hypothyroidism and depression

[four corners]

Hello, I am currently taking Levoxyl for hypothyroidism. And had thyroid removed.. Non cancer.. I am suffering from depression, my thyroid levels are normal on labs,  1.96 tsh.. But could I feel better if my levels were closer to zero? Also do antidepressants affect thyroid metabolizing currently? If so could you name them.? And which can be taken with thyroid meds. I know that cymbalta says not to take, while on thyroid replacement. I am feeling like i need to take something to relieve this depression.. If you have any other suggestions about depression, and hypothyroidism... I am terrified of the anitidepressants, because of the severe side effects I get, I have tried them before.. But I feel that the hypo,is also affecting the antidepressants. I am very confused.. and severely down!! Maybe I need more Levoxyl? I am only on 68mg, Levoxyl, with no thyroid! Which does not seem possible, but my labs are in range,, Do I need more Thyroid med.? Even though in the range?  Hope to hear from you soon. Linda.

[Jenipeni]

Hi Linda,
I empathise with your situation, I also had total thyroidectomy for obstructive multinodular goitre (non-cancerous).  How long since your surgery / started replacement hormone?  

You are right to think that some antidepressants intefere with thyroid hormone - BUT if you feel you need them, then you probably do... I don't mean that in a bad way.  We all need assistance at different times in our lives and if a chemical imbalance is making you feel depressed then you are wise to turn to antidepressants.  Unfortunately as you'd know, there is no test which can say yes or no you don't have depression.

I'm in Australia so we have different brands to you but here's a quote from the prescribing info for Levoxyl;

-Tricyclics (eg. Amitriptyline)
-Tetracyclics (eg. Maprotiline)
-Selective Serotonin Reuptake Inhibitors (SSRI's eg. Sertraline)

Concurrent use of tri / tetracyclic antidepressants and levothyroxine may increase the therapeutic and toxic effects of both drugs, possibly due to increased receptor sensitivity to catecholamines. Toxic effects may include increased risk of cardiac arrhythmias and CNS (central nervous system) stimulation; onset of action of tricyclics may be accelerated.  Administration of Sertraline in patients stabilized on levothyroxine may result in increased levothyroxine requirements.

http://www.kingpharm.com/uploads/pdf_inserts/Levoxyl_Web.pdf


There are a few other types of antidepressants (eg. MAOI's -monoamine oxidase inhibitors) - so don't despair!  Personally I'd choose SSRI's over the tri / tetracyclics... but it all depends what works best for you.  You said that you've tried some before so maybe you've got some idea if that type suited you ie. gave desirable results.  

My Sister In Law and others in that family have found that a particular type suits them more than others - this phenomenon is not unheard of... I wonder if there's anyone else in your family who takes antidepressants to compare to?

Remember the best treatment for depression is a combination treatment - antidepressants and counselling of some sort.  Is there someone professional in your area that can provide a objective ear for you?  Maybe a good friend - better if you can see a professional though as this can really test/stretch friendships.

68mcg Levoxyl.... with a TSH of 1.96.  Yes as you said you are in the normal range BUT it depends what is the goal TSH - because you didn't have cancer it will not be for supression (eg. 0.05 or under). My goal is around 1.0 or just under.  In all reality you are not far off that number and it is hard to say with certainty that you would find improvement for your symptoms with an increase - BUT for the chance you did find improvement, personally I would push my doctor for a very slight increase in dosage.  If they agree, you'll need to be patient as it takes anywhere between 4 -  12 weeks (average 6-8) for levels to stabilise before you may see improvement.

I know this dose seems low to what others are taking after a TT but it is possible.  Even after a total thyroidectomy there will be a small amount of residual tissue left OR your body may have really good absorbtion and be making the most of whatever dosage you ingest.  Your TSH numbers say that this dose is close to optimal replacement for you - if your TSH was in the high end of normal or greater than 5 you would need a big increase.  BUT you are very close to TSH nirvana -  and that doesn't guarrentee that you'll feel great and all your symptoms go away either.  While it is entirely possible that the depression is linked with the changes in your thyroid status there are also many other causes that should not be totally discounted... it may not be your thyroid status at fault at all.

I've waffled on too long again- here's one last suggestion for you.  It won't cure or treat depression but many people do find some improvement when they take a daily vitamin B supplement - also known as brain food.  The B vitamins help the body/mind deal with stress and can boost energy levels a little bit.  Our bodies don't store this vitamin so its vital you get sufficient from your daily diet but many don't.  If you choose to try this buy a 'complex' formula with all the different B's (B1, B2... B6... B12 etc), they work better together.  Oh your pee will go bright yellow/orange when you take B supplements so don't be alarmed!! LOL!

I don't know if I've really answered you questions but I hope this helps a bit.
Best wishes on your journey...
Jenipeni

[scarlet37]

     I'm sorry you're having a tough time right now. I've been there several times since my thyroid removal 12/06. I wish I could answer your ? about what anti deppressants can work with levoxyl. You should discuss it with your dr.
     I did take lexapro fro a while but have since stopped and I only take xanax occasionally  for anxiety attacks.

    Don't hesitate to talk with your dr and get something to ease you through your depression.

   Best Wishes~

   Teresa