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Anxiety Attacks and Panic Attacks Synthroid Cytomel

A few months ago I saw a Doc for a running related injury that was bothering me.  As I was new to his care, he did a full physical with blood test.
I came back a TSH of around 16.  He explained how common (man, do I know now) hypo is in society.  He put me on 50mcg of synthroid.  Great I thought, at least I know why I'm unusually tired all time.
Within a few days of starting it, I was raving mad.  I felt like I couldn't communicate correctly, was terrified of god knows what (anything), felt like my motor skills were impaired to the point where I shouldn't drive, had ringing in my ears.  These anxiety/panic attacks are not like classic 5mn horrible ordeals.  Thay can and do go on for hours.  I feel like I've taken some kind of street drug.  I'm not talking about a little inconvience here, this is full insanity.
It has totally altered my thinking.  I can look at an lifeless object (street light, moon rise. . anything really) and feel like crying.
I made an emergency appt and told him what was going on.  Well, there really are no side effects to this stuff, but lets knock you down to 25s cut in half so your only getting 12.5mcg.  He also had me go and get a blood test at the same time, same day.  My number had dropped to about 9.  This is a good sign, he said, you body is taking it.  We might just need to work up.  I did it, went great.  After 10 days, with his consent I upped to the full 25, knowing I'd have to anyway for the TSH to come down.
[I should point out here, that I had few if any recognizable symptoms of hypo prior.  It only turned up because of this blood test in a physical.]

So, the saga continues, I go up to 25mcg.  Have some good days, where I feel fine.  And I have bad days where I feel atrocious and mad.  I always feel like there is someplace I'm supposed to be or something I'm supposed to doing and I don't know what it is.
After all this, and not quitting the 25, my first 6week blood check comes around.  I decide to skip the pill on the morning of my meeting with the Doc a few days later, just to see if I can feel "normal" again.  He says, that my 9.? has stayed the same, not moved a bit.  Is it possible that a TSH, over a six week period of time and measured as finely as it is, has not moved a decimal point?  Could the lab have merely sent the second test results, on the day of the emergency appt where we first saw 9.?
Could these be the symptoms of having hit some sort of hyper status?  And instead of the 9.? I'm really lower in TSH?
The doc sent me to an Endo.  He's great, seemed to listen to my feelings about insanity.  Put me on 5mcg of Cytomel.    I will give the endo credit, he said he'd never heard of this happening but I shouldn't take the synthroid any more. I took one dose and the whole damn thing happened again.  I had four hours of hell, and what felt like the hangover of an emotional breakdown!
I write this today as a cry for help.  I'm what I thought was a healthy 40 year old father.  I love my wife and kids, but now they just irritate me.
I know people who 225mcg of synthroid a day and don't feel a thing.
Is or has any of this happened to anyone else?  Am I alone in this? What if I had a standing blood test/appt with a endo every three months and didn't treat it with hormones?  From what I understand, the main concern is high chloesterol and I cut mine in half through lifestyle changes (quit smoking, don't drink, low fat high fiber diet, lost 60lbs while supposedly hypo) in the year prior to diagnosis.  Plus, I'd rather take Lipitor than this ****.
I'm sorry for the longwinded nature of this.  It stands testement to how wired and panickey these drugs are making me and my own desperation.  I wish they never would have found this.
Any help would be appreciated.
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Avatar universal
Just to clarify, it is not likely that those reactions are due to the Levo itself, but low levels of the biologically active thyroid hormones Free T4 and Free T3.  Have you been tested for those?  If so, please post results and reference ranges shown on the lab report.  Also, please tell us about any other symptoms you have.  What is your daily dose of Levo?
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Avatar universal
I am so glad I am not alone in this!! I had a feeling the panic attacks and anxiety was because I am on Levothyroxine. Now after reading and doing more research, I see that I am correct! I'm going to see an endocrinologist soon. I ended up in the hospital with a diagnosis of SVT and had to have a heart ablation done and I also got diagnosed with hypothyroidism and put on Levothyroxine. When I told my doctor that I was having anxiety and panic attacks, all she wanted to do was throw anxiety pills in my face. And I did not take them because I know they have really bad side effects!!
Helpful - 0
Avatar universal
You seem to need the T3 med, yet you have a reaction to it.  From what I have read this may be related to high/low cortisol or low ferritin.  So, I think you should consider testing for both.  

The best test for free cortisol is diurnal saliva cortisol (four tests) taken at different times of the day.  Few doctors will order this test because they don't think it is necessary, or that it won't be covered by insurance, but it is the best way to test for cortisol.  The other test usually used is morning serum cortisol (total), which is not as definitive as the diurnal cortisol (free).

