Conflict of Medication

[mus2]

Hi

I am on 50mg of Sertraline and have recently been diagnosed as having Hypothyroidism. I am presently on 50mg of Levothyroxine before another test in 6-weeks time. My question is: anyone in a similar situation, taking both meds and any side effects they may be having?

[SlowDragon Administrator]

One of most common symptoms of hypothyroidism is depression. So yes it's common

Levothyroxine should always be taken on empty stomach and then nothing apart from water for at least an hour after

No other medication at same time as Levothyroxine, leave at least 2 hour gap. Some like calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

Many people take Levothyroxine soon after waking, but it may be more convenient and more effective taken at bedtime

verywellhealth.com/best-tim...

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. Watch out for brand change when dose is increased or at repeat prescription.

Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients. Teva is the only brand that makes 75mcg tablet.

blood should be tested 6-8 weeks after each dose increase

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)

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

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

What were your thyroid results before starting on Levothyroxine?

[shaws]

I wonder, and I am not medically qualified, but this is link of the clinical symptoms:-

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

On this forum doctors may prescribe for a 'symptom' rather than doing a Full Thyroid Function Test which is:-

TSH, T4, T3, Free T4, Free T3 and thyroid antibodies.

SlowDragon has given excellent advice. We have to read and learn if we want to feel much better and members are very supportive.

[Naomi8]

I took Sertraline for 18 months.I took my Sertraline at night,my thyroid medication in the morning.I was a UK size 14 until my thyroid started to fail then I stayed a size 16 for 20 years,until Sertraline,when my weight went up to an 18.

The only 2 side effects that really bothered me were weight gain & fatigue.

If I ever experience severe anxiety with depression again,I would not hesitate to take it again.The first time my chronic anxiety with depression turned into an acute condition,I endured it for 2 years.I tried everything I could to avoid ADs.My second experience,when I took Sertraline,ocurred while gluten-free & taking thyroxine with liothyronine & LDN.

I tapered off at 10% per month.I have now almost returned to a size 16.I don't eat til one o'clock & I don't eat after 7pm.I think that has helped.

[mus2 in reply to Naomi8]

My main concern is since taking Levothyroxine I've been having gastro problems, nothing painful just lower stomach cramps now and again and I wondered if they were linked. BTW I've been taking Sertraline for over a year now so my system is used to it.

[mus2]

Hi, the reason I was given Sertraline was due to anxiety. More recently after numerous blood tests over the past few years the doctors started me on 25 and then later 50mg of Levothyroxine due to persistently high TSH levels. Yes I am aware Hypothyroidism can cause anxiety/depression and I'm now beginning to think this was the problem all along. My main concern, referring to 'medication conflict' is that since taking both meds I have developed stomach cramps/ trapped wind/ indigestion, nothing too bad but enough for me to notice. I did read Levothyroxine can cause such problems and I did wonder if perhaps that might be the problem or maybe it's the combination of Sertraline as well as Levo. which is affecting things?

[TSH110]

May be you are under medicated and the hypothyroidism is the culprit. Your results might shed some light on it. 50 mcg is a very low dose of t4 thyroid hormone replacement, only a starter dose really.