Re: Can I take antidepressants as well as my thyroid meds?

[Guest guest]

I take citalopram, 20mg and HC and armour, all I can say is that it has helped me out of a very anxious, low mess and I feel better, it does help and may help you.

HelloIts been a long time and I hate to be back just asking for help again.Can anybody tell me if they think it would be a bad idea to take the antidepressants?Thank you, warm regards, Louise

[Guest guest]

Hi Louise,

I'm available on the phone if needed.

best wishes

Bob

>

> Hello

>

> Its been a long time and I hate to be back just asking for help again. We

have had a VERY stressful time - a real stress overload - and this has taken me

into a state of depression. It all started 8th June and was dreadful for a few

weeks and then I started to make sure I took my tabs regularly throughout the

day and have felt more on a level keel. I have been advised to take 20mg of

citalopram to help me get to a position where I can see the wood from the trees

and zopliclone to help me sleep. I really need to sort my head out fast. I am

seeing Dr P soon for a follow up. I take T3, T4, Armour, HC & so many vitamins

I rattle as suggested by Dr P.

>

> Can anybody tell me if they think it would be a bad idea to take the

antidepressants?

>

> Thank you, warm regards, Louise

>

[Guest guest]

Hi - long time no hear! How are things these days. I hope

the reason you are not around much these days is that you are feeling so much

better and able to get on with your life outside of thyroid and adrenal

problems at last.

Luv - Sheila

I take citalopram, 20mg and

HC and armour, all I can say is that it has helped me out of a very anxious,

low mess and I feel better, it does help and may help you.

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17:54:00

[Guest guest]

Hi Louise

We are here to help where we can, so don't feel guilty because

you are needing help again. Some of us need an awful lot before we get to that

place we are looking for. Good that you are seeing Dr P so soon and I know he

will have the answers. From my own view point, I would leave the

antidepressants as a last resort, though I do appreciate there is a time and

place for them for some people. Perhaps it is that you are not yet on the right

thyroid hormone replacement yet, either the combination or the dose, and/or you

are not on the correct dose of hydrocortisone, especially as I know you have

been going through so much this past year. You ARE allowed to stress dose

you know, and if this was me, I would increase your HC - you will probably have

a terrific effect doing this alone. If you cannot see the table you can get

this in our FILES section in the Adrenal FOLDER - the file is headed 'CORTISONE

DEFICIENCY'

Here is what Dr Thierry Hertoghe recommends:

CORTISONE DEFICIENCY

Dr. Thierry Hertoghe

For

everybody whose results show low cortisol production in the morning and

increasing levels (or even high) cortisol levels at night, there are many ways

to naturally boost the cortisol levels. The principal lifestyle changes that

boost the effects of the cortisol are:

1)

Increase exposure to sunlight, especially in the morning and maximise darkness

at night by sleeping with an eye mask for example, which helps having optimal

cortisol levels during the day and minimal cortisol at night. Avoid living and

working in semi--darkness during the day.

2)

At each meal, blood levels of cortisol temporarily triple. Dietary saturated

fat is necessary for the production of cortisol as saturated fat cholesterol is

the first building block for cortisol synthesis. Avoid alcohol, vinegar,

caffeinated drinks, sugar, sweets, soft drinks, cookies, bread, pastas and

cereals. Avoid cereal fibre (whole grain bread, bran flakes) Avoid milk

products.

3)

Beverages with caffeine (coffee, tea, cola) and alcohol should be avoided

before bedtime as caffeine can increase cortisol and considerably reduce

night-time secretion of melatonin, a hormone that tends to reduce any cortisol

production at night. Dietary starch and especially sugar and sweets increase

the blood sugar level, which in turn, reduces cortisol production.

4)

Excessive prolonged stress exhausts the adrenal glands that finally become

unable to produce adequate amounts of cortisol anymore (burn-out syndrome).

Evening or night-time stress is a strong stimulator of cortisol secretion,

but depletes the adrenal supply of cortisol resulting in decreased cortisol

levels for the next morning at a time when the serum level of cortisol should

be high.

