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SSRI Antidepressants & Thyroid Hormone Therapy

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By JimLow



Balancing Hypothyroid Therapy With An Antidepressant

A number of times over the past few years, SSRI Antidepressants have been the subject of discussion on thyroid forums I have posted on and been moderator for. I also receive frequent emails from thyroid patients asking questions about these drugs in regard to their effect on thyroid hormones in the body. These drugs prompted one of my first-ever searches online because as a newly diagnosed hypothyroid patient in early 2003 and having been prescribed an SSRI antidepressant, I was curious as to how these drugs might affect my thyroid hormone levels. In my case I ended up weaning off the drug because my doctor at the time, in my opinion was jumping the gun so-to-speak in not first allowing my thyroid hormone replacement therapy to relieve my symptoms of anxiety and intermittent low mood. It turns out in my case, my hypothyroid therapy did very well in balancing my emotions and I was not in need of an SSRI antidepressant.

I’m listing some medical research below about antidepressants and their affects on thyroid hormone but let me first express the fact that I’m a firm believer in the ability of these drugs to be extremely effective in people who need them. I do feel however that this is an area of education about these drugs that thyroid patients should have, especially if the drug is added by their doctor after they are already being treated for hypothyroidism with hormone replacement. It’s possible some of these patients will either need their hormone dose adjusted due to the slight lowering effect the drugs have on thyroid hormone or they might need addition of T3 to their hormone replacement therapy (most Dr.s treat with T4 only) if it is not already in their regimen.

Title of study published on U.S. National Institutes of Health stating that SSRI antidepressants have been found to lower thyroid hormone in the body> Peripheral thyroid hormones and response to selective serotonin reuptake inhibitors
QUOTE: "Thyroid hormone levels decreased with treatment, but these decreases did not correlate with clinical improvement." (PubMed Central)


An article citing studies in regard to better improvement in treated hypothyroid patients, placed on SSRI antidepressants when T3 was added to their hormone therapy, titled>‘Supercharge’ antidepressants by adding thyroid hormones/Why hormones help, and new data on SSRI augmentation.
QUOTE: "Three open trials to date have investigated using thyroid hormones to augment SSRIs in treatment-resistant MDD. In a prospective study by Agid and Lerer, 10 of 25 (40%) patients who did not respond to SSRI treatment did so after T3 was added." (The Journal of Family Practice)

(NOTE: MDD above is abbreviation for "Major Depressive Disorder")

In regard to antidepressants actually causing "thyroid dysfunction", the only one actually recognized for doing this is "lithium".

ARTICLE: "How should lithium-induced thyroid dysfunction be managed in patients with bipolar disorder?" (U.S. National Institutes of Health/Journal of Psychiatry & Neuroscience)


Despite the fact that the first research quote above doesn't refer to the lowering of thyroid hormone as "thyroid dysfunction" you could still say it hinders thyroid hormone enough in the body as to merit use of thyroid hormone replacement to supplement the SSRI therapy. Unfortunately, you will find very few doctors who are aware of these studies.


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donotfear profile image

donotfear  says:
10 months ago

I'm glad to see you publish this article. I will certainly go to the links you provided. I am on an SSRI (Prozac, low dose) and was diagnose with low functioning thyroid 2 years later. I don't see any change in the way I feel since beginning my medication for the underactive thyroid. However, I'm beginning a 6 month process of weaning off the Prozac, so I'll be curious to see how things change. Seems there is usually a weight gain involved after long term SSRI use, happened once before, too. I't gradual, but it did happen. Very good information here and I'll follow up with it.

JimLow profile image

JimLow  says:
10 months ago

donotfear,

I'm so glad the article was informative on the subject for you!

It may also be possible you were developing thyroid disease and the timing of it was while treated with the SSRI. Tests I always suggest to people with thyroid panel abnormals are the "thyroid antibodies" tests. These would be the "anti-TPO" and the "Anti-TG" (anti-thyroidperoxidase and anti-thyroglobulin antibodies). If you test positive for both or either, it means autoimmune thyroid disease has been in process. While your SSRI antidepressant may have affected your thyroid hormone levels to a mild degree, thyroid autoimmunity will do so more significantly. The type causing low-functioning thyroid is called "Hashimoto's thyroiditis" and it's a slow damage occuring in the gland from antibody destruction. It's the most common cause of hypothyroidism.

(Note: the Amazon e-books & audios around my thyroid articles are mine.)

Feel free to ask questions any time and thanks so much for the comments!

ContessaP profile image

ContessaP  says:
3 months ago

I have been on Paxil for 8 years and have had hypothyroid in conjuction with a total of six thyroid nodules. My first nodules and the onset of hypo symptoms started about six years ago. Its been quite the balancing act. Thank you for sharing this information.

JimLow profile image

JimLow  says:
3 months ago

You're very welcome and thank you for reading!

Also: Best Wishes with your ongoing treatment!

Daniel Carter profile image

Daniel Carter  says:
3 months ago

Good article, Jim.

Hypothyroidism is actually a culprit in many mood disorders, as well as some autoimmune diseases. However, it's not necessarily the primary culprit, but in many cases can factor in to the whole equation. One of the things that probably ought to be addressed in mood disorders is a complete thyroid test. Perhaps in other cases as well. Unfortunately, it seems to be a complex, delicate dance of sorts to get everything in balance, but I think if a person is persistent, over time it does get better.

Glad you had success with this. I think this will be great info for a lot of people.

JimLow profile image

JimLow  says:
3 months ago

Thanks much Daniel for the comments.

I agree, it can be very complicated to balance everything, especially in patients with multiple problems, plus takes a doctor willing to do so.

Like you, I'm a firm believer in diagnostic blood testing and in doctors resorting to it more often to find underlying, root causes of emotional and other symptoms. Statistics by the AACE (Endocrinologist society) state that half of thyroid disease cases remain undiagnosed and number in the millions.

Thanks again!

crazybeanrider profile image

crazybeanrider  says:
2 months ago

Informative and needed information. Good writing. I took lithium for a number of years, and was diagnosed with hypothyroidism a few years later. It is hard to say if lithium or genetics caused it. My 4 siblings and mother all have a thyroid condition to some degree.

My sister being on medication for 30 years. My sister finds her thyroid medication works better w/o the SSRI prescribed.

I take an anti-psychotic medication and often wonder how that effects my thyroid medication. I have on many occasions stopped taking the thyroid med to see if it is necessary.

It is such a fine line, your article puts it into a bit of perspective. I added you so I can keep track of your other hubs.

Boo :}

JimLow profile image

JimLow  says:
2 months ago

crazybeanrider,

Thanks for the comments, they are appreciated. If I may advize, don't stop your thyroid hormone med, that can cause you serious problems. It can in fact trigger emotional and/or psychotic type episodes and they used to refer to it as myxedema madness. In addition to this, your hypothyroidism would worsen which can eventually lead to organ shutdown or "myxedema coma".

If you do a search with this term> "SSRI Antidepressants for Thyroid Patients", it'll take you to another of mine on the subject.

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