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Avatar universal

Panic attack from hell.

I am a 49 y/o male. I've suffered from anxiety since childhood (I think I've been hypo-thyroid since birth) and began self medicating with alcohol at 21. At 40 y/o, after drinking one night, I woke up with the first of what would be a series of psychotic episodes - I had what I call a nervous break down. I was told they were panic attacks, but panic attack seems too weak a word to express the horror I experienced. The severity of these attacks were so great that after nearly 20 years of abuse, I stopped drinking completely and have been alcohol free for the last 9 years. When I stopped drinking, the panic attacks stopped, but the anxiety is ever present, just below the surface and I am not able to hold a job because of it. My life has a - nothing is real, I'm not really here kinda quality to it, tinged with an occasional, 'I'm about to go crazy' thrown in for good measure. I've tried SSRI's to varying degrees of success over the years, and they wont give me anxiety meds because of my past alcohol abuse. The only thing that works now is Vicodin, and obviously that's not approved for panic disorder, and thus is not an option.

The summer of 2014 I was diagnosed with thyroid cancer, and I had a total thyroidectomy on Sept. 5, 2014 at the VA Hospital. I was put on thyroid replacement (Synthroid) before surgery, then put on a different one (t-4? they said it was a faster acting one) after surgery, then taken off completely for 2 weeks before oblation. During all of this, the panic/anxiety was the same as always, it was there, but I could deal with it - it felt no worse than the last 9 years. Fast forward to now...

Today is day 5 of being on 0.075 MG of Levothyroxine NA (Synthroid) And 500mg of Calcium. I'm supposed to take .075MG for 6 weeks and then .15MG after that.

The first couple days were ok - though I have zero energy, stayed in bed all day (like I have for the last 3 months), but I could tell the anxiety was starting to bubble below the surface. Well, today it hit pretty hard...I literally had to take the bullets out of my revolver for fear of a momentary lapse of judgment. I felt like I was losing my mind..that I was going crazy and couldn't get any relief...Judging from some of the posts I've read here, some of you know what I'm talking about.

What irritates the crap out of me is when I explained the symptoms of my panic attacks to even my thyroid Dr., he didn't see a connection to hypo thyroid, and I wouldn't know even now if it weren't for this board. My heart rate doesn't speed up and I don't sweat, but I get the confusion, fear, ect. and the worst part is the Bloat/indigestion/constipation. It feels like my system is dry, nothing's moving and for some reason that causes some chemical reaction that gives me panic attacks.

And the strange thing is when I'm in the middle of these attacks, I'll burp or break wind...or my stomach will just 'gurgle' like it's digesting and that little bit of pressure will release a wave of relief/endorphins through me - alleviating the panic attack. Does anyone else have this? Has anyone else figured out how to fix this?

I'm on Omeperzole for stomach acid, but I don't think it helps much. I was told I have gastritis, irritable bowel syndrome, and I don't know what else it's been called. The only thing that has really been effective is when I drink like half a gallon of prune juice or Malox and give myself such terrible diarrhea that no pressure can build in my stomach/intestines.  

Is all of this because of my thyroid? Will it get better once my levels balance out? Along with the anxiety attacks, I've had the stuff most of you guys describe in here as well - cramps, cold, tingling arms/legs, weak voice and swallowing problems, dry mouth, ect.

Any help would be appreciated.

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Avatar universal
Not that I know of. I'll look it up. Thanks.
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649848 tn?1534633700
COMMUNITY LEADER
Another thing I happened to think of... has anyone looked at your gall bladder to make sure it's functioning properly?
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Avatar universal
Honestly, I was ready to die at that point. Like a I said, it's been 9 years of living like a zombie most days, with the undercurrent of anxiety waiting.

I took t-3 before surgery I think, I don't remember the dosage. I had one pill left over - that's what I took and got anxious. I don't have anymore so wont be doing it again.

The problem with the food is that sometimes it bothers me and sometimes it doesn't. Even water can give me anxiety attacks sometimes. But I take your point. Portion control is important as well.

I hope the Levo starts helping pretty soon, all I do is sleep!

Thanks Barb, you're very nice to help us all out like this. I'll keep you posted on my progress.
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649848 tn?1534633700
COMMUNITY LEADER
Oh, I wish you'd have come here, when you found out you had thyroid cancer.  We'd have been able to tell you that it's the easiest of all cancers to cure, simply by removing the thyroid and dying from it is almost unheard of.

