Thyroid UK

Hyperthyroidism or anxiety?

Hi, I have Ulcerative colitis but not typical symptoms. I don’t have pain nor diarrhoea. I also have IBSC and following a fodmap diet which helps.

I started sertraline for anxiety 6 weeks ago with terrible side effects then one gp sent me to an endocrinologist. The ultra sound showed a slightly enlarged thyroid and some nodules. Going for a biopsie shortly and started Carbimazole 5mg two days ago. My normal gp doesn’t think I have a hyper thyroid. He said my bloods are border line and have been for years. But I have been ill for years!! My symptoms are trembling hands, fast heartbeat, bloated tummy and a general feeling of malaise like I am going to faint. I am only confortable in bed. I am considering packing teaching. I only work 3 days but they kill me.

How long to see an improvement with Carbimazole? I believe it can take up to 8 weeks for sertraline to work.

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Idalmis,

Your endocrinologist obviously thinks you are hyperthyroid, not borderline, otherwise you would not have been prescribed 5mg Carbimazole. 5mg is a low dose so you aren't overtly hyperthyroid. Symptoms usually improve 1-8 weeks after you start taking Carbimazole.

Antithyroid medicines do not always start working right away. Symptoms usually get better or go away 1 to 8 weeks after you start taking the medicine. It may take as long as 6 months for your thyroid hormone levels to become normal.

Antithyroid Medicines for Hyperthyroidism - WebMD

webmd.com/women/antithyroid...

Sertraline usually starts working after a couple of weeks.

Sleep, energy, or appetite may show some improvement within the first 1-2 weeks. Improvement in these physical symptoms can be an important early signal that the medication is working. Depressed mood and lack of interest in activities may need up to 6-8 weeks to fully improve.

Sertraline (Zoloft) | NAMI: National Alliance on Mental Illness

nami.org/Learn-More/Treatme...

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Thank you. I guess I am impatient to feel better.

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Idalmis,

Understandable but unfortunately it is likely to take weeks/months as nothing about thyroid is resolved quickly.

You should have a blood test in 4 weeks to check thyroid levels on 5mg. Ask your GP or endo to check ferritin, vitamin D, B12 and folate which are often deficient in thyroid patients and can make you feel very unwell.

If you post your results and ranges in a new post members will advise whether you need to supplement.

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Many years before I was fiund to have Graves’ disease I was tested in case I was hypo. My doctor back then said she was very surprised because I was borderline hyper!

Nothing was ever done about it and back in those days I didn’t know about blood test results and lab ranges, not to mention the implications of borderline or that your results are good / OK/ fine might be good / ok / f8ne for your doctor, his receptionist or the receptionist’s dog but possibly not for you.

I was off the scale hyper and feeling really ill by the time I was diagnosed - I had been seen by a different doctor three months previously and she told me I was ‘needing my holiday’!

I started on 20mcg carbimazole and after four weeks I got a letter from my endo (who I didn’t see for another two months) telling me to increase my dose to 40mcg a day.

I had lots of work scheduled for the January after I started the carbimazole and ended up cancelling it all because I wasn’t sure I would be able to do what I was booked for and I was frightened I would end up cancelling at the last minute. My first endo appointment was at the end of February, I started ‘block and replace’ treatment then and I started working again in the April and was fine.

You need to be very kind to yourself, you need to get lots of rest, in fact you need to be a bit selfish and put yourself first - if you don’t no one else will. Don't do anything unless it is something you really want to do.

Ask for records of all your blood tests (and their ranges) you have done and keep them with you, write down any questions you have - just bullet points - to remind you of things you want to ask your endo or anyone else you see.

My pharmacist came round when I started carbimazole and told me to take high strength vitamin C along with it so I always took 1000mcg slow release vitamin c with zinc I don't know why that was, I was naive and shell shocked back then, after all, after years of feeling like a hypochondriac with lots of weird symptoms, there I was I actually had something really wrong with me!.

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Thank you so much for your reply. My mum who is 88 and still very well had a goitre for years but had her thyroid removed when she was in her 50’s.

The trouble with me is I don’ t really what is making me feel so poorly . Is it the colitis as my tummy is always bloated but the calprotectin test came back ok or is it the thyroid? All will be revealed soon I hope.

