Sertraline and TSH rising link: Has anyone found... - Thyroid UK

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Sertraline and TSH rising link


Has anyone found a link between starting sertraline and TSH rising, I thought it was being on HRT but then I found this and thinking maybe sertraline is the cause of my underactive thyroid?

5 Replies

Your results from 6 months ago(below) show low FT4 , that will raise your TSH....

The pituitary gland sends a signal (thyroid stimulating hormone - TSH) to the thyroid

when T4 level is low that then prompts it (the thyroid) to produce more T4....the Feedback Loop

You appear to be converting T4to T3 adequately

TSH we are told should ideally be close to 1

You are under medicated.

I imagine the Sertraline is a red herring but others may advise differently

TSH 3.1 mIU/L 0.27-4.3 mIU/L

FT3 5.22 pmol/L 3.1-6.8 pmol/L

FT4 13.1 pmol/L 12-17 pmol/L

T4 72.6 nmol/L 66-181 nmol/L

SSRIs such as setraline can affect the absorption of levo. Some find that they need to increase the dose of levo to counter this affect. I would think that this is why your TSH is rising.

Sorry I should have worded my post better. What I meant was before I even started taking levo and sertraline my TSH was normal and it wasn’t until I started taking sertraline that my TSH started to rise but because I started HRT around 4 months later I quickly assumed it was that until I read the link above and now I’m wondering whether sertraline is the cause of my TSH rising and therefore now on levo. I’m on 75mcgs at the moment but my last TSH was actually 1.3 mIU/L

But I’m now worried that that I didn’t need the levo and that I should stop taking sertraline to see if then my TSH goes too low. My heart rate is also 50-60 since being on sertraline but I put it down to the fact I quit drinking and smoking but actually it’s all starting to point to starting sertraline.

in reply to Cade83

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

Ask GP to test vitamin levels and thyroid antibodies

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

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

Cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )

For thyroid including antibodies and vitamins

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

Stopping smoking often reveals hypothyroid problem, especially Hashimoto's. Risk is increased for t so years after quitting


Your original private test confirms cause is autoimmune thyroid disease also called Hashimoto's

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