Two different medications

[heps56]

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 .

[Lalatoot]

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.

[heps56 in reply to Lalatoot]

Hi thanks for reply. Will get in touch with my GP and mention. Thanks 😊

[SlowDragon Administrator]

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

[heps56 in reply to SlowDragon]

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🙂.

[greygoose in reply to heps56]

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!

[heps56 in reply to greygoose]

Hi thanks for that advice I will ask for a print out next time and post results on here. Thanks again

[greygoose in reply to heps56]

You're welcome.

[SlowDragon Administrator in reply to heps56]

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...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

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

[SarahJane1471]

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 🤷‍♀️

[heps56 in reply to SarahJane1471]

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.

[SarahJane1471 in reply to heps56]

Sorry should have said the higher Levo dose needed is because Sertraline can lessen the absorption of Levo 😬

[heps56 in reply to SarahJane1471]

No worries😊. I can see now where I could possibly need an increase. Thanks 😊

[Sparklingsunshine in reply to heps56]

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.

[heps56 in reply to Sparklingsunshine]

Hi thanks for message. I am starting to do that now even thought about entering tuff mudder to give me that extra boost to do something. Thanks again.

[tattybogle]

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.