For ferritin a serum ferritin test works well.  Ferritin should be about 70.

By the way, please post your thyroid related test results and reference ranges shown on the lab report so that we can also assess your levels.    
Helpful - 0
Avatar universal
I just want to chime in on this - yes it's an old thread, but it may be relevant to someone currently.    I am on 88mcg levo and tolerate it quite well, but it wasn't enough as I still had very serious physical fatigue.  So the doc put me on Cytomel a few years ago, and I have had a host of problems that I believe were side effects from it - anger, rage, agitation, horrible horrible anxiety,  like can't breathe anxiety, a touch of paranoia, and a lot of symptoms that mimic heart symptoms like sweating profusely when bending over, and so on.  I actually went to the hospital and had the heart situation checked out and came out clean which is good news.  

I am on the generic now for the Cytomel and had to drop it recently but it made a huge difference.  Honestly I hate the stuff but to some level in my system it does help.  But a hair over that and I am way too agitated. I am going to get the levels tested here soon and see where things are now. I came down a bit and immediately, like immediately, felt better.  
My severe menstrual cramps are back now (the Cytomel was the only thing that ever helped, or maybe it was thyroid levels being treated in general), and I am more tired. My hair is starting to fall out again.  But at least I am not psycho.  

The last few years on this stuff has not been pleasant and it got to the point where the anxiety was disabling.  Some of it is attributable to other stuff perhaps, but I"ve never had it like when on the Cytomel, because what it did was ramp up my system to such a level that every issue like that was just on 10 volume.   So what might have been a 4 level anxiety was now a screaming 10 volume.   My dosage is very, very small (originally more but came down to 5 mcg, now I take 3/4 pill a day - 1/2 in the morning and 1/4 in the afternoon (yes you can break them in quarters by hand, who knew?) .  
I suspect there may be complicating factors in my system that simply do not tolerate stimulants, and am in the process of finding out what those may be.  Caffeine, any other stimulants, and chocolate (the love of my life) have a problematic effect as well, although not as bad as the Cytomel unless I really overdo it.   So it may be better tolerated by others but I simply cannot handle the Cytomel except in small amounts.  

I know for a fact that the med was causing these side effects because they got better when I brought down the dosage, immediately, and got worse on days when more was taken.  And  I did not have this level of these issues before starting.  It also may have something to do with the ratios between the T3 and T4 in my system at any given time, but that's something that's going to have to be answered by a doctor because I really don't know how that works, along with all the other hormones that play into the picture.  

But yet, if it validates this for anyone here, I have had a nightmare ride with Cytomel.   You are NOT crazy.   If your doc says there are no side effects they are wrong because some people have horrible side effects on this stuff.