The levo is kind of hard to cut into quarters, but if you can it into 4 equal quarters without ending up with a bunch of powder, taking 3/4 would be good, after your 6 week starter period is up.

How much T3 did you take and under what circumstances did you take it?  One should never self-medicate with T3 med as you can get into trouble very quickly.  Since you had an anxiety attack, most likely, you took too much at one time.  

If you're noticing a difference in how you feel after you eat certain things, then you should avoid those things... and yes, it's quite likely you will have carb cravings if you don't eat carbs.  The craving will go away after a while.  You can eat brown rice, so try replacing some of your carbs for that.  Another thing is to make sure you keep your portion sizes in check.  Instead of eating 2-3 portions of a grain in one sitting, make sure you eat just one, or even limit yourself to a half a serving.

While the levo may help some, you can't depend on it to completely make this go away.  You have to be responsible for eliminating things in your diet that make you feel bad, just like I have to be responsible for eliminating things (sugar and the carbs) in my diet that raise my blood sugar too high, since I have pre-diabetes and am trying to stave off full blown type II diabetes.  Thyroid med, either T4 or T3, won't cure those ills for us, that's our responsibility.

The reason your doctor gave you T3 med before your surgery is because T3 is fast acting and only stays in your blood for a short time.  Now that you've had the surgery and will need thyroid hormones on an ongoing basis, the standard treatment is via T4 (levothyroxine), which is a storage hormone and is converted to T3 for use by the individual cells.  From what we know of the VA, they very rarely give it on an ongoing basis, but before they'll even consider it, you'll have to get your levels stabilized and keep track of your own levels in order to prove a need for it, since T3 med is given only when one doesn't convert FT4 to the usable FT3.  

If you don't understand how the thyroid works, we can/will certainly explain it all to you.
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Avatar universal
Hi, Barb. Again, thanks for taking the time to help me out, I appreciate it!

I think what i can do with the Levo is cut it into 4ths and take 3/4 of a pill in 6 weeks instead of a full one. I had a left over T-3 so I took it along with a T-4, I wanted to see what it was like, and I'll never make that mistake again. It was anxiety. I'll break up my calcium intake as well.

I had an endoscopy done a few years ago and the guy said there was no gluten intolerance, though I'm not sure I believe he even checked, I remember not being very impressed with his reaction to possible celiac disease. Like he didn't believe it was a real thing.

I do find that eating meat and vegetables and no starch do help somewhat with my stomach, though I severely crave carbs when I do that. The first panic attack I ever had was after ingesting beer and pizza the night before, and I've had them since with just pizza, so probably something there, though I think that over eating was an issue there as well. I'm hoping the Levo will help out a ton once I get the dosages right, and maybe I can get my dr to give T-3 as well, he gave it to me before the radioactive test so he might go along with it.

Honestly I've felt so bad the last 9 years that once I found out I had cancer, I was kinda resigned to dying and didn't really take much interest in my treatment. But every so often now (like yesterday after taking the gas ex pills) I'll feel like I did 20 years ago and get a second wind.

Anyways, thanks again!
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
IMO - doubling your dose, all at once, is not the way to go... there might be a dose between 75 mcg (0.075 mg) and 150 mcg (0.15 mg) of Levothyroxine that might work well for you.  Aside from that, it's almost always better to increase dosages slowly and let your body get used to each dosage before moving on to the next dosage.

Yes, do make sure you take your calcium at least 4 hours from your thyroid medication, since calcium block thyroid hormone absorption.  Since you're taking the calcium 3 times/day, try taking one at noon, one at dinner and one at bedtime - the body can't absorb more than 600 mg calcium at one time, so there's no point in trying to double on those.

It sounds like you're being treated by the VA and we know from other members that with VA, testing and treatment is often very limited.  You are, however, entitled to copies of your blood work and you should always get a copy for your own records.  You have a right to know what's going on with your own body and the lab reports should eventually become a running record of your thyroid condition, which will tell you at what levels you feel the best.

From what we know of the VA, treatment, typically consists of T4 med, which is the Levothyroxine you're, currently, taking.

There are certain foods that can cause the type of build ups you're referring to... you should make notes on what you're eating (don't try to commit it to memory) and when you get the bloating, gassy, acid feelings.  Certain fruits (including oranges and orange juice), veggies and grains can cause it.

