Hashimotos and Anti depressants

[Daffers123]

Hi

Does anyone have a view on which anti-depressant wreaks the least havoc for Hashi's patients. My choice is Mirtazapine or Sertraline. I can tolerate Mirt (low dose) but wonder if Sertraline might be more uplifting.

I am taking T4 and T3.

Thanks

[1Artist1]

Sertraline works for me with T4 and T3 x

[breadmaker]

Sertraline works for me too. Am on a low dose but it keeps me ticking over and helps with anxiety etc.

[MichelleHarris]

Duloxetine is very effective. One of the newer ones x

[humanbean]

These are the top 100 side effects reported for sertraline :

rxisk.org/top_100_reactions...

You can look up other SSRIs, and drugs generally, on the same site.

I tried it many years ago and got no benefit from it. I've also tried (also many years ago) Prozac, Seroxat, and Citalopram. I got no benefit from any of them but I did get side effects from them all. Permanent headache is the one I remember mostly, and extreme sleepiness which hit out of the blue with no warning was another. That was scary when it happened when I was driving.

Nowadays I take an over-the-counter supplement for depression that has worked for me for nearly ten years. It's called 5-HTP (short for 5-hydroxytryptophan). It's widely available on Amazon and other supplement sites and it would be worth reading any reviews.

en.wikipedia.org/wiki/5-Hyd...

It is important that 5-HTP isn't mixed with any prescribed anti-depressants. Just like you wouldn't be prescribed Prozac and Sertraline to take at the same time, you shouldn't take 5-HTP and Prozac at the same time or 5-HTP and Sertraline at the same time.

Unlike SSRIs, you will know if they are going to work for you within the first week or two. If you haven't benefited after a couple of weeks I'd suggest giving them up.

Doses of 5-HTP vary hugely. Personally, during most of the years I've taken 5-HTP I've taken 50mg once a day just before bed, which is a very small dose. But I know other people take massively more, or take doses 2 or 3 times a day. It is possible to buy tablets/capsules which are a dose of up to 400mg. Anyone interested in trying it would be best to start with 50mg and only work up if they thought it was necessary. (Low dose products are actually harder to find than higher doses, which is annoying.)

5-HTP raises cortisol, which may be why I can only take a very low dose (my cortisol is already high).

5-HTP is made out of a plant, and because it comes from a natural source it can't be patented.

Although doctors never mention this, SSRIs, some painkillers, and some other drugs and supplements including 5-HTP have been implicated in people developing serotonin syndrome.

en.wikipedia.org/wiki/Serot...

Note that 5-HTP has been mentioned on the forum a few times so search for references to it.

[Daffers123 in reply to humanbean]

Thanks HB for all the info. I have heard about 5HTP but had forgotten all about it! It would be preferable to ADs I agree 100%.I will reread and thanks for your comments

[malancy]

I take Sertraline for anxiety and panic attacks and I'm fine. Many years ago I had Citalopram which mad me panic more.

[Wired123]

Have you thought about optimising your thyroid first?

An untreated thyroid disease can have similar symptoms to anxiety and depression.

[Daffers123 in reply to Wired123]

Yes you're right about thyroid but I am struggling with raising my dose of either hormone. I can only tolerate a small dose. I was trying to find a quick fix for traumatic situation but I do know there is really no such thing!

[Wired123 in reply to Daffers123]

What if you raised your level of thyroid hormones slowly?

I’ve seen the negative side of anti depressants (and they are not pretty) so would only recommend as a last resort. Doctors are far too keen to prescribe them!

[Daffers123 in reply to Wired123]

Yes maybe that is the answer, to try slow raising. I don't understand how some people can take vast doses of T3 and T4 and not even notice yet even the tiniest increase sends me over the edge for a day or so!

[Wired123 in reply to Daffers123]

Well then perhaps your thyroid hormones are fine. My private endo said adding T3 you will know in a few days if it’s right for you or not. If you can’t tolerate it then you’re over medicated.

I will add though my own experience is the first is uncomfortable, so if you can get through that and you’re ok then you need it, if after 2 weeks you can’t tolerate then you’re over medicated. I was tempted to stop after a few days as it was uncomfortable. I’ve persevered and am mainly ok.

Advice on here seems to be about tapering up slowly. I followed that and am glad I didn’t follow my Endo’s advice to start on 10mcg. I did 5mcg per day for one week and then increased by another 5mcg. Doctor was silly to suggest 10mcg from day 1 as side effects would have been too much.

Perhaps you can try tapering up in small amounts, some even do 2.5mcg per day initially.

Anti depressants are horrible and only last resort. A good friend of mine is a psychiatrist and another is a psychologist, they see this daily.

Anti depressants are great for those who REALLY need them. For others they either just numb you out (which is a waste of a life) or they can make you even worse and suicidal which is the last thing anyone needs. Plus getting off them is terrible and traumatic, so best avoided unless absolutely needed. The NHS seems to be happy to numb people so they aren’t a nuisance and pharma companies actively market the “benefits” to doctors hence they are at the forefront of doctors’ minds. If only T3 and better thyroid treatment were actively marketed to doctors their actions might be different.

Anti depressants are just as easy way out for doctors and make life easier for lazy/overworked doctors who don’t have time, energy or knowledge to get to the root of their patients’ problems.

[Daffers123 in reply to Wired123]

Hi and thank you so much for your reply, comments v much appreciated. I was interested to read your T3 experience as my (ex) private endo who gave me a T3 trial said I should start on 10mcg and raise up to 25mcg within a couple of weeks.i was very unwell and it made me nervous of T3. Currently I take 10mcg daily but its taken several months. I will get my bloods done and attempt slow small raises . I don't feel optimum!

Thank you so much you have given me courage.

[Angel_of_the_North]

I would read Dr David Healy's blog (he's a UK psych) before taking any ADs

[Daffers123 in reply to Angel_of_the_North]

Thank you, I will read that.