Helpful - 0
Avatar universal
Interesting - I had something similar - did not have problems breathing but was wondering if there was a swelling in my throat - but to this day am not sure what it was.  Talked to the doc about it but scans of the throat showed nothing.
I had to come down on the Cytomel due to a whole host of what I presume were side effects from it, especially anxiety and agitation.  Immediately felt better on all counts.  
Helpful - 0
1202943 tn?1347840652
I had RAI to kill my thyroid about 3 years ago and had similar symptoms when I was on synthroid only.  My dr at the time was relying on TSH and TT4.  Sounds like you need to find a new dr who will test FREE T3, Free T4 and RT3.  You also may be having adrenal problems.  You should post your own question here on the forum and include any recent lab results you have.  Someone may know of a good dr in your area!
Helpful - 0
Avatar universal
Wow.  Its strange to read these comments and see that what i live is being experienced by many others.  I have chest constriction, pain and the other day i had a very serious panic attack.  However the emergency room doctor said i had too much to drink.  I thought i was going to die.  I thouht somebody had drugged my drink.  I couldnt feel my arms or legs.  I was hyperventilating and very cold.  The er  doctor didnt check my urine sample and just sent me home.  ?!  It seems that doctors dont know much about synthroide.  My endo says to take all the missed doses when i iremember.  He gave no warnings about food intake.  I told him i have gained 20 lbs in two years since my thyroidectomy but he relies on the tsh numbers.  This is all a little alarming.
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Avatar universal
Wow.  Its strange to read these comments and see that what i live is being experienced by many others.  I have chest constriction, pain and the other day i had a very serious panic attack.  However the emergency room doctor said i had too much to drink.  I thought i was going to die.  I thouht somebody had drugged my drink.  I couldnt feel my arms or legs.  I was hyperventilating and very cold.  The er  doctor didnt check my urine sample and just sent me home.  ?!  It seems that doctors dont know much about synthroide.  My endo says to take all the missed doses when i iremember.  He gave no warnings about food intake.  I told him i have gained 20 lbs in two years since my thyroidectomy but he relies on the tsh numbers.  This is all a little alarming.
Helpful - 0
Avatar universal
How much Cytomel are we talking about here?  Was the Cytomel an addition to, or a replacement for the Synthroid?
Helpful - 0
Avatar universal
It is so comforting to realize I am not the only one "losing my mind" when trying to get my thryoid leveled out.  I have been on Synthroid for 15 years and it worked fine until recently.  My dr. placed my on cytomel  a week ago and I thought I was going to lose my mind, jump off my balcony, and had extreme depression.  She said to hang in - I don't know if I can do that as I am so unpleasant to be around, depressed, and wired.  I went off it for two days and took my old dose of 75mg Synthorid and felt better but I guess I need the T3.  If any have experienced the T3 problem how long did it take you to get it evened out so you could stand it???
Helpful - 0
Avatar universal
OMG.  OK.  I thought my life was over---that was it for me.  I started talking Synthroid 25mcg and immediately shot upp to 50mcg per dr.  Mine was for hypothyroidism -secodary to pituitary tumor...adrenals not checked yet-my bad. reaason:
UNCONTROLLABLE hours-long CRYING FITS AND RAGE FOR ABSOLUTELY NO REASON- to the degree where I hyperventilate and ppl think I'm having a nervous breakdown.  Memory lost, inability to tell which day it is, what is real or what is a dream I had last night, what day it is, jumping out of my skin, shaking no appetite.  I cannot take this anymore.  I am stopping this madness.couldnt drive my car, get dressed or go to the mailbox downstairs.
Helpful - 0
Avatar universal
I have been on synthroid for about 20 years and 10 yars ago I was put on cytomel. Started feeling better for a while but last year I developed these symptoms where I would feel something growing in my throat and could not breath. Kept going to the emergency room and they would give me oxygen to calm me down. The endo said it had nothing to do with the meds. Went for all different kinds of test, all normal. The docs made me feel like I was going crazy. When the attacks would happen I felt like I wanted to jump out of my skin could not get no air. Felt like I would die, was so scared and just thinking about it would give me anxiety atacks. My doc gave me Xanax, it seemed to help. These attacks still happen and the xanax does not work as well. Am on synthroid 100mcg and cytomel 5 mcg. Now I stopped taking the cytomel cause would get heart palpitations. Would like to know if this happens to anyone else or am I crazy. I am very scared and docs don't know what it is. Maybe should see a cardiologist, but what is this feeling of a growth in my throat. I have been tested and they find nothing.
Helpful - 0
Avatar universal
It's the meds!  It's the meds!  It IS the meds!  Yep, congratulations on figuring it out.  An imbalance of thyroid hormone causes neurological problems... but also causes a change in mental status  (eg: moods, irritability and anxiety).  Beware!  Physicians don't acknowledge it!

My thyroid replacement medication now includes a list of side effects and "anxiety" and "irritability" are among the effects.  I wish I had known this.  But more importantly... I wish my doctor knew it.  

Although historically a very content well-adjusted person, I had developed the same anxiety symptoms described by others; restlessness, feeling like I left something undone or had to be somewhere.  But, because I am a woman in my early 40's, I attributed my symptoms to the wrong hormone.  I began tracking my menses cycle with the mood changes but couldn't figure it out.  It wasn't until I got tachycardic (rapid pulse) that I went to the PA (Phys ***'t) and got checked.  My PA didn't even listen.  Told me to go to a counselor and get on anti-depressants.  I had no depression.  Nothing fit the DSM criteria for depression.  I agreed on the irritability and anxiety, but it seemed so intermittent.  When the blood test came back, it showed hyperthyroid.  So again, I asked my PA... could the anxiety be from the thyroid?  Again, she offered to make an appointment for me to see a counselor.  I am all for holistic health... but how about at least considering the possibility that medication can cause a change in mental status?  Weeks later, after lowering my dose from 75 to 50 to 37 to 25... I feel amazing!  My primary doc (I'm not seeing the PA anymore) thinks I should never have been on thyroid replacement and we will discontinue the meds after in another five weeks and see how I do.

