Sertraline and levo

Just looking for a quick bit of advice. I’ve been on sertraline for the past two months. Starting to feel weaker, breathless, muscle aches, pulse down to 55bpm, I’m sure lots of you recognise the picture. I’m due thyroid tests on Monday but does anyone know if sertraline affects Levothyroxine absorption or metabolism. I’m also struggling a bit with long term covid symptoms do not sure what’s what. Thanks, Mike

[SlowDragon Administrator]

Are you taking any T3 as well now, or just levothyroxine?

When were vitamin levels last tested?

Low pulse suggests under medicated or poor conversion

Next step....full Thyroid and vitamin testing?

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TSH, FT4 and FT3

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[Hidden in reply to SlowDragon]

Thanks @SlowDragon, I’m back on levo only for past ten months. Got corona in March and still weak and breathless. GP suggested checking thyroid levels and doing another comprehensive blood check, I’m pretty lucky to have such a supportive GP. I just suddenly feel like my hypo symptoms are worse and not sure if this is covid or if the sertraline I started recently is doing something to my levo. Hope all is good with you.

[greygoose]

Just wondering why you needed to suddenly start taking sertraline. Could be that you are under-medicated, and needing a higher dose of levo. Depression/anxiety are hypo symptoms.

[Hidden in reply to greygoose]

Hi the sertraline was to help with the covid. It triggered very odd symptoms including anxiety. I don’t think it was psychological, just started hyperventilating and super fast heart. It’s turned out to be quite common. Also the gasping for air in the early stages is pretty anxiety provoking.

[greygoose in reply to Hidden]

Well, I can't see how sertraline would help with that. Did you find it helped? Your doctor obviously thought 'it was all in your head'!

[Hidden in reply to greygoose]

Hi there, it did seem to help. My GP is so much more supportive than most consultants I’ve seen. With the covid because there was nothing else to do he’s treated symptoms as they present. So when my heart was racing and I was anxious he prescribed beta blockers and sertraline but also arranged bloods and cardio follow up. I can’t fault him and feel lucky to have him. He’s even offered to challenge the pct if there was any problems prescribing t3 (not on it currently). I wish I’d stuck with him and given endocrinology a miss at times.

[greygoose in reply to Hidden]

Yes, most endos are diabetes specialists who know nothing much about thyroid. We're often better off without them.

[Smorzando]

Yes, there is an interaction between levothyroxine and Sertraline. It's on the CKS (Clinical knowledge summary) NHS pages.

cks.nice.org.uk/hypothyroid...

I don't think many people are aware of this interaction - you should discuss it with your GP.

[Hidden in reply to Smorzando]

Thanks Smorzando, I’ll mention it.

[Lalatoot]

Mike it is fairly well documented that ssri medication affects the absorption of levothyroxine. It can mean that you need an increase in levo dose.

I spent years on citalopram and levo. Since I am no longer undermedicated I no longer need the citalopram. It might be worth looking at your thyroid bloods to see if your dose is sufficient.

My problem was anxiety. What my body lacked in thyroid hormones it made up for with adrenaline. It kept me going but it was no way to live.

[Hidden in reply to Lalatoot]

Thanks Lalafoot

[Nanaedake]

Besides interfering with levothyroxine absorption, SSRIs come with side effects, some of which might not be listed on the leaflet as we are all different. Maybe you have a kind of PTSD triggered by inability to breath with COVID and maybe some kind of specific non drug help for it would be better? There are some specific types of non drug treatment but not sure if available on NHS. Worth looking into.

[Hidden in reply to Nanaedake]

Thanks Nanadrake, thankfully I don’t have PTSD. I’ve ended up with what’s being called long haul covid or long covid. Basically means your lungs and circulation are in a mess and taking ages to recover. The virus seems to have some direct affect on mood with lots of long haul patients experiencing anxiety, palpitations etc that seems to be physically based as well as the obvious psychological anxiety of dealing with a long term illness. I’m sure the first few weeks of terrifying breathlessness has caused ptsd for many. Here’s a piece that helps describe it. Wishing you health, Mike

google.com/url?sa=t&source=...

[Nanaedake in reply to Hidden]

It sounds grim. I hope you get some answers and sensible help.