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Could my levothyroxine be the cause of my anxiety?

Not too long ago, I was diagnosed with hypothyroidism and was started on 25mcg of Levothyroxine. Everything seemed fine up until recently when I went in for routine blood work and it still came back as hypo so my Dr. decided to increase my dosage to 50mcg. I started the increased dosage actually one month ago today and about a week later I started experiencing very bad anxiety and panic attacks.

Now, I have always had anxiety since I was a child and a few years ago I was finally diagnosed with GAD and OCD after my panic attacks became severe after the births of my sons in 2007 and 2009 and was prescribed Ability which worked great for me for quite some time. Then when my son was about 5 years old, my anxiety seemed to go away and I was able to eventually come off the ability and have been fine since!

So after my panic attacks and anxiety came back recently, I figured maybe an ingredient in my new multivitamins was causing it so I stopped taking my multivitamin.. but my panic attacks and anxiety we're still coming. Today I decided to call my Dr. to tell her what was going on and she told me to reduce my dosage of Levothyroxine back down to the original 25mcg and I am seeing her on Friday.

My question is, can the levothyroxine be causing my anxiety to come back?. I just had a new TSH and T4 blood test done on Thursday and my levels are in the normal range (I think). My TSH came back at 3.14 and my T4 came back at 1.5. I put that I THINK my results are normal because to be honest I'm not really sure how to read the results, but it does say by my results that anything from 0.5 to 4.4 is within the normal range. So I would assume I have not become Hyperactive, so the only thing I can think of is the increased dosage of the levothyroxine causing it?.. but i don't know if that is possible

If anybody has any advice or opinions, it would be GREATLY appreciated!! Thank you in advance for your help.
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Avatar universal
Honestly I agree with everything you have said.. it seems to me like maybe some more tests should have been ran before making a decision. I think when I go to the Dr. on Friday I will talk to her about the additional tests..

Thanks a lot for your responses and advice!! I appreciate it.
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Avatar universal
Since you took your thyroid med before the blood draw, your Free T4 result may be falsely higher than actual.  It is recommended even by the ATA/AACE that the morning dose should be delayed until after the blood draw for thyroid tests.  So keep that in mind for the future and delay your Friday dose on the expectation that you will get some needed tests done.
  
Being diagnosed as hypothyroid when only having the symptom of being tired and an elevated TSH is surprising.   Usually in that situation the doctor will also test for Free T4.  If Free T4 is below range then it is classified as hypothyroidism.  If it is within range, then it is classified as subclinical and treatment is initiated only if the TSH is greater than 10.   Not saying that is correct either, but it is the normal practice.   Symptoms should always be the most important consideration in any evaluation for the possibility of hypothyroidism, but you should have also been initially tested for  Free T4 and Free T3,  Vitamin D, B12 and ferritin.  Also, since the TSH was over its range,  you should have been tested for the antibodies of Hashimoto's Thyroiditis, which is an autoimmune system disorder.   Those tests are TPO ab and TG ab.  

You really cannot know what is going on without the additional tests.  Without all the tests mentioned above,  I don't see how the doctor could be sure of the original diagnosis.   And since your only symptom was tiredness,  you also should have been tested for Vitamin D, B12 and ferritin.  So if you can get all these tests done, then I think you can make an informed decision about the need for treatment.    If the doctor resists doing all these tests, just insist and don't take no for an answer.  When you have additional test results please post them here and we will be glad to help interpret and advise further.  

If you want to confirm what I have said here, click on my name and then scroll down to my Journal and read at least the one page overview of a full paper on Diagnosis and Treatment of Hypothyroidism: A Patient's Perspective.
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Avatar universal
Thank you for your response!. So to answer your questions in order..

I did take my 50mcg of Levothyroxine the morning of my blood test. I would always take it first thing in the morning before I ate my breakfast.

When I was diagnosed has hypo, they didn't give me a cause. My Dr. Just told me that my thyroid was underactive and started me on the 25mcg

When I was originally diagnosed, the only symptom I really had was I was always overly tired... they saw my levels were low at the blood test

Besides the anxiety, I'm very irritable but that's about it. My other symptoms have improved! I'm not as tired anymore and feel more energized overall

Here are my lab results going back to when I was first diagnosed:

7/2017: TSH was 7.13 (normal range is 0.27 - 4.20). No T4 test was done.. or if it was I can't see it online

6/2018: TSH was 5.71 (after being on the 25mcg daily) and my T4 was 1.2 (normal range is 0.9 - 1.7)

7/2018 (my test on Thursday): TSH was 3.06 and T4 was 1.5 (after being on the 50mcg for a month)

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Avatar universal
First thing I would ask is if you took your Levo dose in the morning before the blood draw for the TSH and FT4 test?    When you were diagnosed as hypothyroid, what the identified cause?  Was it Hashi's?  What were your TSH and Free T4 test results at that time?  What symptoms did you have when originally diagnosed?  

Do you have any other symptoms now besides the anxiety?  

Please post the reference range shown on the lab report for the T4 test.

The reason I am asking all these questions is that if there were some ingredient in the Levo  that you reacted to  then it seems that it would have happened with the lower dose as well.  If it is not the Levo itself then perhaps it is related to the dosage being inadequate to relieve your hypo symptoms, of which anxiety is a common one.  The reason I say this is that a relatively small dose of  T4 is not additive to your prior level.  The med causes TSH to drop and thus reduce the stimulation of the thyroid gland to produce hormone.  Since serum levels are the sum of both natural thyroid hormone and thyroid med, the net effect is little to no change in level until the dosage is high enough to essentially suppress TSH.  After that, additional increases in dosage will start to raise your Free T4 level and Free T3 level (although usually not as much as FT4)  That is why a recent, excellent scientific paper concluded that:  " Hypothyroid
symptom relief was associated with both a T4 dose giving TSH-suppression below the lower reference limit and FT3 elevated further into the upper half of its reference range."   So I expect that it is most likely your problem is related to still being hypothyroid due to inadequate thyroid med dosage, and perhaps some other variables that affect metabolism of thyroid hormone, such as Reverse T3, cortisol, Vitamin D, B12 and ferritin.  Have you been tested for any of those?
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