Palpatations, tremor, tingling, chest pain, depression!

Looking for advise about family member. She was diagnosed underactive about 4 years ago. She said she never had symtoms of being hypothyroid. She was on 75mcg Levo which was increased to 100 and then 125mcg in October last year.

She decreased it as was unable to tolerate it. She has been having bad mental health problems ever since;depression, panic attacks and anxiety.

She says this is due to physical symptoms; palpatations, hand tremor, chest pain (crushing sensation) unable to sleep, sweating and clammy, tingling sensation over head and headaches and diarrhoea. Gp has said it is not thyroid related, which she believes. Gp has prescribed diazepam and citalopram. I don't know what tests she has had or results of ones she has even though told her to ask. ECG is normal and bp is low-normal. She was treated with antibs for helicobacter pylori about a month ago. Does anyone think this is thyroid/cortisol/vitamin related? Appreciate any advice! X

20 Replies

  • Yes, I experienced some of these symptoms when I restarted levo. They eventually settled down but took a couple of months. Endo told me it was nothing to do with hypo or drug but it definitely was!

  • Thank you :) how long did it last? Surely she is over treated or there are other underlying issues such as cortisol or iron/vitamin and mineral deficiencies?

  • I cannot say if she is over-treated as she needs a blood test for this. In my case, I was definitely under-treated. Increasing the dose helped but it was a systemic issue - my body was reacting to the medication. I tried to change the medication - as Shaws suggests below, it could be the medication itself - but in my case it made no difference. Hence, I realized quickly that it was just a reaction to any thyroid hormone entering my body, whether levo, T3 or NDT. I stuck it out and have improved. As I said, it has taken around 2 months for symptoms to settle. Unfort., I think for some people it's not an easy road to recovery.

  • Many of those symptoms sound thyroid related to me. I had several of them when on Levo: palpitations, panic attacks, unable to sleep. Unfortunately they can occur if over OR under medicated. I still get some palpitations (nowhere near as many), but the panic attacks and the dreadful 'tired but wired' insomnia have gone since I stopped take Levothyroxine.

  • May I ask what you take instead?

  • I think all of her symptoms are clinical symptoms of hypothyroidism. That usually happens when we are undermedicated or the medicine doesn't suit us. The pity is the doctors don't believe that we can feel more unwell on levothyroxine than before diagnosis. I am one of those patients.

    If you can get a copy of the latest thyroid gland blood test results for your friend, with the ranges, and post them on a new question if they're not to hand and we will do our best to assist.

    Most of us this forum have had trouble either with the medication or undiagnosed etc. Although many who have thyroid gland dysfunction may do well so wouldn't need to search the internet.

    Every single cell in our body needs thyroid gland hormone, the brain contains the most and we have billions of cells in our body which cannot function without optimum medication.

  • Thank you :) I too am hypothyroid, although not diagnosed by gp. I went private and now self medicate with NDT.

    I always thought she was being over medicated as a slight increase and she gets palps, diarrhoea, weight loss, anxiety, tremor ect but her bp and pulse is low, thigh she is fit and exercises regularly. I have asked her to get results but she hasn't and is believing that all these symptoms are just anxiety and depression which is a shame m.

  • Those symptoms shout overmedicated.

  • Hi I disagree with the GP. it may be that she cannot take synthetic T4, I cannot, she may in time need to change to NDT, armour etc. At the moment, she should just be on tiny dose of treatment, retest in 6 weeks. This should be continued until stable.Essential tests are TSH, T4 and free T3, on line if gP can/will not.

    She should ask to see an Endo, but find the best one first, then ask for a referral.

    There is also an intermittent condition called Atrial Fibrillation, A.F . thyroid disease is known to bring on an early onset of this. A normal ECG will not show it. it needs a 7 day , or if not 24 hour, monitor at home. If this is positive a cardiac referral.The first medical test for A.F is normally simple. BP and heart rate, manually after 10 mins resting, 3 times a day, for 2 weeks. chart.The carotid artery, neck, is easy, fingers not thumb. This should include any "funny" times. If AF it can clearly be felt with a swinging heart rate ( pulse)

    Not too serious but essential to sort lout.

