Feeling suddenly bad on natural dessicated thyroid

[PieuvreJaune]

Hello,
First of all, sorry if my english is not perfect, I'm from France.
I've been diagnosed with Hashimoto thyroiditis at the age of 16, and I am now 27. After a lot of struggle (my first endocrinologist didn't want to give me any substitution until my TSH was at least 10), I was put on synthetic levothyroxine during one year. I was feeling better, but still fatigued and depressed. I then decided to self-medicate with Armour thyroid (available in Belgium).
I felt better but had to switch to Thyroid-S for some reasons (Armour was not available anymore).
It's been 6 years i'm on 3 grains of Thyroid-S and everything was great, until last june when I began to have severe panic attacks.
Basically I'm having 2 to 3 panic attacks every single day since mid june, and it became really unbearable. At the end of july, when i realized it was "just" anxiety, I decided to reduce my dose to 2 grains.
Since then the situation got better, the frequency of panic attacks didn't decrease but the intensity and duration did.
After 3 weeks to this new dose of thyroid-S, I got my hormones levels checked:
TSH → 0.018 mUI/L (0,270 - 4,200)
FT4 → 7,6 ng/L (9,3 - 17)
FT3 → 2,4 ng/L (2,0 - 4,4)

So everything seems a little hypo to me, but I do feel less nervous.

Do you think these panic attacks could be caused by my thyroid issues?
I feel like I cannot tolerate dessicated thyroid and/or T3 meds anymore.
I'm currently trying to switch to synthetic levothyroxine & cytomel to a 10:1 ratio. Do you think it might be a good idea?

Thanks a lot for your help.. I'm feeling really desperate right now.
I really hope I won't have to take some antidepressant or anxiolytic pills, which I want to avoid since i'm still breastfeeding my daughter... i don't know what to do anymore. :(

[PieuvreJaune]

Hello, thanks for your help.

Yes, I think my lab results indicate hypo too. My T4 might have dropped even more if I waited 6 weeks to do the blood test.
I don't know how was my hormones levels when I was on 3 grains. Actually doctors here tend to check only TSH level because most people are on synthetic levothyroxine. Natural dessicated thyroid is forbidden and cytomel is not used (some endocrinologists don't know it even exists).

Maybe panic attacks were caused by hypothyroid but decreasing my hormones dose surely decreased tachycardia, tremors, hot flushes and all those anxiety symptoms common to thyroid disorders. So it suited me to decrease the dose somehow.

When I used to be on 3 grains, I was taking 2 in the morning (at the same time), and 1 in the afternoon.
Then on 2 grains I was taking 1 in the morning and 1 in the afternoon;
Now I'm trying to take only 1 grain splitted in 2 (half morning & half afternoon), with 50 mcg of levothyroxine in the morning.

Since I used to take 2 grains which are approximately 38*2 = 76 mcg T4 and 9*2 = 18 mcg T3, I'm trying to reduce T3 intake (to check if I became too sensitive to it), and to increase T4 intake. Now I'm taking the equivalent of 88 mcg T4 and 9 mcg T3.
My goal is to get a more natural ratio of T4:T3 (around 10:1).
I will probably have to increase T4 intake a little more in a few weeks.

[Barb135]

Your lab results, most certainly, indicate hypo, since your FT4 is actually below the reference range and your FT3 is only at 17% of its range.  It's recommended that FT4 be at least mid range and FT3 be in the upper half to upper third of its range, so you have a long way to go.

Both anxiety and panic attacks can be symptoms of under medication, as well as over medication, so there's a good chance that you've been under medicated the whole time and instead of decreasing your medication, you should have increased it.

Some people don't feel well on desiccated hormones, but you might not have given them a fair chance.  Did you do any testing while you were taking them, other than the results you posted above? Regular testing should always be performed when taking thyroid hormones, even if one feels well.  

Many people on desiccated hormones, have higher levels of T3, but not high enough levels of T4, so they often have to supplement with another source of T4... perhaps what you needed to do was slightly decrease your dosage  of desiccated and add an outside source of T4.  

Were you taking all of your daily medication at one time or were you splitting it into 2 equal dosages throughout the day?  Most of us taking a T3 medication find that splitting the total dosage into 2 doses works best because we don't get all of the T3 at once, so our Free T3 levels remain more stable throughout the day...

Thyroid S is produced in Thailand and may be different from the Armour you were purchasing in Belgium, which could explain why things changed so drastically.  

Have you already changed over to levothyroxine?  If so, what dosage are you now taking?  Have you added synthetic T3 to it?  What dosage of that are you taking?