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Avatar universal

Please help, I'm losing my mind and my life

I need some advice from others who hopefully can understand. Brief history, I was doing really well until after thanksgiving when my whole household came down with the stomach flu. I managed to get it the worst and was sick for over a week. Ever since then I started feeling very poorly. My symptoms incuded fatigue, dizziness, anxiety, hot/cold, etc  I tried to wait it out but finally I went to my doctor at the end of December to have my levels checked. At that time I was on 100mcg of Lexoxyl. I didn't get my labs back until after the first of the year due to the holidays but they were: TSH 7.320 (0.340-5.600), FT4 0.74 (0.61-1.12), FT3 261 (210-440). My doctor increased my meds to 125 and I am sad to say my symptoms have gotten much worse despite my labs being better,. My most recent labs were TSH 3.230, FT4 0.83, FT3 324. The thing that is bothering me the most is the horrible anxiety. I am not functioning well at all and am having terrible anxiety and even panic attacks my doctor said. She is trying to get me to start an antidepressant but I don't know if that's the right answer. I am looking and desperate for advice. Is this my thyroid? Do I need more medicine? Less medicine? Could this really just be anxiety and panic disorder that came out of no where?? Please help, thanks!
20 Responses
Avatar universal
First let me say how lucky you are to have a Dr who actually tests both FT4 and FT3!

You need more Thyroid meds!

Most people don't feel well and symptom free until their FT4 is in the MIDDLE of the range or slightly higher.  AND (that means in addition to) their FT3 in the UPPER 1/3 of the range. Simply being within range is NOT, repeat NOT sufficient. The ranges are far to broad.  They should be adjusted but they do not seem to ever change.

Mid range given for FT range above would be 0.865 and you are currently testing at only 0.74 so there is room to improve.

Similarly upper 1/3 of the FT3 range would start at 363 and you are testing at 324.

Given that your FT3 improved along with your FT4 it would indicate that conversion is operating OK.

Anxiety and depression both are common or consistent symptoms with being HYPO.  Thus unless it is totally unbearable.  I would be tempted to try to get your Thyroid labs up to the mid and upper 1/3 ranges shown above first.  Thus an increase in your T4 medication would be the first thing I would try.  But you have to judge for yourself.  You know your symptoms and yourself the best.

Once your FT4 is mid range and IF your FT3 is not towards the upper 1/3 or symptoms don't go away.  Either another small increase in T4 med OR the addition of a small amount of T3 med may be in order.  But give another dose increase of T4 to maybe the next step of 150 mcg a try and see how that works out for you.

Also remember that often times symptoms are not relieved for several weeks after the blood labs have stabilized.  So there seems to be some lag or delay in symptom relief.

If the Dr insists on the anti anxiety pill.  I would ask the Dr. why it would make sense to put you on a new mind altering drug, when you KNOW that you have a Thyroid problem?  Also consider that when previously you did not have these anxiety issues and they only seemed to start when you went Hypo.   Isn't it worth a try to increase the Thyroid meds first.  There is plenty of room left in the range.

Just my non Dr. 2 cents worth of opinion.
548668 tn?1394190822
I'm wondering whether the 125mcg has really kicked in yet, and the hypo symptoms have yet to respond.   I know that when you're hypo, there is an imbalance between oxygen/carbindioxide the lungs which can make us feel uneasy, breath more shallow and lead to a panic attack.  

My doctor told me years ago that when I start experiencing a panic attack or hyperventilation, to take a big breath and hold it (does the same as breathing in a paper bag).  I know I've felt very spacey hypo and too much happening around me tends to put me in panic - I've had to remove myself from over-busy situations at work to make myself relax.   I think, when we're hypo, we need to take as easy as possible until we're comfortable again.

Your levels were too low and the adjustment to 125mcg should give you some days of feeling better after a couple to three weeks, but won't be hitting the peak until the 5-6 weeks.  I hope you wake one day feeling slightly improved.   My levels are similar to yours but my FT4  and FT3 are higher.   I know there's still room for improvement on the 3.5 tsh, but I also know it can take sometime for the hypo symptoms to settle.,,  and am assuming/waiting that I'll feel in two weeks time, where my blood tests are now....
649848 tn?1534637300
COMMUNITY LEADER
Your latest FT3 and FT4 indicate that you might still be a bit hypo; however, I'm wondering about the range for the FT4.  I'm not familiar with one that only goes to 1.1; most go to 1.6-1.8.  Could you check to make sure that's not a a typo.

