daily early morning anxiety

[jzzlvr13]

I was diagnosed with a goiter thirty years ago. I was on Synthroid with no symptoms until last July. All last summer I had many symptoms of hyper, the main on being anxiety. Since then, with the exception of a few months last fall, I have been awakened DAILY at between 5 and 6 with an intense feeling of anxiety, particularly in my back and stomach. It will increase if I don't take medication. By noon it stabilizes and by afternoon it is gone.
My TSH was .05 last summer, 12.6 this spring, and 1.5 at the present. Free T4 is a bit low and Free T3 was quite low the last time tested. During the entire period most symptoms have subsided, but the anxiety remains constant. It feels more phyical than mental. I was put on low dose HRT  patch, but didn't help (I'm 61) Twenty four hour urine test was normal.
Is there something else that I could have checked that might be causing this very uncomfortable anxiety or something else I could do. I'm getting to the point of dreading waking up that I'm sure it's becoming both physical and emotional. I would like to be able to get off the anti anxiety med that only takes the edge off of it. Any suggestions would be appreciated.
Barbara

[Mark Lupo, M.D.]

The goiter is most likely multi-nodular and benign -- sometimes these nodules can gain function and produce thyroid hormone -- this sounds like the case last summer but now the TSH is normal again and the T4/T3 on the low side.  Did the synthroid dose decrease?  Were you hypothyroid before starting synthroid?  Has the goiter decreased in size (I presume this was the purpose of the synthroid originally unless underactivity was documented)?

May be worth a trial off synthroid to see what happens.  The other causes of symptoms: pheochromocytoma (probably the 24h urine was for metanephrines/catecholamines to eval for this), menopause, hypertension, cardiac disease, anxiety/panic disorder, carcinoid (unusual over-production of serotonin).

[doodlebug1]

Hi Barbara. I was particularly struck by your mention of having a low free T3, plus the differences in your TSH. Have you had your antibodies tested? Because IMHO it sure seems like you are having the hypo/hyper swings of Hashimotos, and/or another goiter, as I've seen in others.

Also, I have personally experienced that being on T4-only meds like Synthroid does keep the free T3 too low, which results in frustrating symptoms, including anxiety. And docs, who are trained to put folks on Synthroid, don't understand yet that these symptoms are DUE to an inferior treatment! So they end up treating the symptoms of poor treatment (i.e. giving out anti-depressants, anti-anxiety meds, HRT therapy, etc), rather than figuring out that T4-only meds do NOT do the job. When I switched to Armour, which is known as natural thyroid hormones, the change in how I felt was profound. And I've seen this in MANY folks out there! In fact, I would say that there is a strong revolution going on with hypo folks AGAINST T4-only meds, and to better treatment like Armour, as they become more informed, which the internet has done for us all.

And those of us who have switched to Armour are being able to dose by SYMTPOMS..i.e. dosing until they are gone, which puts our free T3 at the TOP of the range, no matter how low it does put the TSH.

So, all the above is food for thought. Because anxiety is OFTEN a result of inferior treatment, and a low free T3, I have noted.

[ArmourGal]

I don't know if your anxiety is hypo related or not, but I would be suspicious that it was since you mentioned having low Free T3.  

Anxiety and/or impending sense of doom feelings are listed as hypo symptoms.  I suffered with anxiety for 10 years before I was properly diagnosed with Hashimoto's/hypo.  After starting Armour Thyroid (a desiccated thyroid extract, not a synthetic thyroid hormone medication), I was able to stop taking anti-anxiety meds I'd taken for 10 years.  

A study has indicated that T3 improves mood and cognition, and I've certainly found that to be true in my case.  Perhaps you can discuss that with your doctor.
Cindi

[jzzlvr13]

Thanks for the comments. I am taking Cytomel, just started recently. I take 5mg divided and think that's what reduced the depression I was feeling. The anxiety remains. I'll stay on Cytomel at this level and increase if I see no change. I don't have a goiter anymore...that was checked. I haven't had much luck with two tries at an endo....they just don't listen....so have been working with my PCP. In regards to not taking Synthroid. My TSH is very responsive to changes in the med. I've been on 200mcg down to 125mcg over this past year and the changes in dosage is what has controlled my TSH. Last year when I dropped to .15 and changed my Synthroid it raised to .87 for a short while. I felt OK at that level but quickly went to 12.6 and it started all over again. I have experienced menopause, high blood pressure for years, and three major surgeries during the last three years....could this be affecting me? I bet so!
Thanks
Barbara

[mj0304]

Is there any way do distinguish between anxiety and a thyro condition?

[PurpleParrot]

Hello, I have been reading this forum a little bit and decided to join. It is so nice to see a forum for thyroid disorders. Sometimes the best way to learn about your new disease is by talking to others who have been there and experienced the same symptoms, etc.

I was diagnosed with Hashimoto's this past April. I decided to get checked after my mom was diagnosed because we both had very similar symptoms. My TSH was 5.5 and antibodies were 117. I began taking herbal thyroid medicine and within two months my TSH went down to 2.79, antibodies the same. Then I began feeling really crummy after female surgery and began experiencing increased depression and anxiety cycles, often in the same day. I have a multinodula thyroid, also, which the doctor at that time wanted to do a RAIU scan which scared me because I've heard it can actually destroy the thyroid. I declined the scan and was sent to a surgeon to discuss biopsy, but he felt that it was most likely not cancer but wanted to do the biopsy anyway and said I might have to have part of my thyroid removed. I said "no way" and got a new doctor who has been most wonderful. My TSH went up to 8.09 in early October and I began Armour Thyroid. For the first two weeks I began to feel better, and about two weeks after starting Effexor for depression and "just not feeling right" it feels like my symptoms are coming back and that my thyroid is "off" again. I look forward to learning much from this group and helping where I am able to. :)

I want to say that I can relate 100% to what Barbara (do I have the right name there?) described. Anxiety in the early morning, sometimes heart racing and palpitations. In addition to getting your meds adjusted you might want to ask your doctor about Deproloft (a St. John's Wort vitimin and herb mixture, natural antidepressant) which helped me with the anxiety.

Hello to the group!

[jk1947]

It's so nice to read your success story with Armour. I'm on 3 grains - had thyroidectomy in 2003.  Just curious do you ever have a bad day or a few bad days? And if yes, what do you contribute it to-stress-foods? Thanks

Like you. I like Armour-had a bad time with Synthroid.

[ancientmariner]

Armourgal isn't allowed to post here any more - apparently they thought she was giving medical advice. Try the MedHelp groupies forum on Yahoo

[peggy64]

A related discussion, just HOW long? was started.