Antidepressants and thyroid problems: Hi, my GP... - Thyroid UK

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Antidepressants and thyroid problems

Sazzle1969 profile image
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Hi, my GP has just started me on Levothyroxine at 25mc. I was on Liothyronine, which had been prescribed privately, but had to come off it as can't afford it anymore and it wasn't really helping my symptoms. I have become very depressed recently too and doc wants me to take antidepressants, but I don't want to because of risk of even more weight gain and other side effects. I have v high cortisol levels and suspect that is causing problems with my thyroid system. Has anyone else tried antidepressants and found problems with weight gain with thyroid problems? It seems pretty standard that antidepressants are linked to weight gain, and I think that is part of what is causing my depression, along with a load of other stressors. Any advice/info? Many thanks

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SlowDragon profile image
SlowDragonAdministrator

Being hypothyroid causes depression

Standard starter dose of levothyroxine is 50mcg.....unless over 60 years old

Bloods should be retested 6-8 weeks after each dose increase

All thyroid tests should be done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Getting dose increased upwards in 25mcg steps after each blood test ....as fast as tolerated

Important to regularly retest vitamin D, folate, ferritin and B12 too. These need to be a good levels to tolerate getting dose levothyroxine increased upwards as fast as possible

Obviously essential to test TSH, Ft4 and Ft3 together

Have you had BOTH Tpo and TG thyroid antibodies tested

Come back with new post once you get test results

humanbean profile image
humanbean

I have v high cortisol levels

Was your cortisol tested via blood or saliva? Do you have the results and reference ranges?

I refuse to go on prescribed anti-depressants. They've never helped me to become less depressed.

The things that I have found helpful or I have read helps others...

1) I discovered that low iron and ferritin makes me very depressed. Having optimised it as much as I can my depression and anxiety dramatically reduced. Some people reduce depression and anxiety by optimising/improving their vitamin B12 and folate levels. For some people optimising vitamin D helps enormously. Having too low a level of any vitamin or mineral will increase depression and anxiety.

2) I have reduced my cortisol with Holy Basil (an adaptogen). Some people find that ashwaghanda (another adaptogen) helps to reduce cortisol. With the reduction in my cortisol I get far more benefit from my thyroid treatment and can tolerate more effective doses than I could before.

3) Eating a better quality diet. Eating lots of carbs makes me feel terrible, but a higher protein diet which includes some natural fats helps a lot.

4) Starvation makes people depressed. So many women deprive themselves of sufficient food to try and control or reduce their weight but it doesn't work for the majority of people.

5) Have you been tested for Cushing's Syndrome?

mythreecats profile image
mythreecats in reply to humanbean

Human bean, would anxiety produce high cortisol or high cortisol produce anxiety.... Since developing a mouth isdue from sjogren's im anxious 24/7... Its making it hard to deal with this new condition... My cortisal is rising and a private test has it above rangr... My mouth is probably dry from sjogren's but this terrible anxiety mudt play a part.... I usually sleep well but im totally sleep deprived now... Im sooo struggling.... Would magnesium lower cortisol.... And does lowering it reduce anxiety?

humanbean profile image
humanbean in reply to mythreecats

Edit : I didn't notice that I had already replied to this thread a couple of months ago, and have managed to repeat myself, at least partly.

...

would anxiety produce high cortisol or high cortisol produce anxiety

I can't say - both situations could occur, and it depends on the individual whether their anxiety produced their high cortisol or vice-versa. And in some people there could be a mixture of the two depending on their health and life experiences.

As an example, my anxiety reduced when I improved my iron and ferritin. I didn't know in advance that this would happen - I had no idea they could even be related, but I have since found occasional references to anxiety being a symptom of low iron. (Unfortunately I haven't kept them.)

But which of these sounds more likely?

1) Scenario 1 --- I became anxious for no reason and as a result my iron and ferritin became low. My anxiety made my cortisol rise.

2) Scenario 2 --- My iron and ferritin dropped and one symptom of this was that I developed anxiety. The anxiety made my cortisol rise.

3) Scenario 3 --- My iron and ferritin dropped and as a result my cortisol rose. As a result of the rise in cortisol I became anxious.

I am convinced that Scenario 2 is what happens in me - the others just make no sense to me, given what I know of my own life and my own stressors. I have never heard of anxiety reducing iron and ferritin, for example. How would it even work?

Another situation that is very common is that people don't realise there is a connection between low iron and tachycardia (fast heart rate). Heart rate rises when people are frightened and/or anxious. So if someone has a fast heart rate they might interpret what they are feeling as anxiety, when what they are actually suffering from is low iron.

Another complaint of mine is that people, including doctors, always assume that stress and anxiety is a mental health problem. Doctors don't look for physical causes they just dish out anti-depressants. Anti-depressants don't raise iron so anti-depressants never did anything for me.

I don't know anything about you or your life (and I don't want to know - I'm not a doctor), so I can't tell you what might be causing high cortisol for you. But I would suggest doing everything you can to optimise diet, thyroid, sleep, nutrients, and levels of exercise, and just see what happens.