Secondly, since you had the flu, it takes a while (sometimes, months) for the body to actually "get well", even if the numbers are good.

Anti-anxiety meds are not "mind altering". While panic/anxiety are common with being hypo,  being hypo is not the ONLY thing that causes it, and medications for it, certainly have their place.

I've been through this and had to resort to anti-anxiety med, myself, because of things going on in my life, that were out of  my control.  

It doesn't have to be a permanent solution, but can help you over the hump. .
Avatar universal
Thank you all for your reply.  I just NOW got a copy of my lab results faxed to me at work and either the medical assistant gave me the wrong info or I wrote it down wrong, which is very possible in my state of mind.  The results from 02.09.12 are as follows TSH 3.230 (0.340-5.600), FT4 0.83 (0.61-1.12), and FT3 in only 237 (210-440).  Barb I am looking at the labs right now so the range for the FT4 is correct.  I don't know what to think anymore.  My doctor did say I have not been on the 125 long enough so to stay at that dose right now but this anxiety is killing me.  I don't feel like I am just having these symptoms for no reason and I cannot figure out what the problem is.  I do have a lot of stress in my life and people tell me all the time that I have too much on my plate but it's no more than I always did so why would this anxiety just hit now???  I can barely function at work, I had to drop one of my classes at school (yes I am back in school), and just overall am not good.  I cry all the time when I am not screaming at everyone including my husband and children and I don't enjoy anything in my life.  I am starting to get scared to go anywhere because of this dizziness and anxiety as well.  I have an appointment with my doctor this afternoon so hopefully she will have some answers other than the antidepressants she keeps pushing at me because I cannot accept that I suddenly have an anxiety/panic disorder.  Thank you for your help and support!
929504 tn?1332589534
To talk about the anxiety: I had a Total Thyroidectomy in 09 and after that my whole world fell apart and still is! My Anxiety/Panic Attacks returned of years of having no symptoms. They are bothersome and scary, however for me I held out long enough without any med's and recently decided to start taking them because of my worsening symptoms. My labs are in range but I have lots of hypo symptoms and lots of health issues due to not having a thyroid. Anxiety Disorder can stem from stress because it happened to me along time ago where my body shut down and I was unable to work and became afraid to leave my house. If you are totally against med's, talk to your Psychologist about other options but do know that it can and will become worst without some form of treatment.
Avatar universal
I'm not saying that there is no place for anti-anxiety or anti-depression medication.  That is why I stated to only try dealing with getting the Thyroid levels figured out first IF she thought that she could reasonably handle the anxiety issues.

I guess I figured that any medication that is specifically designed to alter the chemicals in the brain that effects mood and behavior mind altering.  But I could have used better terminology.  I did not mean that to be offensive.

I just find it offensive that a Dr will without hardly a 2nd thought put people on psychiatric medications. Yet won't even consider testing for Free T3 or consider a medication dosage change when the patient is still low in the range.  Instead the implication is that the patient is normal and any symptom they feel must be in their head.  That is what I find appalling and offensive.
Avatar universal
I know what you are going through.  I suffer with terrible dizziness and feel fatigued.  My dr has never tested my T3 or T4, only TSH.  She refuses to believe this is from my thyroid and is angry that I have refused to take an antidepressant or antianxiety medication.  It is very scary to not feel well and have children to care for.  I wish you the best.
548668 tn?1394190822
I was borderline aniety/panic - the only thing that would calm me down was lying on the bed playing 'Angry Birds', and, in the evening, look forward to my half tablet of zopiclone.

My bloods have just come in, and the TSH is 3.5;  the T4 is up near the top of the range and the FT3 in the top third.   Two weeks I tried to convince my doc to consent to an increase (and I did increase by 12.5mcg one day), but he said not to until my next blood test, which I did a week early to prove him wrong!!   But am really surprised by the blood draw and by how I'm feeling today.    Only 3 days ago I was feeling spacey; and dreaded going back to how I was feeling in November.  