I haven’t a clue about my blood test results but when I saw my gp (the one who doesn’t think I have a thyroid problem ) I saw on his screen that results were highlighted in red for a few years, at least since 2012. Let’s hope I get sorted and live well into my 80’s in good health of course.

My family also think I am a hypochondriac. I don’t tell them much now but am not at my daughter’s beck and call to look after my twin grand-children and I love them dearly. I just can’t manage it.

Same with work. I crawled into bed at 6 absolutely exhausted. I might have to give it up. But I am 62 so it might be a good time.

By the way, is hyperactive thyroid always Graves‘ disease? I feel pressure behind my eyes.

Thank you again for your reply.

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There are different kinds of hyperthyroidism, including Graves' Disease, various types of thyroiditis, toxic multinodular goitre and toxic adenoma (not as terrifying as it sounds I don't think!). These can be distinguished by blood tests for antibodies and by thyroid radioactive iodine uptake scan I believe.

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I forgot to say I take 1000 vitamin c and have beeen on vitamin D with calcium for a while now. That was prescribed.

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Has endocrinologist tested Thyroid antibodies

TSI needs testing to confirm if it's hyperthyroidism

Hashimoto's (hypothyroidism) can appear to swing from hyper to hypo

For full evaluation you ideally need TSH, FT4, FT3, TT4, TPO and TG antibodies, plus vitamin D, folate, ferritin and B12 tested

You are unlikely to get full thyroid and vitamin testing from GP

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH and most consistent results

Link about antibodies

thyroiduk.org.uk/tuk/about_...

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Thank you. This is all new to me. I’ll have a read.

yes The endocrinologist sent me for blood and an ultrasound scan. I don’t have the blood results. Do I ask the endocrinologist ‘s secretary for them?

I can do that when I go for the biopsie which will be in the next couple of weeks.

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Hello, I'm sorry you are ill. Anxiety is a classic symptom of hyperthyroidism. I have been hyper and my anxiety was terrible! I had a lot of GPs try to give me antidepressants but I just knew something else was wrong: I had muscle weakness and strange sensations in my limbs and then a general malaise like flu which was the worst symptom - I just knew that couldn't be anxiety alone. Also a hand tremor, fast pulse, palpitations, sleep problems etc.

It would be interesting to see your blood test results if you have them. I hope the Carbimazole works quickly for you: I was told 1-3 weeks to start feeling improvements. (I actually got improvements in a week or so but it turned out I had thyroiditis and Carbimazole was too strong for me so I may not be representative.)

I was also given Propranolol beta blockers. Thee were very good for both the anxiety and the symptoms such as tremor and fast pulse. I found it very useful for immediate help. If you are struggling you could always explore this option with your GP. I took a pretty low dose of 10mg 3 x daily.

Hang in there.

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Well, 6 weeks ago, the gp prescribed me sertraline which is an anti depressant. He said I was going through a bad time and they would help. But I am not depressed just I’ll. They haven’t made me feel any better as yet and the side effects could be colitis or thyroid. I wasn’t given any beta blockers.

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You say your thyroid results have been high for a while so that seems the most likely cause of you feeling ill and having anxiety. The carbimazole should help with that. I felt like an entirely different person (or, actually, like my real self) physically and mentally when my thyroid hormones levels had come down. No anti-depressant was going to achieve that. I am not knocking them entirely, I have had them in the past for post natal depression and they were very helpful.

Re beta blockers, I wasn't offered these at the outset. I remember getting very upset about my new diagnosis and returning sobbing to the GP's surgery a few days later, terrified I was going to go into thyroid storm. As I say, I was highly anxious! I think at that point the GP thought it was a sensible move to offer the beta blockers. I was very hyper though. Anyway, there is no harm in you going back to the GP and asking to discuss this, even if they say it's not suitable/necessary. Also to discuss the side effects of the anti-depressant.

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Hi ildamas im on titration dose of carbimazole now but when i first started on 20mgs one a day it took me around the 8th week mark to notice a slight improvement but i could not work as i was a complete wreck, trembling, heart palps,breathless, and dreaded panic attacks but it does get easier, i gwt my bad days still at tbe moment as im not on correct dosage at present but as clutter said it can take several months, but sadly im still signed off work and this is my 3rd month but the key is resting lots and lots , also try not to worry about every little thing you feel as i did this at first and drove myself crazy thinking i was gonna die. Ha.be kind to yourself.xx

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