Sertraline and contraindication

[Elly333]

Background - I was recently started on levothyroxine after many years of not feeling well after having a private health screening through work which flagged up a higher than normal tsh and a low t4 reading. It seems that my tsh had been going up for a long time but was never flagged as it was deemed ‘normal’ by GP.

Anyway…for a long time I’ve also suffered with low mood and anxiety and have been on and off SSRIs for quite a few years. For the last two, I’ve been taking Sertraline but tried to wean myself off. I was feeling okay but now find that things at work are making me feel low and tearful so feel like I need to restart but notice that Sertraline is contraindicated on the leaflet. Can I still take it(a few hours after Levo) or should I change to a different SSRI. I’ve just been put up to 100mg by private Endocrinologist and don’t want to risk lowering the effectiveness through Sertraline.

Any advice would be appreciated. Thanks

[Buddy195 Administrator]

Increased anxiety has been the worst symptom of having a thyroid condition for me and it is always worse if thyroid medication or key vitamins (ferritin, folate, vitamins B12 and D) are not optimal. I have been offered anti depressants several times by my GP but actually haven’t needed them, as my symptoms have alleviated when I improved BOTH thyroid medication & key vitamins.

Obviously, optimising thyroid medication and key vitamins may not alleviate all anxiety/ low mood symptoms and if this is the case, anti depressants can be extremely helpful for many.

What SSRI are you currently taking/ what dose?

Can you share your thyroid blood tests for TSH, FT3 and FT4 and key vitamins with us?

[Elly333 in reply to Buddy195]

TSH was 6.8 and t4 was 12 before I started 50mg of levothyroxine. Had a private appointment with a brilliant female Endocrinologist. I’ve never felt so listened to and it was great to be taken seriously. She took bloods and said I should go up to 100mg of Levo. She also noticed that my folate was low so advised to start taking over the counter supplements. I’ve been on 50mg of Sertraline(although had weaned off when I saw her) - it takes the edge off low mood and stops me stressing so much. I do swim regularly too. I also use oestrogen gel for HRT and she said my oestrogen was low and I needed another pump.

[Buddy195 Administrator in reply to Elly333]

I would retest thyroid levels 6-8 weeks after being on a new dose of thyroid medication and share results with us. Also add ranges ( in brackets after results) as these vary between laboratories. It is likely you will need another increase in Levothyroxine as TSH should be significantly under 2 (with many members here reporting they only feel well when TSH drops below 1).

Personally, I’m an advocate of low and slow increases in medication as, for me, this causes spikes in my anxiety levels. I therefore increase only by 12.5mcg and find a pill cutter very useful.

Some members report needing more HRT when taking Levo. However, in my case, I needed slightly less. That is why retesting levels is very important.

[SarahJane1471]

I take Sertraline at night and Levo in the morning. No one has ever told me that there is a problem with this

[helen_m in reply to SarahJane1471]

Hi SarahJane1471, apologies for asking this but I had posted this question with no replies yet about the timing of Sertraline with thyroid meds. Of course GP says oh you can take it with thyroid meds (yeah right). Do you find that taking it at night has any adverse effects like stopping you from sleeping well?

Many thanks

[SarahJane1471 in reply to helen_m]

Not really because I take sleeping tablets as I have a sleep disorder. I have friends who take Sertraline at night and have never said it causes insomnia

[Elly333]

Thanks for advice.

[humanbean]

There is an over the counter anti-depressant you could try. I wrote about it in this thread :

healthunlocked.com/thyroidu...