I think, definitely, there's heaps of room for improvement in your labs and hope you can put in place something that will help get you through (I can't really recommend lying on your bed playing Angry Birds with a vengence, but I know I simply couldn't take on anything extra and cancelled my mother-in-laws visit, and backed off from volunteering anything extra at work - during the days I felt on the precipice of losing it).   Let us know how you get on with the 125mcg - I  hope it cuts in quickly for you.
Avatar universal
I have been trying to get my hypothyroidism under control for a while now, with no help from my doctor, and I stumbled across some interesting reading that I think you all might find informative also. Just google stop the thyroid madness.  Some of you may already be familiar with it, but just in case, I wanted to share.   I would love to hear from everyone who does decide to read the info and/or from those who already have. Good luck to everyone.
649848 tn?1534637300
COMMUNITY LEADER
125 mcg of what medication?  How long have you been on it?  It takes at least 4-6 weeks for the medication to reach full potential, then it often takes even longer for symptoms to abate, because once your blood levels come up, your body still has to get well.

Didn't you have a doctor appointment yesterday?  What did she have to say?

Anxiety can come from anywhere, at any time and totally knock your socks off.  As I said before, anti-anxiety med does not have to be permanent, and sometimes, it's best to give it a try, in order to get things under control again.  

Stress is not good for thyroid either, and could actually make getting well that much harder.  Denying anxiety could, not only, make your illness worse, but think of the effects your behavior has on your family.

I'm not pushing anti-anxiety med; I'm simply saying "they have their place" and I think it's very important to look at the various aspects and repercussions before ruling them out completely.  I speak from experience and could have saved myself a lot of grief, if I hadn't been so stubborn. Seeking counseling may also help.

Avatar universal
Well when I went to the doctor I was in a terrible state. I was crying hysterically, bumping into the walls becasue I can't walk straight, heart was racing, I was very hot, dizzy, etc...etc...etc basically the same thing that has been happening non stop since February 3rd.  She looked at my labs and said "your levels look good on paper but we can't treat everyone by what the levels show, symptoms are more important than numbers" .  So after an hour long appointment (she wouldn't leave me until I was calmed down enough drive) this is her opinion.  She said I have some pretty major underlying anxiety and stress issues going on and I need to take action with that.  She again gave me an antidepressant and an anti-anxiety medication to take in the interm until the antidepressant kicks in.  She also said I am very medication sensitive (which is true) and since we were only increasing my meds by 12-13mcg each time, maybe the increase by 25 was too much for me thus increasing my anxiety.  She told me to stop the thyroid meds for 2-3 days and then I am to start back on the 100 for awhile, then go to 112, and then to 125 and so forth.  Does any of this make sense?  I thought it did when I left there and I talked with my husband last night and he said that doesn't make any sense.  He said I couldn't be having anxiety every day for the past 2 weeks non stop.  So now I am back at not knowing what to believe.  I am seriously at my witts end and thinking there has to be something more wrong with me that they don't know about.  
Avatar universal
I think it makes sense.

The symptoms you state in addition to the anxiety would be consistent with being HyPER. So maybe the last dose increase caused you to switch from being Hypo to being Hyper.

Anxiety is one of those symptoms among several that are common to BOTH hyper and hypo.

So if it was the over medication condition, cutting back down to a level that you did not have many of these symptoms would make sense.

Also people do have some issues from time to time with the jumps in dosage and it takes time for the body to adjust.

Your husband has to understand that it takes several weeks to build up T4 levels into the blood steam and it can take time to lower them as well.  IT takes up to 6 weeks for T4 levels to stabilize. So it is possible that you could be still feeling the effects of the higher dosage and it has not cleared out yet.  And will take time to do so when you step back down in your dosage.

Taking the anti anxiety pill and anti-depressants is up to you.  Hopefully it will be a temporary situation if you do decide to take them.

you still unless I missed them told us how long you've been on the higher dosage of 125 mcg.  Did all these anxiety and Hyper symptoms come AFTER this increase?

As my alias indicates. I am a private pilot.  And one of the basic rules one of my flight instructors told me was:  "If you just did something and you don't like the results. Undo what you just did!"