That brings me to ask if you've ever been tested for celiac disease?  An intolerance/sensitivity to gluten in certain grains can cause that bloating feeling.  You might try giving up/severely limiting your wheat, rye and barley intake, as well as eat mostly whole food rather than processed foods.  Intolerance/sensitivity to dairy can also cause the symptoms.
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Avatar universal
Also, I take 500mg calcium 3 times a day if that means anything to ya.
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Avatar universal
I have no idea what my levels are/were as I don't have a copy of the lab work.

Yes, the Levo bottle says take half a pill for 6 weeks and then a whole one after that, and it says 0.15 MG

I was taking the calcium at the same time, I'll switch it up. Thanks for that. The part that bothers me the most is that the Dr. didn't even mention that I might need different kinds of meds (T-3 T-4 ect) - just the Levothyroxine. And the 'that's crazy' part doesn't help. It's the VA hospital so I have no choice in going somewhere else either :(

As for the constipation/anxiety, I do take miralax several times a week, eat fruit, and I poo everyday, stuff just still seems to build up anyways and I have to break it loose. Been like this for 9 years now.
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
What are your actual thyroid hormone levels?  You should have been tested for Free T3 and Free T4, along with the inevitable TSH.  Please post the results, along with reference ranges, which vary lab to lab and have to come from your own report.  It sounds like you are still very hypo.

Do you really mean:  "I'm supposed to take .075MG for 6 weeks and then .15MG after that."  That means your doctor is doubling your dosage all at once... that's just plain crazy!!  

Are you taking your 500 mg calcium at the same time you take your thyroid medication?  Calcium inhibits the absorption of thyroid medication and should not be taken at the same time.  They should be separated by a minimum of 4 hours.  You can take your thyroid medication as directed first thing in the morning, with water on an empty stomach, then take your calcium, either at lunch, dinner time or bedtime.

Acid reflux/GERD is a very common symptom of hypothyroidism and I agree with Red_Star that many times, the problem is too little acid, rather than too much.

If you tried just the vinegar with water, I'm not surprised that you had a burning feeling.  Try adding a drizzle of honey and make it warm water.  Dill pickle juice also works well.  Another thing you might try is peppermint tea (sweeten with stevia or honey, not sugar) or peppermint oil pills (find them at your health food store) which actually work better in some instances than the vinegar.

Constipation is another very common symptom of hypothyroidism and left untreated can cause anxiety and pain, as well as painful hemorrhoids.  It's best not to let it build up to the point where you have to release it in explosive movements.  Make sure you eat plenty of fiber and try mixing Miralax with your morning coffee or into your oatmeal, cereal, a breakfast shake etc.  This should help keep the gas from building, as well.  If you watch what you eat and keep things going on an even keel, you shouldn't have a build up of, either, acid, gas or stool, all of which should help with your anxiety.

Will look forward to seeing your current thyroid hormone levels, with reference ranges.
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Avatar universal
Thanks! I tried the vinegar and noticed a burning sensation but that's about it. I'm thinking about stopping the omeprazole since it's the only big change I've made and had the big panic attack tonight. Not sure what I should do.
Helpful - 0
1756321 tn?1547095325
That is interesting about the stomach. I found an article from Harvard Medical School - The gut-brain connection...

"The brain has a direct effect on the stomach. For example, the very thought of eating can release the stomach’s juices before food gets there. This connection goes both ways. A troubled intestine can send signals to the brain, just as a troubled brain can send signals to the gut. Therefore, a person’s stomach or intestinal distress can be the cause or the product of anxiety, stress, or depression. That’s because the brain and the gastrointestinal (GI) system are intimately connected — so intimately that they should be viewed as one system."

There is also baking soda test (sodium bicarbonate, not baking powder) test you could try out...

The following steps help to determine your stomach's acidity:

1. Perform this test first thing in the morning on an empty stomach (before
eating or drinking)

2. Dissolve ¼ teaspoon of baking soda into an 8 oz glass of cold water

3. Drink the solution and start timing

4. Record the time until you first burp up gas

5. Perform this test for 5 consecutive days (or longer) at the same time each day to give a better estimation of your stomach’s acidity

Time until first burp:

If you burp immediately and excessively your stomach acid level is probably too high

Under 2 min: indicates normal acidity

2 - 5 min: low normal acidity

Over 5 min: possible hypochlorhydria (low stomach acid)

No burping indicates possible achlorhydria (no stomach acid).
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Avatar universal
Thank you for commenting! When I wrote my original post I was feeling so terrible that I can't even put it into words. I took 4 Gas Ex chewables with 16oz prune juice, and an hour later the gurgling in my stomach reached a fever pitch and the pressure released and I evacuated violently and almost all of my anxiety vanished, and I was left with such feelings of relief that I almost cried with gratitude. Why this stomach ailment (whatever it is) has such an affect on my anxiety levels I don't know, but it does.