Just for reference...

I said that anti-depressants never worked for me. I have found one OTC supplement that reduces my depression. I've been taking it at a low dose (50mg) for about 10 years now. It is called 5-HTP. It comes in various doses, from 50mg - 400mg per capsule/tablet. It gets mentioned on the forum occasionally, so do a search if it interests you.

mythreecats profile image
mythreecats in reply to humanbean

Thanks human bean. Appreciate

mythreecats profile image
mythreecats in reply to humanbean

Human bean, u mentioned in a post u used holy basil to reduce cortisol... Would that ultimately refuce anxiety?

NIKEGIRL profile image
NIKEGIRL

Personally I have tried anti depressants and found they did not work. I believe In using a psychologist to get to the root cause of depression. Being hypothyroidic can cause a depression but that’s a very simplistic way of looking at things. We are complex creatures.

Imaaan profile image
Imaaan

I've used an anti depressant, prozac to be exact and it helped a wee bit but still was really struggling until I received my true diagnosis with hypothyroidism. l Haven't used it for over a decade because A) my symptoms were largely due to my thyroid and B) it increased my prolactin levels which ended up in me getting an MRI or ct scan cant remember. After all the usual causes of high prolactin came back negative, the doc did some digging and found out that fluoxetine can increase prolactin. So I stopped. Humanbean hit on the nail that other deficiency can cause anxiety and depression as well. Whenever my levels are off I feel awful physically and mentally.

I've also gone the natural way and have tried 5 htp, st John's worth and adaptogens. A word of caution 5 htp can cause palpitations in some and I was one of them. I couldn't even do the 50 mg. As for st John's worth there are countries that actually prescribe it for depression. One possible thing to note is that something in the herbs can effect the eyes. I cant remember. I read it in medical literature many many yrs ago.

Another possibility is that maybe your free t3 is low. I know you said it didn't work for you but possibly u were not on the correct dose. You can read online that there is an off label use of t3 by docs in psychiatry. It has been shown that it can help some who have resistant treatment depression.

For adaptogens, I use a supplement that has several but I absolutely love ashwagandha because it's good for cortisol and the thyroid.

Also supplementing with magnesium and a good quality fish oil with a high epa is amazing for mood

humanbean profile image
humanbean in reply to Imaaan

A word of caution 5 htp can cause palpitations in some and I was one of them.

5-HTP is known to raise cortisol, and mine has already shown up as high on testing. This is why I keep my dose low (50mg). It still helps me.

It's actually much easier to buy higher doses of 5-HTP than it is to buy the 50mg ones, which I think is mad. And I know someone personally who thought that 5-HTP must be completely innocuous - because it was sold over the counter - so she took about 5 or 6 all at once expecting to get,I suppose, just a little bit more relaxed or happy. She nearly ended up in hospital. She does take it now, in much more modest doses.

Just as a point of interest for anyone with an interest in cortisol, these links are worth looking at :

stopthethyroidmadness.com/s...

rt3-adrenals.org/does_it_af...

Unfortunately, neither link tells people whether the substance raises cortisol or lowers it, so people have to do their own research.

Imaaan profile image
Imaaan in reply to humanbean

Never thought of the cortisol aspect and I've had results where my random cortisol was above normal. I always really appreciate talking to others in a similar boat with thyroid and stuff. I'm always learning. Yes, my heart went into overdrive everytime I tried it. I couldn't even do 25. We really are guinea pigs in our search for better health. Its literally trial and error. I feel terrible for the poor soul who took the few pills and landed in the hospital.

I really dont understand, like you, why they dont have smaller doses for supplements. Its really nuts. I've been having the hardest time with B complex supplements. Some of the doses for each are either too high or not enough. Ive spent soo much money. My body is sensitive and I just need 400 folate, 400 b12 and a lower amount of everything else because I react to it. It's been the bane of my existence trying to find something that doesn't make my heart go in to over drive.

By the way I've been stalking you and SlowDragon . I love your posts and more importantly I love your bedside mannerisms in replying.

SlowDragon profile image
SlowDragonAdministrator in reply to Imaaan

Igennus B complex is a good vitamin B complex option....full dose is two tablets per day (ideally as split dose)

Many people only need single tablet.....or can cut into half or 1/4 tablet too

Imaaan profile image
Imaaan in reply to SlowDragon

Thnxs for the reply. I looked into it in the past and correct me if I'm wrong but one dose has less than 400mcg of folate.

SlowDragon profile image
SlowDragonAdministrator in reply to Imaaan

Yes...one tablet is only 200mcg folate

igennus.com/products/super-...

So too low

Imaaan profile image
Imaaan in reply to SlowDragon

Yup and the full dose I cant take because the levels of b12, and b6 are too much for my heart. Anytime I've tried anything over 400mcg of b12 and 33mcg of b6 I get crazy palpitations. Anyways thnxs for the suggestion. It's much appreciated.

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