I had my thyroid removed when I was 28 yrs due to Graves’ disease. I had severe goitre, benign nodules, palpitations and weight gain (not the standard weight loss). This was 3 years after my first born. A year later I had an ectopic pregnancy and had to have a tube removed. I luckily fell pregnant again and gave birth to a healthy boy 3 years later. I have been on levothyroxine daily since having my thyroid removed.
My issue now is I’m 43, perimenopausal, with depressive tendencies. Hypothyroid as no thyroid, on levothyroxine daily. I was put on sertraline which swelled my tongue, gave me diarrhoea so I was then put on fluoxetine which has led to further swelling of my throat, puffy face and weight gain. I’ve read how SSRI antidepressants can counteract against levothyroxine and instead TCA antidepressants should instead be used. Anyone have experience of this?
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Please add most recent thyroid and vitamin results and ranges if you have any
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
Do you always get same brand levothyroxine at each prescription
How much levothyroxine are you currently taking and which brand
For full Thyroid evaluation you need TSH, FT4 and FT3 tested
Also both TPO and TG thyroid antibodies tested at least once
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
what vitamin supplements are you currently taking
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
List of private testing options and money off codes
Whilst I can't answer your immediate question I do know that once I found the right thyroid hormone replacement for me - I too am with Graves Disease but post RAI thyroid ablation back in 2005 - I now have no need for any anti depressants and the worry of thinking I was dealing with the early onset of dementia also kicked into touch.
It is imperative that you are dosed and monitored on your Free T3 and Free T4 readings and these 2 vital thyroid hormones need to be high enough in the ranges, generally with T4 being in the top quadrant, and balanced at around a 1/4 ratio T3/T4 - in order to relieve your symptoms of hypothyroidism, one of which is depression.
A fully functioning working thyroid would be supporting you on a daily basis with trace elements of T1, T2 and calcitonin + a measure of T3 at around 10 mcg + a measure of T4 at around 100 mcg -with T3 said to be around 4 times more powerful than T4 :
T4 is a storage hormone and needs to be converted by your body into T3 the active hormone that runs the body and in order for T4 to work effectively in the body and convert well to T3 we need to maintain optimal levels of core strength vitamins and minerals, especially those of ferritin, folate, B12 and vitamin D .
The thyroid is a major gland responsible for full body synchronisation including your physical, emotional, mental, psychological and spiritual well being, your inner central heating system and your metabolism.
Some people can get by on T4 only medication - Levothyroxine :
Some find they need to add back in that little bit of T3 ' lost " when they lost their thyroid to restore hormonal balance.
Some find they can't tolerate T4 and need to take T3 only - Liothyronine.
Whilst others find their health restored better taking Natural Desiccated Thyroid which contains all the same known hormones as that of the thyroid gland and derived from pig thyroids, dried and ground into tablets referred to as grains.
I’m currently taking Amitryptaline which is a TCA. The PIL indicates that there can be interactions but does not specify how. Further research indicates that each can potentiate the effect of the other. This is not inevitable however. I haven’t been on this AD for long enough to evaluate what effect, if any, it’s having on my thyroid levels
I’ve also taken Fluoxetine (an SSRI) for two years. This did not affect my thyroid levels. Neither did it improve my depression. Only when T3 was added to my thyroid meds and my FT3 Levels became optimal did depression improve
I think the effects of ADs are very specific to the individual. TCAs are said to have more side effects than SSRIs. That hasn’t been so in my case
I’ve also taken Fluoxetine (an SSRI) for two years. This did not affect my thyroid levels. Neither did it improve my depression. Only when T3 was added to my thyroid meds and my FT3 Levels became optimal did depression improve
This is interesting to hear. I was prescribed fluoxetine back in the 90's when I had a bout of unexplained depression, which, looking back was probably a symptom of my then undiagnosed Hashimoto's. No test done. They had no effect and I weaned myself off them.
Fast forward 10 years, I was prescribed other SSRI, citalopram, when I had similar symptoms. It had no beneficial effect. By then I was on levothyroxine 50mcg, and thyroid profile was 'in range', but, crucially, T3 was not tested. It is only many years later, through this site, that I have learned the importance of T3.
I have also learned that T3 is used in 'treatment resistant depression'
Hi there, I am currently taking Clomiprimine, it's a long story, that I won't go into, but I've recently discovered a link between the drug and poor thyroid, this may not matter in your case. If you can, I would avoid taking antidepressants as they have their own problems. Good luck
Hi, I've been on Thyroxine due to underactive thyroid for approx' 25years. I was put on Sertraline in April, off work with depression and anxiety. Weeks later, I asked for the Sertraline to be changed as I was feeling more anxious etc. The gp put me on Citalopram, which I've had previously. Never had problems with Citalopram, though he upped my dose from 20 to 30mg. Almost 8 weeks later, and feel these tablets are doing their job, as well as counselling. I suppose everyone's different and anti depressants work differently with each person. This last doctor also stopped my Naproxen for my torn ligament, saying it's incompatible with Thyroxine - but it was one of his colleagues that gave it to me! I have used that on and off for years for my arthritis! Try a different gp in your surgery if it's possible or one that you can have a good talk with.
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