It's funny you mention having too low HCL as sometimes when I'm suffering stomach problems and tums isn't working, I'll drink some OJ and it seems to do the trick, staving off a panic attack. So it seems to be too much acid one day and not enough the other...or it's just something all together different that I don't know about.

Before I had my first 'break down' I lifted weights 5 times a day and rode my bicycle up to 80miles a day. Now, even before thyroid cancer diagnosis, I can't even get up and walk on the tread mill for a half hour most days.

Funny thing is that symptoms of low acid vs too much acid are similar...and when one works one day and then the other works the next day, it makes it kinda hard to figure out which one is the problem!

Thanks again for your help, just nice to have a response and know that other people are going to similar things (though I'm sorry for others' suffering as well).

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1756321 tn?1547095325
I meant conditions not correcting. I'll stop now lol.
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1756321 tn?1547095325
Edit: I still had bad anxiety (although improved) after treating those correcting but this improved drastically when I started exercising. :)
Helpful - 0
1756321 tn?1547095325
I've had two nervous breakdowns. That is an old term for a very bad cases of adrenal insufficiency. It was terrible but I reserve the word horrendous for severe vitamin B12 deficiency (due to autoimmune pernicious anaemia). Until you are going literally mad (incorrectly termed megaloblastic madness since it has nothing to do with blood cells) you really don't appreciate how much you love your sanity.

My anxiety worsened with severe magnesium deficiency, hypothyroidism, hyperthyroidism.  I still had bad anxiety but this improved drastically when I started exercising. Not sure how long it took though..possibly a few months and I had NO idea you could be so calm. O_O

Here is some excerpts from Gallbladder Attack on Stomach Acid...

"Signs of Deficient Stomach Acid

Gas, bloating and burping shortly after a meal could be lack of HCl
Constipation
Diarrhea
Feeling of fullness or food not digesting
Heartburn and/or gastric reflux (sometimes too much HCl but most often not enough)
Bad breath
Foul smelling stools
Loose stools in the early morning
Food allergies
Dialated blood vessels on the cheeks and nose - Rosacea
Pernicious anemia or iron deficiency
Anal Itching
Nausea especially after taking vitamins and minerals
Weak or cracked nails
Parasites - or at least increased susceptibility to parasitic infections
Chronic yeast infections
Acne in adults - especially if you have other symptoms from the list
Asthma
Since low levels of stomach acid results in poor absorption of nutrients, many symptoms that accompany a deficiency of that vitamin or mineral makes this list much longer. The nutrients most affected are calcium, iron, folic acid, vitamin K and many B vitamins. See pernicious anemia.

If you're nervous about trying supplemental hydrochloric acid, you can do a trial with 1-2 TBSP of organic apple cider vinegar mixed with 1/8 to 1/4 cup of water after a meal. If it makes you feel better and does not hurt, you most likely would benefit from taking 500 - 1000 mg. of Betaine HCl with your meals."

"Risk Factors and Causes of Low Stomach Acid

Allergies
Anemia
Adrenal fatigue
Alcohol
Atrophic gastritis
Heartburn
Gerd
IBS
Rheumatoid Arthritis
Hives
Candida and other Yeast
Bacterial Dysbiosis or infections in the Gut
Adult acne
Eczema
Alcohol consumption
H. pylori infection
Stress even in children
Age. HCl production decreases with age

Diseases Associated with Low HCl

Asthma
Diabetes
Osteoporosis
Arthritis
Hepatitis
Eczema
Acne rosacea
Dry Skin
Psoriasis
Parasites
Gallbladder disease
Herpes
Hives
Hypothyroid
Hyperthyroid
Thyrotoxicosis
Autoimmune disorders
Lupus erythematosus
Myasthenia gravis
Pernicious anemia
Celiac disease
Sjogren's Syndrome"


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