Thyroid or anxiety?

[brbangle]

Dr. Lupo, I am trying to conclude whether or not some panic-like symptoms I am experiencing are thyroid-related. The symptoms--transient "episodes" of heart palpitations, chest pain, shortness of breath, hot flashes, stomach upset and insomnia--started with much more intensity about 8 months ago. In addition to the above symptoms, I experienced loss of appetite, weight loss, diarrhea and extreme fatigue. My endocrinologist tested my TPO antibodies (which came back very elevated at the time) and attributed it to transient thyroiditis, as the gland itself was also swollen to the point I was having trouble swallowing pills. My levels came back normal on my 50mcg Synthroid dosage. Ultrasound showed no unusual nodules. The doc put me on 10mg Lexapro.

Since then, my endo has steadily increased my Synthroid dosage to 88mcg. I am still on 10mg Lexapro. The "episodes" have decreased in intensity, but they are not completely gone, and I often wake up around 3 a.m. with a pounding heart and shortness of breath.

I know this could easily be written off as classic anxiety/panic symptoms. But, I always thought of generalized anxiety/panic as having physical symptoms like mine as a result of an emotional trigger. I don't seem to have that, so I cannot help but think it is thyroid-related… possibly something to do with the elevated antibodies? Does this sound possible? If not, do you think the Lexapro could be a contributing factor? Thank you!

[memommy338]

I had my first problem with my thyroid 5 years ago. tsh high I was hyper, To this day when my tsh is .6 or under I feel anxious. I just started st johns wort to see if that will help, as taking a medication rather makes me more nervous. All I know is when my tsh is good I feel better and no anxiety.

[mcintosh]

I have had an obvious enlarged goitre for 8 years and symptoms of hypothyroidism but blood tests are always borderline and no treatment implemented.  I wondered if there
were any homeopathic remedy I could take especially for the fatigue and weight gain??

[maz135]

I have hashimotos and also have panic attacks and I believe they are related...I have no emotional triggers for my panic attacks but are exacerbated when my thyroid is off...

[Mark Lupo, M.D.]

There does not have to be a trigger for anxiety.  It is hard to sort out but in my experience there is usually an underlying panic-anxiety disorder and sometimes adjustments in thyroid meds (and thyroid disease itself) aggravates it but is not usually the sole cause.

The TPO antibodies are not known to cause symptoms - they just reflect the cause of hypothyroidism: Hashimoto's.

The lexapro is probably doing more to decrease the symptoms than the synthroid dose increase.

Hopefully that is helpful.