For the past 4 years I've had several stressful events happen to me plus health issues (H Pylori, Hashimoto's, iron deficient anemia to name the biggest issues). As the months have ground on it seems to me that I now wake up feeling just filled with dread as to what my day will hold. I cannot seem to grasp that the Tirosint could be working for me although my TSH is down 1.2 at this point after 5 weeks of being on Tirosint 75 mcgs. I realize this is not a very long time to be on replacement hormone, so maybe i just need to give my body more time?
My worst symptom is the lightheadedness, which is nearly constant from AM to PM and makes playing with my 4 year old almost unbearable. I cannot seem to deduce if the lightheadedness is from the Hashimoto's or from anxiety. Or both?!
Also I am having trouble sleeping at night, when I lay down I get the worst ball of anxiety in my chest and have to take an Ativan to get to sleep. I should add that my diet is extremely clean - no caffeine or alcohol, and I eat plenty of veggies every day. I have been gluten free for over a month with no change in symptoms.
I am planning to see a doctor about this issue and I already see a therapist monthly, but in the mean time I am curious if anyone else has developed an anxiety disorder from either having Hashimoto's or simply worrying about it, and i would love to hear what has helped you. Did getting the correct/med hormone levels help? Or did you have to go on something like an anti depressant to fully get control again?
Thank you,
Rose
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thyroidrose
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Untreated hypothyroidism can certainly cause anxiety and exacerbate anxiety in someone already experiencing it. It's unlikely you are undermedicated with TSH 1.2 but without seeing FT4 and FT3 it isn't possible to say you are optimally dosed on 75mcg.
It will have taken 7-10 days to absorb the Tirosint before it started working and usually takes up to 6 weeks to feel the full impact of the dose. Symptoms can lag behind good biochemistry by several months.
Gluten-free can reduce thyroid antibodies but it often takes a year or more to do so.
Ask your GP or therapist to check ferritin, vitamin D, B12 and folate. These are commonly low in hypothyroid patients and symptoms may be similar to hypothyroid symptoms.
My B12 was 687 at last check and folate is over 20. Ferritin was 77. Vitamin D was 60.
Maybe it's just going to take more time for the lightheadedness to fade?
My issue is that lightheadedness doesn't seem to be a very common symptom of Hashi's/hypo. That alone is making me nervous that it's something else entirely that is causing the problem. Maybe pernicious anemia? But my B12 and folate results looked decent. Hm.....
FT4 is just shy of the upper quadrant and FT3 is just shy of halfway through range. Both could still rise as you've only been taking Tirosint for 5 weeks.
B12 and folate are good. Pernicious anaemia causes B12 and folate deficiency.
What is the range for ferritin? >70 is usually adequate but halfway through range is optimal.
If vitD is 60ng/ml it is optimal.
I used to get very lightheaded and dizzy with Hashimoto's. Thyroid levels were euthyroid (normal) so I assume it was the Hashimoto's.
Thank you Clutter. When you say that you used to feel lightheaded and dizzy, does that mean that now that you're optimally medicated, the lightheadedness and dizziness has gone away?
Ferritin range is: 15-150 (mine was 77 at last check)
I had euthyroid Hashimoto's so thyroid levels were normal and I wasn't on medication but I had a lot of dizziness and lightheadedness and was often close to fainting. I thought it was symptoms of Hashimoto's.
Six months later I had a large nodule removed which turned out to be malignant so I had completion thyroidectomy 3 months after that. Symptoms improved after thyroidectomy. I'm not sure whether it was because Hashimoto's burned out without a thyroid to attack or whether it was due to the Liothyronine (T3) I was prescribed. I was very unwell when I was switched to Levothyroxine 3 months later and dizziness and lightheadedness resumed. They cleared up after I was optimally dosed on Levothyroxine and T3 18 months later.
Very interesting story Clutter. I have heard from online searching that many times people with Hashi's and lightheadedness only find relief when T3 is added. Hmmmm...
When the body has too low a level of thyroid hormones it compensates for the lack by producing cortisol (C) and adrenaline (A). It is the excessive C and A that causes the anxiety. As thyroid hormone levels drop lower, so the body pumps out more C and more A, making people more and more anxious. (C and A are the "fight or flight" hormones that the body produces in times of stress, so this is why people feel anxious.)