    Berst wishes,


  • I couldnt take levo, didnt work at all and it sounds more like she is undermedicated or on the wrong medicine. it might be worth trying NDT as this helped my depression lift. however if she has adrenals problems which the nhs wont diagnose unless you are critical this may be what is not helping either. I have an upset stomach a lot and have been being treated for adrenal exhaustion, though not via the nhs. It might be worth her tracking her temperature on waking and then midday and evening along with resting pulse should wake up with around a 36.5 temp rising to 36.8 and coming down again at night....if shes below those temps with low pulse it might be she is not getting the right medicine, she might need more T3 less T4......of course stuff like upset stomach and hunger can lower your temp too so you have to take a rounded view. xx

  • I would say she needs vitamins tested. H Pylori is associated with B12 deficiency as are many of the symptoms you describe. Diarrhoea and the need to go urgently is one of the most common symptoms described by sufferers, as well as everything else you've listed. Low folate can also cause anxiety and depression, and I personally get that crushing feeling in the chest when my iron is low. So she needs to get eyes on whatever blood tests she's had already, and make sure she asks to get tested for B12, folate and ferritin. She may have had an FBC done already, that would be handy to get hold of as well. Full symptom list here:

    And a useful what to do next link here:

    Info about H Pylori and B12 deficiency here:


  • I have asked her about b12, folate and ferritin but she doesn't know. All she knows is gp did tests and are normal. I advised her to have a look at stop the thyroid madness which she did but still thinks it must just be depression. I dont like to keep going on about thyroid when she seems settled on this diagnosis and is taking diazepam and antidepressants. She is vegetarian so is more likely deficiant. That's interesting that it could be b12 but surely gp would have checked? Probably not. I will mention it again. Thank you :)

  • The GP won't automatically test it. They tend to just do an FBC and for B12 deficiency will look for signs of anaemia and macrocytosis. There are 2 main problems with this approach - firstly, you can have B12 deficiency without having macrocytosis or any other haematological changes; and secondly, a co-existing iron deficiency will mask it. Low iron causes microcytosis (small red blood cells) and low B12/folate causes macrocytosis (enlarged red blood cells). So if you are deficient in all 3 they cancel each other out and the FBC appears normal.

    Depression is strongly associated with B12 and folate deficiency. See if you can get her to look at this link:

    Most B12 deficient patients are put on AD's before they are diagnosed, or repeatedly offered them.

    I hope you can convince her to get tested. Maybe ask her to watch this documentary:

  • It's just she was taking levothyroxine for a few years and had no problems. Then when it was increased from 75 to 125 when she was pregnant she began having issues. She suffered a miscarriage and then put her dose back to 75mcg herself, but is still having all these symptoms. What could be the reason when she has out dose back Down? As she started having these symptoms when dose was increased? They never took took bloods to increase dose, just increased because of pregnancy?

  • The mental health problems sound like me when I was on levo. I was always a little over anxious (v out if character for me) but this was magnified when I went on levo. Especially around the 75-100mcg mark. Dreadful anxiety and mostly to do with my symptoms although other things as well. Went up and up with the levo until it made my muscles hurt so switched to Armour. So so so much better for me! I'm so much more relaxed. Turns out I need the T3 for my brain to function properly. Also going up in dose calms my digestive system down (not what you would expect, I know!) Hope this helps! :-)

  • I was also told I was experiencing panic attacks and with hind sight I now know mine were just hypothyroid symptoms which would come on all of a sudden. Food for thought!

  • I've had the same symptoms was on 100 eltroxin and 75 alternate days. Been underactive for over 10 years. Over 5 weeks ago started to feel very anxious not sleeping, eating very jittery palps had bloods done caus I thought I had gone overactive but the results came back as way under TSH of 24. Was sent to endo he put me on t3 20 ml and 75 eltroxin the symptoms of palps and anxiety have gone but I'm feeling rotton on new meds no energy. Had all vitimin tests done all came back ok according to doc. Was told that I was depressed too but I know it's definitely my thyroid. Hope your sister gets sorted soon. Wish these docs would listen to us.

  • It sounds like 'being overmedicated' symptoms but at the same time being under medicated/ hypo. It is hard to know without blood tests.

    Please stop this person from taking Diazepam, if she takes it, this shouldn't be longer than 2-4 weeks. Benzodiazepines are an easy, quick fix, often over-prescribed. Very easily to get addicted, consequences of long term use are horrific! Believe me. Benzos badly affect endocrine system in particular cortisol levels, also sex hormones, not to mention thyroid.

    Best thing to do is to test cortisol, tsh, free t4 and t3, also b12, d, folate and iron to see where does she stand with her levels. Best wishes. E

  • I had bad withdrawals stopping diazepam after just 3 days! I wasn't medicated at the time so I wonder if that might have had something to do with it and was just extra sensitive. Use with care!

  • I'm getting notifications that others have replied but can't see them :( sorry x

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