Vortioxetine for MDD

[sobs1962]

My psychiatrist is considering putting me on vortioxetine for MDD(major depressive disorder) and I've googled it's ingredients and it apparently contains mannitol which I've had a problem with before in the Teva brand of Levothyroxine and it's ultimately my decision whether I go on them or not. If I've had a problem with mannitol before is it inevitable I will have it again. Anyone had any experience with this medication and any advice most welcome.

[SlowDragon Administrator]

Are you currently only taking levothyroxine

Why don’t they try adding T3 instead

[sobs1962 in reply to SlowDragon]

My last blood test in February showed TSH 0.01(0.35 - 5.50) and Ft4 18.7(10.0 - 20.0) and endo said if it stays that way, they will reduce my levo dosage, so there's no way, they'll give me T3 and they wont check my ft3 levels so cannot diagnose thyrotoxicosis without those. Anyway if this antidepressant contains mannitol, I can't take it as it gives me palpitations and feels like I'm going to pass out, so it doesn't really matter anyway. Not making myself ill for the sake of some doctors ego.

[SlowDragon Administrator in reply to sobs1962]

Obviously essential to test TSH, Ft4 and Ft3 together

Just testing TSH and Ft4 is completely inadequate ..it tells you nothing….

Ft3 might be right at bottom of range

Especially if vitamins are low

When were vitamin D, folate, ferritin and B12 last tested

Low Ft3, tends to lower vitamin levels

Low vitamin levels result in poor conversion of Ft4 to Ft3

Poor conversion results in low TSH, high Ft4 and low Ft3

Unless you test everything you can’t see what’s going on

Can you test yourself

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)

Is this how you do your tests?

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

If you can get GP to test vitamins then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Medichecks Thyroid plus antibodies and vitamins

Often on offer at £59

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

[sobs1962 in reply to SlowDragon]

Vitamin d,folate,ferritin and b12 last checked in May 2020 and I suspect I'll have a fight on my hands to get them re-checked despite telling the doctor I suspect I may have coeliac disease. Unfortunately my practice are quite useless and I really can't afford to be spending hundreds of pounds on private blood tests, as not currently working due to severe mental health problems.

[Batty1]

Just so your aware antidepressants can effect your thyroid levels and taking them hours from thyroid meds don’t seem to make a difference. I was on Cymbalta for chronic pain and my thyroid levels plummeted so low.