Hi can anyone help. On antidepressant tablets sertraline 50mg 1 a day. Can this counter act with my levothyroxine tablet 100mg gaining weight . If not best time to take them?. Thanks .
Two different medications : Hi can anyone help... - Thyroid UK
Two different medications
Setraline is an SSRI. SSRIs alter the levels of serotonin. Much of our serotonin is in our gut. Altering the levels can affect how our gut works which in turn can affect the absorption of levothyroxine. It is well documented that folks on SSRI medication may need a slight increase in levo to compensate for this.
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
verywellhealth.com/best-tim...
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
How long have you been on 100mcg levothyroxine
Bloods should be retested 6-8 weeks after any changes, eg if you recently started on antidepressants….or if you change to taking levothyroxine at bedtime
Always test thyroid levels as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
What were your most recent thyroid results and ranges
Are you currently taking any vitamin supplements
When were vitamin D, folate, ferritin and B12 last tested
Hi. Have been on 100mcg for a few years but the antidepressant only 8 months. Last blood tests where summer last year. When I phone the doctors back after blood test they just say everything is fine never give a copy of results or any details of levels. Thanks for reply and advice🙂.
It's very rare for a doctor to give you your actual results - they'd rather you don't know! You have to ask at reception for a print-out - it is your legal right to have one, if you live in the UK. And you really should ask for one because you need to know exactly what was tested and exactly what the results were. If you find you need an antidepressant, I'm willing to bet you're under-medicated. But your doctor would far rather give you antidepressants than thyroid hormone!
Do you know the cause of your hypothyroidism?
About 90% of all primary hypothyroidism in Uk is due to autoimmune thyroid disease also called Hashimoto’s, diagnosed by high thyroid antibodies
Low vitamin levels are particularly common with Hashimoto’s.
In several of your previous posts recommended getting FULL Thyroid and vitamin testing done
You are legally entitled to printed copies of your blood test results and ranges.
The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results
UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.
Link re access
healthunlocked.com/thyroidu...
In reality many GP surgeries do not have blood test results online yet
Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.
Important to see exactly what has been tested and equally important what hasn’t been tested yet
Far too often only TSH is tested and is completely inadequate
Depression is frequently linked to low thyroid levels
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine or after starting on antidepressants
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
In U.K. medics never call it Hashimoto’s, just autoimmune thyroid disease (and they usually ignore the autoimmune aspect)
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
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...
Medichecks Thyroid plus antibodies and vitamins
medichecks.com/products/adv...
Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test
bluehorizonbloodtests.co.uk...
If you can get GP to test vitamins and antibodies 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...
NHS easy postal kit vitamin D test £29 via
Link about thyroid blood tests
thyroiduk.org/getting-a-dia...
Link about Hashimoto’s
thyroiduk.org/hypothyroid-b...
List of hypothyroid symptoms
thyroiduk.org/if-you-are-un...
First step is to get hold of recent GP thyroid results, see exactly what has been tested
Then get FULL thyroid and vitamin testing done 6-8 weeks after starting to take levothyroxine correctly on it’s own on empty stomach…..
Come back with new post once you get results
I take both sertraline and Levo. Levo in the morning sertraline at night. Sertraline has never made me gain weight ( been on it for 10 yrs) buy hypothyroidism has made me gain 2 dress sizes in last two years 🤦♀️. From my reading you made need a higher dose of Levo 🤷♀️
Hi Thanks for that advice. I will certainly try taking it that way too. I also used to run a lot but my enthusiasm for it has gone. Which I also find depressing . A viscous circle 🙄. Thanks for replying.
Sorry should have said the higher Levo dose needed is because Sertraline can lessen the absorption of Levo 😬
No worries😊. I can see now where I could possibly need an increase. Thanks 😊
Hi
SSRI's can cause weight gain in some people. Like any side effect it varies. Some find they eat more, some eat less and others, that it has no effect. Also if you're exercising less but eating the same amount as when you were that can lead to weight gain.
And being undermedicated won't help. Ironically exercise has been found to be as effective antidepressants in mild to moderate depression. It's a vicious circle though, as you become depressed your motivation to exercise drops and your mood decreases.
I've had the same feeling since Xmas but am making myself go out for a walk each day or go on my rowing machine at home as I know exercise always boosts my mood.
As well as the potential for absorbing less Levo..... weight gain is listed as a potential side effect of sertraline anyway. Mind you , my daughter was just on it for a coupe of months , and the opposite effect happened .... weight loss ... but that was because as soon as she took it she became so disinterested in anything , that her desire to eat anything at all pretty much disappeared.
She decided to come off it , and found a private counsellor to talk to instead .... and her appetite has returned.