Low mood : So after speaking to my gp this... - Thyroid UK

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Low mood

Macey2009 profile image
11 Replies

So after speaking to my gp this morning regarding low mood/depression/anxiety she had prescribed fluoxitine.

I'm convinced it's thyroid related along with other symptoms (have hashis)

I just feel stuck in a rut and there's not much i can do other than my gp monitoring me every 6 months.

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Macey2009 profile image
Macey2009
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11 Replies
shaws profile image
shawsAdministrator

I hope your GP tested Free T4 and Free T3 before prescribing fluoxetine!

This is a link that might be helpful/informative:

nhs.uk/medicines/fluoxetine...

Macey2009 profile image
Macey2009 in reply toshaws

Hi i had my tests done last week. I'm not diagnosed btw. They are just monitoring my levels every 6 months.

tattybogle profile image
tattybogle

I just did a quick google of TSH /Fluoxitine

Results at first glance seem a bit contradictory as to whether TSH rises or falls with fluoxitine,... but there is clearly an acknowledged association with thyroid function , even if it's quite small..

Found this one saying oit lowers T3/4

researchgate.net/publicatio...

" Patients with normal thyroid function who were treated with fluoxetine demonstrated a significant reduction of T(3) after 15 and 30 days of treatment (p = 0.034 and p = 0.011) and a significant reduction of T(4) throughout the intervention period (p = 0.04 after 15 days; p = 0.015 after 30 days; and p = 0.029 after 90 days). However, all thyroid parameters remained within the euthyroid range."

Given that you have TPOab, and they are monitoring your TSH every 6 months.. i think it's likely that lower T3 /4 will not help you feel better than you do now.

So do a lot more reading before you agree to take it, because since you are currently stuck waiting for your TSH to rise enough for a diagnosis , if it did lower your TSH , it will just mean it takes longer to get diagnosed.

(having said that, since you are nowhere near getting diagnosed at the moment , i suppose it's possible that it might help with depression, you wouldn't know unless you tried it...But before you do, at least get GP to acknowledge that it may affect your TSH.)

Also it was in the news recently that NHS have now acknowledged that Antidepressant's can be hard to withdraw from.

Macey2009 profile image
Macey2009 in reply totattybogle

Hi thank you for a detailed reply. I had no idea it could lower TSH levels.

I don't really want to ask my gp about that to be honest. I think i know the response. 'Don't worry about that, there's nothing wrong with your thyroid'

It was actually a rheumatologist that recommended the 6 monthly tests via gp based on high antibodies. I think if it was up to the gp they wouldn't bother.

tattybogle profile image
tattybogle in reply toMacey2009

Trust me, if the GP didn't want to bother, they wouldn't agree to testing 6 monthly , regardless of who suggested it . They are testing every 6 months because they Know that you are more likely than some one without significant high TPOab to become hypothyroid at some point.( >1000 is significant) This is not a matter of GP opinion .. it's a matter of fact..... one that even the NHS acknowledge and have put in their recent thyroid diagnosis and treatment guidelines. So he may say "there's nothing wrong with your thyroid" and that may be true at the moment.. but he's supposed to be keeping an eye on your TSH in case it goes up .. so whether there is anything wrong with your thyroid at the moment is irrelevant to that.

And prescribing something that may affect what he's supposed to be monitoring is something he should be aware of.

Hopefully he already is aware if it , but there 's no harm in you checking he is ... in fact it would be daft not to.

So don't let them make you feel stupid / or a nuisance for pointing it out if you want to.

Discuss it , he'll then have to write something about what was discussed in your notes... If you don't discuss it , your notes will just say "prescribed antidepressants" and it will say that forever , which will not help with getting prescribed levo if your TSH does go slightly over range ... The next GP will see "antidepressants" and think .. oh but this lady was depressed before so that is probably all that is wrong with her now, so even though her TSH is a bit over range i still don't think it's her thyroid that's the problem.

So .. be a nuisance .. make then write something like .. "she has agreed to try flouxitine but was concerned it may affect her TSH"

Macey2009 profile image
Macey2009 in reply totattybogle

Thanks again. You're always so helpful.

I'm never very keen on discussing things over the phone or face to face. Not assertive enough and just gp along with whatever gp says.

Is there anything i could send in writting for evidence ect that could be documented in my notes?

Jump1 profile image
Jump1 in reply toMacey2009

What are your levels

Macey2009 profile image
Macey2009 in reply toJump1

Only had 3 tests so far

August 2020

TSH 2.5 (0.20-4.50)

Free T4 14 (9-21)

Feb 2021

TSH 2.8

FREE T4 13

AUG 2021

TSH 2.2

FREE T4 14

All same ranges

Tests done 8.15 water only.

tattybogle profile image
tattybogle in reply toMacey2009

Crikey ...i've just realised it's "prozac"Did they discuss with you how careful you have to be to come of this really slowly due to withdrawal effects ?

I haven't done enough reading to find a good bit to send for notes .. but as far as i know, anything you send them on paper has to be put in your notes.. so even a hand written note that said "Dr Doctor x , i am concerned that taking 'x' could affect my TSH and may delay any future diagnosis of hypothyroidism" would end up in there.

There is a shopping list in my NHS notes , cos i'd written points to raise with Doctor on the back ... GP asked if she could keep it to remind her.... years later i discover both sides of note were scanned into NHS notes .... Reminders of my symptoms on one side .. Onions /Post Office /Gas Bill /Bog Roll , on the other :) lol

Macey2009 profile image
Macey2009 in reply totattybogle

She did but can't remember exactly what she said. She did say to call her in a couple of weeks to see how i'm getting on.

Ok well that's good if they scan and put into notes. Just need an idea what to write lol

shaws profile image
shawsAdministrator in reply totattybogle

They are very quick to prescribe anti-depressants before testing both Free T4 and Free T3 to make sure they are at an optimum dose or nearing optimum.

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