do a T3 test very interesting, thanks for answer.

[Hidden in reply to Byern2018]

Sertraline is medication, and not "Natural". It is like a walking stick to help you get along when your legs are not so good, or a plaster cast when you break a bone.

Levothyroxine on the other hand is a copy (maybe not a perfect copy but as close as can be got) of a completely natural substance that we need in order to live.

But I just looked up "subacute thyroiditis" and it does seem as if there is hope of recovery in your case. Which is brilliant!!!

en.wikipedia.org/wiki/Subac...

restartmed.com/subacute-thy...

[Angel_of_the_North in reply to Byern2018]

What is your free T3? that is most important hormone and the one that affects depression. I wouldn't test TSH on its own, I'd test my actual thyroid hormones as well, as they are a much better indicator of thyroid function

[Byern2018 in reply to Angel_of_the_North]

They have nerver tested T3 I will do that on my own private, thanks for that information!

[m7-cola in reply to MaisieGray]

Thank you for the information about Sertraline and its effect on T4.

[pet-lamb]

Hi I think you should ask your doctor about this I take levothroxin but not the other one if I'm right that's a ani depressant both are important and neither should be stopped abruptly sorry i'm not much help.

[Cuarla]

Hi, I take the two together and have not heard about any differences. I would always check with your |GP or prescibign pharmacist if you are unsure though.

[Kandahar]

I changed from Citalapram (20mg) to Sertraline earlier this year. I was also prescribed t3 in January (have to get from Europe) and, apart from the odd hiccough, I’m now feeling so much better. As a result, I decided to gradually reduce the Sertaline. Now down to half dose a day and feeling fine.

The most important thing is that you feel well. Forget most GPs’ reliance on TSH figures and not testing for t3. And as many will tell you on this forum, you might need t3 if you aren’t able to convert thyroxine (t4) to t3 or liothyronine - its full name. But hope you do well with bit more t4.