> Kris Thomas <[log in to unmask]>
>
>  I have been taking Prozac for about 5 years for clinical depression and
>  was recently diagnosed with Hypothyroidism (I've known I've had
>  Hashimoto's for about 4 years).

Low thyroid causes depression, some doctors know enough to treat Hashimoto's
from symptoms and don't wait for the TSh to rise.

>I am taking 112 mcg Levoxyl to treat the
>  hypothyroidism and am wondering if there are any adverse effects if I
>  continue to take the Prozac?

There is one relevant thing you need to know about thyroid hormone.  the
thyroid primarily produces a hormone called thyroxine we call T4.  In order
to work, the T4 has to turn into the active hormone T3.  This is relevant to
you because there are some things that will interfere with the conversion of
T4 to T3.  One of those is a hormone called cortisol produced by your adrenal
glands.  I don't know if it's general knowledge, but I've seen at least one
web site that said Prozac causes an extreme excess of cortisol to be
produced.  Prednisone or Hydrocortisone are like cortisol.  The drug
information on them tells that they interfere with conversion and may even
mention they artificially lower TSH, meaning your doctor cannot treat by
using your TSH reading.

In the event you cannot find a site that mentions Prozac increases cortisol,
I would at least make sure your doctor does a cortisol test to make sure
yours isn't high, because if it is you will have the conversion problem
meaning the medication you are on which has T4 only will not do you any good.
 You will need a combination drug called desiccated or Armour thyroid.

My psychiatrist said he didn't want to
>  reduce the Prozac (even though I'm still feeling really fatigued all the
>  time) because he says "going on Thyroid medication can often make you
>  depressed in and of itself".
Some psychiatrists use T3 to treat patients, because it helps with depression
.  T4 does to as long as you are adequately treated and your body can turn it
into T3.

Anyway, if you are like many of us, you've been fatigued and feeling terrible
for a long time, and as you get better you really start to see how many years
of your life have been wasted.  If we focus on that we have reason to be
depressed.  Frequently, it cures the depression.

  I have been feeling fatigued and often more
>  depressed since going on the Levoxyl 3 months ago.

Many thyroid patients stay depressed due to poor treatment.  If you are still
with the doctor who ignored treatment while knowing you had Hashimoto's.
that's a sign he probably doesn't know how to do anything except follow
recipes.  An acquaintance calls this a "cookbook doctor."  I can cook using a
cookbook, in fact on the rare occasions I cook I may need to.  Unless just
throwing on meat, I need recipes because I do not know what I am doing.  My
wife on the other hand, laughs a recipes and is one of the best cooks around.
 Baking generally requires recipes she tells me, but then she adapts them and
makes them better.  She's good at cooking, so she may use recipes as a guide,
but can in most cases make something come out far better than the recipe.

 Most doctors on the other hand will listen to a hypothyroid person talk,
suspect a thyroid problem, run at least the TSH if not a full thyroid panel
and when the TSH shows up as normal decide the lab's recipe for diagnosing
hypothyroidism is absolute and not be willing to deviate from it.  The lab on
the other hand, says their values that give normal ranges on them are not a
well/sick cutoff, in fact normal means 95.5% of the population fall within
that range.  So, if you are in a room with 10,000 people, the high end of the
TSH range is 5.5, and you are exactly at that level, then only 225 people
have a more hypothyroid level than you.  9,775 of the other people are either
tied with you or their TSH is lower.  Some doctors know this, most don't.

Skipper Beers

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