Be your own advocate.  Pay attention to the most subtle of symptoms.  The docs can't keep up on everything and there is a lot of denial regarding the harmful effects of medications.  Vaccines are a great example of this.  Best wishes to you all.  Stay healthy.
Helpful - 0
Avatar universal
I went thru the very same thing probably about 15 years ago. Synthroid gave me the horrible panic attacks when I first started taking it for Grave's Disease (overactive thyroid but they radiate the thyroid gland so it is rendered functionless). I made a switch to Levothyroid and it took about 6 months but I was OKafter that. Did start taking a little Paxil each day which seemed to help. Now my Dr. wants me back on Synthroid because she says it is a better formulation, but I say "no way!" Good luck!
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Avatar universal
I am so glad to hear that I'm not alone in this (not that I would WANT anyone else to go through this)!  I was diagnosed with hypothyroidism last July.  I was immediately placed on Synthroid.  I was placed on 150mcg per day.  Since I had never dealt with thyroid medications, I didn't know that wasn't quite right.  Anyway, after two months on it, I was SO SO SO irritable, couldn't possible sit still (felt like I ALWAYS had something that needed to be done RIGHT THEN), was hot all the time, couldn't think straight, couldn't talk right, kept falling down, etc, etc.  At my 2-month check up it was brought to light that my prescription was supposed to be for 50mcg NOT 150mcg, had been written incorrectly!  I'd been OD-ing for two months!  I was yanked unceremoniously off the medication for fear of cardiac arrest and told to wait a month without taking any and then have bloodwork again.  After about three weeks, I felt everything bottom out.....I was so tired again, but at least I could talk, walk, and relax!  Bloodwork was done again and I was placed on 25mcg.  After two months my levels were checked and I was told that 25mcg was the right dosage even though I still didn't feel "quite right"....still felt a little fatigued, etc.  It was about the 8-week point on 25mcg that I began to experience anxiety issues.  I just put two-and-two together a couple days ago.  I have a call in to my doc to see if I can be retested even though it's "not time yet" (was told to wait 4 months this time).  All of this began because I went to the doc to try to figure out why I was having daily migraines.  My headaches went away while on the really high dosage of sythroid.....came back daily while off the meds that month....now on 25mcg, I get about one migraine per week.  I have one right now that has lasted two days.  I'm tired of the headaches and I'm REALLY tired of the anxiety.  I'm afraid that I'm going to be told that the anxiety is unrelated to the thyroid meds.  Now seeing these posts, I feel more confident that my guess about the link is actually plausible.
Helpful - 0
739091 tn?1300666027
the website you mentioned is:

thyroid.about.com

Thanks for the tip!
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Avatar universal
Don't know if anyone is still around.  Came upon the thread. I emphathise with you.  I've been going through what you were...but for a couple of years....with a brain trauma in between.  I went off the meds before my accident because the doctors keep insisting on raising my meds.  They switched me to Synthroid which started all the problems... I've tried Armour, that made me worse.  I've been to all kinds of specialists for all kinds of problems.  Gastro, GYN, Sinuses....  I couldn't take the chest pains, tremors, and anxiety attacks anymore.  I stopped.  Now I'm having problems raising meds again.  After going to 5 Endos, this year alone, and being told by two of them that I need a phsycho dr for anxiety... I finally have a doctor willing to work with me.

A website and books by Mary Shomone have been God Sent, and like a thyroid bible to me.  about.thyroid.com.  And also has given me the information strenght and courage to not give up and keep searching for a doctor.

The most important thing I learned is that nobody knows our body better than ourselves.  My trust in doctors has diminished enormously.  As a single parent, losing my job after the accident, and then trying to get through most days what ended up being my thyroid 7 months later, (the neuro sent me back for head therapy...haha!  It was my meds!!!)  the most frustrating thing was not getting the help I needed, or even someone that believed me!!

You can't always go by TSH!!! and that is what most of drs order for blood work or go by... You need to go deeper.  My T4 is fine and my T3...could be raised a smigen...but the doctors are pushing Synthroid on me because my TSH was 14..... At .25 Synthroid it is now 10.5  My doctor told me it will never be in normal range. I'd have a heart attack by then!  I have Hashimoto and am Hypothyroid.  So funny, I've gone up and down with the meds and know all the adjustment symptoms.  I have lost half my hair.  I now keep a daily journal with symtpoms, blood labs and doses......

EVERYONE IS DIFFERENT.  That's important to realize too.  I am now trying Cytomel.  1/2 of a 5 once a day!! lol  I had to quarter my .25 of synthroid.  I can't even take some antibiotics now.  