Using this same logic. If the increased dose sent you over the edge, then undoing that would seem to make sense.
Avatar universal
To be honest I had SOME anxiety before the increase but not this debilitating ones I am having now. What ever is goin on occurs all day everyday! I had none of this on my previous dose and to be honest I did ok with the increase to 125 for the first couple of weeks. After week 3 it started getting worse and by week 4-5........well this is where I am. I just want to know what to do to feel better! I know I probably have some underlying stress and anxiety but in my heart I just don't think that is the cause of all this havoc.
649848 tn?1534637300
COMMUNITY LEADER
Cudos to your doctor for not letting you leave her office until you were calm.  

I said it before, and I'll say it again - anxiety can strike anyone, at any time, for any reason and it can be mild or it can be debilitating.  

Also flew private aircraft, and while my instructors didn't put it in those words, we can take flyingfool's concept and apply it to any number of situations, not just flying.  

Anyone who has not experienced this type of anxiety really has no clue......... I didn't, until I experienced it,  because things in my life went beyond my control..... getting up at 3:30 am to go to work, taking care of my home, deaths in the family, an elderly aunt, living 70 mi from me, that I've cared for, for the past 6 yrs - these are the highlights; if you want the gory details, send me a PM.

I'm sorry, but I have to say - your husband is wrong -- you most certainly CAN have anxiety every day for 2 weeks - I had it every day/night for months... I thought I was "immune", but found out the hard way, I was wrong, too........ I've been there, I've done that and I fought the anti-anxiety med as well....

You said you had "some" anxiety before your med increase, so we can't attribute all the anxiety to the med increase, though jumping by 25 mcg vs 12.5 mcg could have had something to do with it escalating..

I'd think that your doctor is right - you should drop back to a dose of thyroid med that didn't cause issues (even though you will likely go more hypo for a short time), then "creep" up very slowly...

I'd think twice about taking the anti-depressant (one of my previous doctors insisted that I take them and all they did was make me sleep, so I stopped taking them after about 2 weeks), but in the meantime, you might want to give a low dose of anti-anxiety med a try....... that may be all that's needed until your thyroid hormones get into balance, then you may be able to wean off them.  

Of course, I'm not a doctor; only speaking from personal experience...... unexpected things happen every single day and we never know how we will react to them until they happen to us.......  

I've sometimes wished my husband could experience some of what I've gone through, because, while for the most part, he's supportive, he doesn't have a clue and doesn't know how to respond to those days/nights when my anxiety levels escalate or my thyroid levels plunge to hypo levels....