Cortisol

production can be enhanced by correcting any other hormone deficiencies that

influence the working of the adrenal glands. The principal hormone replacement

therapies that can increase or decrease the secretion of cortisol and/or its

action are: testosterone, dihydrotestosterone, anabolic (androgen) steroids.

These are strong stimulators of cortisol. A mild stimulator is thyroid

hormone. Strong inhibiters of cortisol are growth hormone,

hyperthyroidism, melatonin excess. Mild inhibitors are oral oestrogen

(including the birth control pill) DHEA, fludrocortisone, and aldosterone.

Cortisol

supplementation provides one of the quickest improvements of all the hormone

therapies. The higher the dose, the quicker the short-term benefit,

Nevertheless, he recommends using small physiological doses for most cortisol

deficiencies that are not life-threatening.

Patients

on cortisol therapy may improve during the first days of intake, but complete

recovery from physical signs and symptoms of cortisol deficiency takes more

time. With patients who are less responsive, optimal results may take as much

as two to three months.

A

lack of responsiveness most often has to do with a poor diet (high in sweets

for example). Therefore, the patient should be encouraged to improve his diet

as a way of accelerating progress. Please go to our website www.tpa-uk.org.uk and click on

‘Hypothyroidism’ and on

‘Nutrition’.

Once

the treatment has started, fine-tuning the dose means finding the optimal dose

for the patient and not a dose that is slightly too low or too high. This

process is primarily achieved by carefully checking physical signs and symptoms

and much less by relying on lab tests. The optimal dose is the dose that

relieve the patient completely from the symptoms of cortisol deficiency without

causing any signs of cortisol excess. Dosing by lab. tests may help to some

degree to avoid severe over - or under dosing, but are less helpful for the

fine-tuning. The optimal dose may vary following changes in the need for

cortisol.

Dr.

Hertoghe recommends that in most cases, cortisol can be started at the

estimated dose. The minimal efficient dose in women is usually 15 - 20 mg per

day. In men, it is about 30 mg per day divided in at least two separate doses:

one given in the morning and one at noon.

" There are two fundamental contraindications to cortisol

supplementation: when it is not necessary or when it could

cause harm. First: Cortisol treatment is not needed when lab tests are

normal. In that case, cortisol treatment will generally not help and may, on

the contrary, cause harm. Second, cortisol treatment – even

appropriate replacement doses of cortisol, may cause harm if the patient does

not have sufficient levels of anabolic hormones such as DHEA and sex hormones

to counter cortisol catabolic effects. The catabolic effects of cortisol can

cause excessive breakdown of the tissues of the body, which result in

osteoporosis (loss of bone tissue), skin atrophy (thinning), ecchymosis,

petechia (bruising) and immunosuppression (decrease in immune defences). So the

recommendation is to treat only when necessary and to do it safely with the

smallest effective physiologic doses and with simultaneous correction of any

deficit in anabolic hormones.

According to Dr. Hertoghe, the recommended dosing for

cortisol is:

.

men

DEFICIENCY

PRODUCT

7.8am

Noon

4.0pm

Before bed

Borderline

HYDROCORTISONE

15mg

5mg

Mild

20mg

10mg

Moderate

25mg

10mg

5mg

Severe to

total

30mg

10mg

10mg

5mg

Borderline

PREDNISOLONE

2.5mg

Mild

5mg

Moderate

6-7.5mg

Borderline

METYLPREDNISOLONE

2mg

Mild

4mg

Moderate

6-8mg

women

Borderline

HYDROCORTISONE

10mg

5mg

Mild

10mg

10mg

Moderate

15mg

10mg

5mg

Severe to

total

20mg

10mg

5mg

5mg

Borderline

PREDNISOLONE

2.5mg

Mild

5mg

Moderate

7.5mg

Borderline

METYLPREDNISOLONE

2mg

Mild

4mg

Moderate

6-8mg

Hirsutism

DEXAMETHASONE

0.1-0.5

mg

The

principal mental and emotional signs and symptoms of cortisol excess after

several hours to several days are - overly emotional, excessive agitation,

euphoric, insensitive to human suffering, craves stress and creates it,

stressing others but not oneself, insomnia.