I would suggest to get the book by Mary Shomone and check out her website.  Also, your doctor was crazy starting you at .50!!  Unbelieveable!  6 monts after I was put on .25 I became pregnant at 40 yrs.  Every increase I ended up in the ER.... Then after the baby...two years later when the problems started after starting Synthroid, the new Endo was insisting it wasnt the meds!  I said I know!! because every increase before I was in the ER!   The pharmacy and drs said it doesn't cause hair loss.  After 2 years I finally have a derm who said yes, it is the meds!  And yes...synthroid is the #5 drug sold in the US and was not even FDA approved until like 2005!!! It was blanketed under Armour which was around for like 50+ years!  There are definately alot of incentives offered to the doctors and pharmacies by these major drug companies.

And if you have a problem doctors don't want to deal with you, or don't know how!  It is absolutely crazy!

I wish you well in your journey......
Helpful - 0
Avatar universal
The problem is that each person responds differently to a drug. It doesn't matter what your TSH is. The number actually doesn't mean as much as how you feel.

My situation is a good example of that. I feel horrible and yet my TSH is 3.71 (.98 -5.74). Someone else with that number may feel just fine. That is why treating by the numbers is absurd. It simply doesn't work. And my doctor told me "you can't have severe hypo T because your test results came back within normal range." Yes, within normal range for someone else, not me.

Years ago, the only way hypothyroid was treated was by how one felt. There was no TSH level.

As for you, increasing by increments of 12.5 mcg over 6 months to a year, maybe all you can handle. And maybe you'll need very little medication to see a change in how you feel. Maybe 12.5 mcg or 25 mcg is all you need for now. Only you know that because only you know how you feel.

As for me, I need my dose changed every two weeks during the adjustment period. That's just how sensitive my body is to not enough medication.

Every medication is that way with every person, we react to medications differently because we're individuals. I learned this years ago during a continuing education class for nursing. The class instructor had worked for the FDA and then taught pharmacology. The information he shared has stayed with me all these years. And I see the evidence of this truth again and again.
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Avatar universal
your anxiety attacks are not a side affect from the synthroid. It is your body adjusting to new levels of thyroid and that's all. I had the same problems and so do a lot of other people when adjusting to thyroid. It will get better as u take the pills as long as u r not taking too much. U would eventually feel better than u do now once u get adjusted to the higher level if u are really hypo now.start slow and work up. U will see it gets easier to take a higher dose pretty quick.
And stick to the same brand.
Helpful - 0
209384 tn?1231168306
DLA
Am right there with you.  I also went through all of this and it turned out that my dosage was being changed to fast and that the thyroid med wasn't always the same thing, one time synthroid next time levothyroxine, maybe something different the next time.  Finally got mine taken care of when new endo pointed this out and started all over again.  Now I feel pretty good.  Have worked up gradually to 125mcg of Levothyroxine and have TSH of .93.  It just takes time and a whole lot of patience.

Also, some people react to differnet types of thyroid replacement hormone differently.  You made need another kind.  Make sure your endo always knows any side affects the meds are giving you.

Am sorry that you are having so much trouble with it but just remember you are not alone in this.  

Dac
Helpful - 0
Avatar universal
Thank you all.
You are of course right.
I took my first and last dose of Cytomel Friday morning.  And when I experienced a 4 hour terror ride again, I stopped everything cold turkey.
Now I'm going through what I believe to be accute withdrawl.
The only thing worse than the drugs, after less than two months, is being without them.  I thought of weening, but at such a low dose it wasn't really possible.  I was experience anxiety when cutting Synthroids 25mcg in half.
Guess I'll have to muscle through this, but god, I can imagine what herion users go through.
Helpful - 0
198187 tn?1190634330
So you are saying that the cytomel brought your cancer back.
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Avatar universal
U switched to cytomel and the whole damn thing came back.
every time u switch it just makes it worse. Your body will get used to a certain brand or type of thyroid and u should stick to the same brand.Your problems will eventually go away as u get used to the thyroid.I can't believe your doctor hasn't heard of this before.
Helpful - 0
Avatar universal
I thought you folks might enjoy this, or it might re-enforce your already deeply held beliefs about the docs treat hypo/hyper TH.
Saw my endo today, and told him of these massive bone-crushing anxiety attacks.
His response was that there is no evidence that any hormone drugs have any side effects and TH disorder is "easily diagnosed and easily treated".  
Well, I'll choose to go this alone.
I'm going to be responsible and check in every 6 weeks and do blood work and if worse comes to worse, I'll go back on hormone.  However, from talking to cardiologists I know, I'm coming to believe that Thyroid disorder, if you a symptom free, is one of the biggest rackets going.  
I felt fine until these folks told me about my high TSH, and I know it will most likely go higher, but jesus, the drugs are ten times worse.
They are over prescribing these drugs!!!!!
There is a boat load of money to made, and there is boat load of money going to endo programs and docs.
Helpful - 0
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