Questions about Sertraline.

[DeeFish71]

Been to the doctors for my follow up after my scan and blood tests for my underactive thyroid.

My anxiety has been out of control and one illness after the next and been ill with one thing or another from a cold/virus for 7 months yesterday.

The pain when I wake up (physical and mental), will not go.

the doctor said that my thyroid was "fine" and that it was my anxiety that needed checking out. I said I wanted to see an endocronologist as I am still sure it's my adrenal glands.

I am also in for an ECG and then a 24 hour one to be arranged in the future.

But I am now on Sertraline and really do not want to be. Even since I have taken the 1st pill at 4.30 this afternoon, I have felt jittery, cannot focus on any jobs, panicky. is this normal?

And am I safe to have my 100mg Levothyroxine in the morning and this other pill at 4.30? I am dreading how bad its going to affect me, my moods, my entire life.

And whilst hardly a big drinker, I will be having 2-4 the next 2 weekends, is that safe if take that pill at half 4, then drink pm or later?

Would appreciate any help on this.

[Lalatoot]

If you read the leaflet with the sertraline it should guide you. Often the anxiety and jitters can get worse for the first few days. This is usual. This sort of medication takes weeks to get into your system so you may not notice any benefits for a good few weeks. Yes your timings for taking it well apart from your levo are fine. Everybody is different as to how alcohol affects them when on this sort of medication.

I was on citalopram for years along with levothyroxine. My anxiety was caused by being undermedicated with levo. What I lacked in thyroid hormones was being replaced by adrenalin. It was not a good way to be.

[DeeFish71 in reply to Lalatoot]

Thanks for your reply. I just hope I don't get worse and have that awful spaced out feeling and I hope I can sleep ok.

The Doctor is going to write to Endo to see what the Dr there says, she say it will be quicker than a referral.

Also had my flu jab today, so a bit concerned if this will affect how I feel also.

[Lalatoot in reply to DeeFish71]

I often lay in bed with one earbud in listening to an iPod. It helped me drift off or lie reasonably calmly.

[MaisieGray]

If you read the PIL that came with your Sertraline tablets it should say something like this:

Taking Sertraline tablets with food and drink

Sertraline Tablets can be administered with or without food. Alcohol should be

avoided whilst taking sertraline. Do not take sertraline in combination with grapefruit

juice, as this may increase the level of sertraline in your body.

Taking your Levo in the morning and Sertraline late afternoon will be okay.

Regarding side effects and how long the Sertraline needs to take effect, will also be covered by the PIL.

[DeeFish71 in reply to MaisieGray]

I did specifically ask her was it ok to drink in moderation and she said it was fine - and the nhs site said it's ok too in moderation. hate the conflicting info you get on medication leaflets and from your own GP!

[MaisieGray in reply to DeeFish71]

I would always go by what the pharmaceutical company says. They have the greatest familiarity and knowledge of the active ingredients in their drug, and will have carried out rigorous testing prior to it being licensed. The GP is just the prescriber of a vast range of drugs, none of which they can guarantee to have more than a passing knowledge about. My Neurologist who prescribes Propranolol didn't even know that it has an antithyroid effect, until I told him. But you are in a position of needing to be prescribed this drug, and have only just begun taking it - is a couple of drinks worth the possibility of making things more difficult for yourself?

[MaisieGray in reply to MaisieGray]

From Drugs.com: "Alcohol can increase the nervous system side effects of sertraline such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment."

[sy28 in reply to MaisieGray]

In their patient notes, Actavis confirms Sertraline is one of the drugs that 'may affect the way that Levothyroxine works' ... this being the case, anxiety symptoms might heighten if Sertraline is administered. It must be worth raising this with thyroid clinicians, persistent in prescribing antidepressants, that such drugs have the potential to cause harm. If thyroid patients received better care, suggestions of antidepressant use might reduce and its huge budget targeted elsewhere - arguably to the NHS thyroid population genuinely more in need of T3 than a script for depression caused by lack of T3.

[DeeFish71 in reply to sy28]

I wholeheartedly agree - there is still that voice inside me that is convinced this is all thyroid related. They rely too much on a couple of blood tests. Even the scan where the person said the tyhroid was "very small" didn't convince them. They too easily prescribe anti depressants. I hated being on them years ago and don't want them now, but I am desperate to be rid of this stupid anxiety and dizziness. I will phone doctors tomorrow if this continues. I make sure I take the Levo first thing, and this other pill about 4.30, so leaving plenty of time between. It's ok when i feel the "high" and talk ten to the dozen and feel motivated but then its replaced by dizziness and slump. I so hope my Dr will convince Endocronology to see me - I felt ok before I got ill at the end of March. And I still think its those awful antibiotics that started all this and been one thing after the next since.

[greygoose]

If you don't want to take it, why are you taking it? No-one can force you, just because the doctor wants to prescribe it.

Your anxiety is probably due to low thyroid - it's a symptom, not a disease. Your GP may think your thyroid is 'fine', but does she really know? What are your labs like?

[DeeFish71 in reply to greygoose]

Not really sure but the TSH was 0.26 and the T4 was 18. I just hope the Endo man wants to see me.

[greygoose in reply to DeeFish71]

What you need is your FT4 and FT3 tested at the same time to see how well you are converting. Once you are on thyroid hormone replacement, the TSH is pretty much meaningless - it certainly doesn't mean you're well, because it's a very bad indicator of thyroid status.

[DeeFish71 in reply to greygoose]

I know - but getting T3 checked is an impossibility at the surgery. Hoping this Endo wants to see me and will allow it. It really is a stupid situation when the USA do these checks as a given. all about "high prices" over here, but some things the NHS have to pay out for really make my blood boil, but this is not the place to discuss such matters for fear of offence.

[greygoose in reply to DeeFish71]

I know. And, it's a false economy, because it ends in keeping people sick and costing the health services even more money with a drug for every symptom! I'm rotten at maths, but even I can see that, so why can't they?

[DeeFish71 in reply to greygoose]

Exactly.

[Angel_of_the_North in reply to DeeFish71]

You might also want to read Dr David Healy's blog about antidepressants and so on. He is a mainstream UK psychiatrist

[DeeFish71 in reply to Angel_of_the_North]

Thanks, I will do. Had a terrifying episode a little while ago after waking up, went very faint, pouring with sweat and had to lie down on the cold kitchen floor. Is this normal??

[Angel_of_the_North in reply to DeeFish71]

I don't know, but I had similar episodes (but without the sweating so much, but with violent headaches) when I had very low cortisol. If I didn't lie down, I would fall down.

[DeeFish71 in reply to Angel_of_the_North]

Blimey. Just hoping in time it passes. When I get up, the anxiety is still there and the nervousness .

[SlowDragon Administrator]

Suggest you get full Thyroid and vitamin testing BEFORE seeing endocrinologist

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Is this how you do your tests?

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins

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

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random