Avatar universal
Hello,
I was searching the internet about chest tightness and hypot. med relation and I came ascross to this site.
I was diagnised with hypo last week at the ER after CT scan and bloodwork. I have an appt with an endo next wednesday and I just can't wait because my symptoms got worse. There's a tightness in my chest, my hands are shaking (lightly) I'm short of breath, I feel dizzy and the left side of my neck hurts all the way to the head and my neck glands get extremely painful when eating or drinking. To top it off, last wednesday, I could barely throw myself to the ER because I got out of breath, my hands and legs were tingling and my hands actually turned inwards. They said I was having an anxiety attack. It was very scary because I was sure I was having a heart attack. I'm on 50 mcg levothyroxine med and been feeling like crap. Are these normal symptoms ? Do they ever go away. I haven
t felt like myself since last week. It scares me that I may be like that forever. And of course, I'm super worried that I may have a thyroid cancer. I lost my father to lung cancer in April and I can't get the fear out of my head either. It feels as if I'll collapse from a heart attack any moment. Please let me know what you think.
Avatar universal
Oh I forgot to mention that the same day I was put on levothyroxine, I also received a depo provera shot for my endometriosis. As far as I know there are no drug interactions.
Avatar universal
It will take a little time to get your levels stableized, and it depends most on the Endo uou will see. Did you get a copy of the tests they did at the ER? If you did please Post them. If you are new to thyroid, there are a few things you need to know about the disease prior to seeing a new MD. The most problem we have is finding an MD that relly knows how to test and treat the disease, Yes, Many MD's do not treat well, they follow one path "TSH" and that is all they go by. To begin with your thyroid produces and secretes a hormone into your system. it is T4, Your body then converts this hormone to T3. this is the actual hormone your body needs to function. When this hormone is low, another gland located in the brain called the Pituitary Gland senses this lack of T3, it then sends a different hormone to "Bump" or stimulate the thyroid gland into producing more T4, This hormone produced and sent is called "Thyroid Stimulating Hormone" If your T3 Hormone is low, this number gets high, If the T3 is high, the TSH is lower. So when you have Thyroid disease, your thyroid can be underactive (In which case your TSH is high) or be Overactive (And your TSH is too low) Its normal procedure to use this test of TSH to indicate a thyroid issue is present, but with a good thyroid MD, that should be the  end of it, from that point on a good MD will base treatment on what is called Free T3, and how you are feeling in regards to symptoms. Thier is also Free T4. When your thyroid produces T4 and your body converts this T4 hormone, it converts what is needed, the remaing T4 is called Free T4, it is the residual or what is left over, the same applies to T3, after conversion your body or cells use so much T3, what is left over is called Free T3. Good thyroid MD's will test for these "Leftover" or Free T3 and Free T4, these tests are done from 5 to 6 weeks apart while neing treated, each lab has a set of ranges, which are provided with each of your levels. When you see your Endocrinologist, Ask him if he tests for Free T3 and Free T4, if he says no, then request him to do them, if he refuses to do these tests, then find another MD that does and save your self a long drawn out period of symptoms and misery. Most of us have all been in this situation with MD's and it is a waste of time, money and dealing with symptoms when it is not necessary. If he/her agrees to do these tests, request a copy of the results and post them here on the forum and members will help you in defining them. make sure you post the ranges provided with each level. Best Wishes FTB4
649848 tn?1534637300
COMMUNITY LEADER
I agree that we need to see your actual lab results, with reference ranges, which vary lab to lab, so have to come from your own report.

If you were only diagnosed last week, the medication hasn't had time to really start working yet, as it takes 4-6 weeks for it to reach full potential in your blood.  

Since you are having the tightness in your chest, anxiety, etc, it's possible that a starting dose of 50 mcg was too much for you.  You might talk to your doctor about splitting that in 1/2 and working up more slowly, as a lot of us have to do.

Do you know if you have Hashimoto's Thyroiditis?  Hashimoto's is an autoimmune disease in which the body sees the thyroid as foreign, so produces antibodies to destroy it. Hashimoto's is progressive, in that, it constantly consumes more healthy thyroid tissue, so the thyroid can no longer produce adequate hormones and will eventually produce none at all.

T4 is the main hormone produced and is considered a "storage hormone", but there is also a small amount of T3 produced, as well.  Of the total T4 produced, a large portion of it is bound by proteins and is rendered useless.  The remaining T4 is the "free", which means it's not bound by protein and is "free" to be converted to T3.  The body does not use Free T4, directly; it must converted to T3 and most of the conversion takes place in the liver, though some takes place in other parts of the body, as well.

T3 is the hormone that the individual cells use for fuel.  As with T4, much of the Total T3 is bound by protein and is not usable.  Also, as with T4, the unbound portion is the "free" T3 that's actually used by the cells.

This why testing for Free T3 and Free T4 is so important, since TSH often does not reflect actual hormone levels.

Will look forward to seeing the actual lab results and reference ranges.  If you didn't get a copy, your doctor is obligated to give you one, upon request, if you are in the U.S.

Avatar universal
I will see an endoc. on wednesday and get my lab results. I really appreciate the extensive information on the T3 and T4. I had no idea and now I will be better prepared for my appt. I will post on wed with updates.
649848 tn?1534637300
COMMUNITY LEADER
When discussing T3 and T4, with your doctor, always make sure you specify FREE T3 and FREE T4, otherwise, you will get total T3 and total T4, which you can see are not the same.  TT3 and TT4 are considered obsolete and of little value.

Will look forward to seeing your labs and hearing how your appointment goes.

One more point to make - it's a good idea to always get in the habit of getting copies of your lab work, for your own records.  My lab reports have become the running record of my thyroid disease.  On each lab report, I note the medication(s)/dosage(s) I was on at the time of the blood draw, as well as any symptoms and how I feel.  
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