The principal physical signs and symptoms of cortisol

excess after several hours – days are: cardiac erythrism

(heart pounding in chest. Several days to more than a week; swollen hands and

feet, swollen face, high blood pressure. After several weeks to several months:

weight gain, obesity, ecchymosis (easily bruises), Petechiae (tiny skin

haemorrhages) and after several months: atrophic skin, osteoporosis.

What

to do in the case of an urgent and stressful cortisol overdose?

Reduce the dose but do not stop completely, except for a

synthetic dexamethasone that can remain in the body for 48 hours.

Hope

this helps.

Luv -

Sheila

Its been a long time and I hate to be back just asking for help again. We have

had a VERY stressful time - a real stress overload - and this has taken me into

a state of depression. It all started 8th June and was dreadful for a few weeks

and then I started to make sure I took my tabs regularly throughout the day and

have felt more on a level keel. I have been advised to take 20mg of citalopram

to help me get to a position where I can see the wood from the trees and

zopliclone to help me sleep. I really need to sort my head out fast. I am

seeing Dr P soon for a follow up. I take T3, T4, Armour, HC & so many

vitamins I rattle as suggested by Dr P.

Can anybody tell me if they think it would be a bad idea to take the

antidepressants?

Thank you, warm regards, Louise

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17:54:00

[Guest guest]

Thanks everybody for your comments.

Bob kindly talked to me late last night and I am trying to up my HC at the

stressful times - morning and hometime after school. All of this scares me but

not as much as antidepressants! However if I am not noticing an improvement

then I will take them after a couple of days because we are having to make a

difficult decision and it is not one to be made in a depressive state.

Thanks again, big hugs, Louisex

[Guest guest]

Louise you are quite right to be very wary of anti-depressants, most especially

Citalopram.

I was prescribed this drug without any warning from my GP (who I have since

changed) and became suicidal within a few days and was placed in the care of my

local Mental Health team. I then read the pack notes and found that suicidal

feelings are clearly identified and that my GP should have informed me.

You should also Google for Citalopram, as it seems that the side-effects are

widely known and recognised.

After due discussion with the MH team about other alternative medications I

decided that I would try to manage without them and I have. I discovered that

small amounts of very high cocoa-content chocolate could have the same

serotonin-raising effect that common anti-depressants are supposed to do and it

has helped considerably.

I also underwent a depression recovery course called WRAP which you will also

find information about online - ask me for more info if you like. The idea is to

give you a 'toolbox' of strategies and positive actions to use to combat your

worst depressive times and put your life back on an even keel.

Anyone wanting to try the chocolate therapy, please email me off-forum and I

will advise what brands are the best to take. Some are available in shops,

others only direct from the manufactureres via distributors.

I was also concerned that if I took anti-depressants, I would not be able to

judge whether any improvements in my condition were due to those or to changes

in my thyroid medication. During the time I was severely depressed, I also saw

an endocrinologist who agreed to put me on T3 along with my levothyroxine and

that has been a great help.

Fletcher

>

[Guest guest]

You are quite right to be very wary of anti-depressants.

At the end of last year, when my thyroid medication was still being adjusted and

I had really bad financial problems, I became severely depressed to the point of

being suicidal.

I had been prescribed Citalopram before, when I split up with my husband and it

had bad side-effects. I became suicidal in a few days, and when the ambulance

men asked me what I had taken in an overdose I showed them the packet. They

asked me if my GP had warned me about the possibility of causing suicidal

feelings and he hadn't. Later I looked it up online and found that this

side-effect is well known.

When I became depressed again, I refused point blank to take Citalopram again or

any other similar anti-depressant. I also realised that if I did, it was merely

masking the problem of my thyroid medication not being right and that needed to

be sorted out first. Since then I have seen an endo, and started T3 in addition

to the levothyroxine which is very helpful.

I then discovered a remarkable natural remedy for depression which I am still

using. Very high-cocoa content dark chocolate can have the same serotonin

raising effects as many anti-depressants which are designed to do exactly the

same thing. You don't need to compromise any diet you may be on. The right

products don't contain milk or dairy and contrary to popular belief, high

quality chocolate does NOT contain caffeine. It does contain a stimulant called

theobromine which acts in a different way on the brain.

For advice about what brands of chocolate you can try, please email me.

I was referred to my local Mental Health team who have proved to be very

helpful. While I was really in crisis, they wanted me in hospital, but I pleaded

that being away from home would be even more stressful as I would be worrying

about my cat, and the security of the house generally. Instead, I had daily

phone calls from members of the team and went to see them two or three times a

week for a couple of months.

As I got better, I was put onto a depression recovery course called WRAP

(wellness recovery action plan). I was in a small group with two other women,

but some health authorities run it on a one-to-one basis or in larger groups.

The idea is to give you strategies and positive actions which can help support

you through the worst times and also to involve family and friends so that they

recognise the signs that you are going into a `bad period' and can prompt you

for the things you need to do.

There is information online about WRAP and you may like to have a look. You can

also look for the name Ellen Copeland who designed this helpful program.

My advice to anyone who is prescribed anti-depressants is to make sure that your

GP tells you the possible side effects, make sure you read the pack notes and if

your GP HASN'T told you what they say, go back and be very angry about it. If

you can find a way of managing without these drugs, do so.

>

> Thanks everybody for your comments.

>

> Bob kindly talked to me late last night and I am trying to up my HC at the

stressful times - morning and hometime after school. All of this scares me but

not as much as antidepressants! However if I am not noticing an improvement

then I will take them after a couple of days because we are having to make a

difficult decision and it is not one to be made in a depressive state.

>

> Thanks again, big hugs, Louisex

>

[Guest guest]

It is all very well if you KNOW about the possible side effects of

anti-depressants BEFORE you start taking them, but my GP did NOT tell me and the

evidence I have from other depression-related forums is that the majority of UK

GP's who prescribe Citalopram and other similar drugs do not give you that

warning. In the US, where doctors are more cautious about what they prescribe,

they read the pack notes to you as a matter of course.

Nor, incidentally did my GP tell me that Citalopram can affect your ability to

drive, as do the sleeping tablets he wanted me to take. It's on the pack notes,

but I was not warned in the surgery. IMO that is professional negligence.

If you are already deeply depressed as I was then you become increasingly

suicidal, you don't think oh it might be the tablets, I'll keep on taking them

and see if I get better, you reach for the bottle, more dangerous drugs or a

kitchen knife.

I'm sorry to be so brutal, but that is exactly how I was, no exaggerations when

I was put on Citalopram without being warned about the side effects. I took a

whole pack of Citalopram, hypertension tablets and painkillers with about 4

large vodkas but obviously it wasn't enough.

When I found out, when I was a little better that Citalopram can have those

effects, I literally exploded at the Mental Health team doctor when he suggested

I should try them again. No thanks. I know how close I came to not being here

today and I don't want to risk being there again. I don't know how a drug

labelled anti-depressant can even be on the market if it is known to have these

side-effects.

Even if they are not physically addictive, I see several people every week in my

'recovery group' session who have been on this type of anti-deressant - and

others like lithium and Depo-Provera - for years and they are very clearly

psychologically addicted. I don't want a crutch, I want to get better and I know

that the key to that is my thyroid medication. One of the women on Depo says she

is hypothyroid, is only taking levothyroxine and is only being blood-tested once

a year. I have urged her to talk to her GP about it, but to be truthful, she

isn't that bright - possibly because she has NEVER had her hypo condition

treated properly. I'm not her parent or carer and there is nothing else I can

do.

Prescribing anti-depressants is a cop-out by GP's who can't be bothered to talk

to their patients or are afraid of incurring costs to the NHS if they refer to

endocrinologists or even the Mental Health services for 'talking therapies'.

There is a great inclination when you are depressed to sit indoors and do

nothing, yet sunlight itself and exercise are great depression-busters in

themselves - even a gentle walk down the road on a sunny day or a bit of weeding

in the garden can be far more help than swallowing yet another pill. Your GP

won't tell you that, or about any of the alternative/complementary therapies for

depression.

Wrapping yourself up in the cotton wool of anti-depressants is not going to

encourage you to get out and fight for your thyroid condition to be properly

treated.