C and A aren't a good substitute for thyroid hormones, and so people don't feel well, at all.
The longer the low levels of thyroid hormone go on, the greater the strain on the adrenal glands (which produce the C and A). In some people their adrenal glands can't keep over-producing indefinitely, and so levels of C particularly tend to start dropping lower and lower and lower. C is absolutely essential to the healthy functioning of the body (and so are thyroid hormones of course), it isn't an optional extra in the body. So without sufficient thyroid hormones and without sufficient cortisol the only thing left is adrenaline. By that time anxiety will be through the roof.
In some lucky people, once they get their thyroid hormone levels optimised their adrenal glands sort themselves out. But problems arise when doctors refuse to prescribe sufficient thyroid hormones, so levels are never optimised. Another problem is that when people have been hypothyroid and untreated or under-treated for years the production of C and A gets stuck at the wrong level and won't change easily, even when thyroid hormone levels are finally treated.
So, what needs to happen? Unfortunately, rather a lot! And because doctors are so bad at treating the thyroid it can be very difficult to achieve.
1) Optimise thyroid hormone levels.
2) Optimise nutrient levels (hypothyroid people all end up terribly nutrient deficient).
3) Work on improving gut health.
4) Find out how much cortisol you are producing throughout the day with a saliva test (can only be done privately - ask for advice on what to order and how, if you want to do this).
5) Treat cortisol levels (this isn't easy, whether the result is low or high).
If you read this post from another forum, it lists all sorts of things that can affect thyroid hormone levels and TSH :
Be aware in that post that references to levels of T4 are not referring to Free T4 in UK units, I think they are referring to Total T4 in US units of measurement.
This is excellent information, so clearly written. I vividly remember years back that I had an almost constant "fight or flight" type feeling going on. That was the early days of hypothyroidism I guess, I just didn't know it. Going to do the 24 hr saliva cortisol test for sure.
Light-headedness is from Hashi's, I too have that, most unpleasant. I find some foods set it off more than others. If you're already gluten-free at least you've eliminated that as a source. I urge you to keep a food/drink diary and note down your symptoms, you may discover a pattern.
It is likely your doctor will try to push anti-depressants at you. My (non medically trained) advice is to give them a wide berth. You need to find out whether you are non-optimal in any of vitamin D, Vit B12, folate or ferritin (not just 'in range' as the ranges used extend too low).
Hashi's is, I'm afraid, a long journey and you'll no doubt have to tweak medication and diet several times before you resolve some symptoms. But the good thing is this forum, lots of help and invaluable advice!
Thank you so much for the response, and I'm sorry you're in the same boat as me. I will definitely try to steer clear of anti-depressants as I simply don't feel depressed per se. Just anxious as to when I am going to feel better! It is a vicious cycle.
Hi there, I am happy to report that I am feeling much better although I cannot pinpoint exactly what was going on. I am gluten free, am now on NatureThroid (although the anxiety did lessen on Tirosint as well), and I take LDN 0.5 mg at night for sleep. I still take Ativan as needed or on a night where I need to get to bed but cannot. I am still battling the 'Hashimoto Hangover' as I call it where I feel lightheaded on and off but it is not constant anymore. I also practice Transcendental Meditation twice daily. Are you working on an anxiety or Hashimoto's issue? Both?
Glad u are better. How much ndt are u taking and how are labs? I tried that one but i got hyper and could not sleep, my t4 was low and t3 was too high. Both, but my anxiety was bad when i added cytomel. I’m waiting to see how my labs look now and i decreased my tirosint as well.
Sorry Danym, somehow I missed this. I am on 1 grain of NDT taken once daily in the morning. I just increased from 3/4 grain after lab results revealed I was under medicated (TSH was 6.27). My anxiety was bad on synthetic T3 too oddly. So far with the NDT I have not experienced any anxiety.
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Am thinking of taking other meds - just 2 issues I have before I commit...
Are any other Hashimotos patients, prescribed T4 only, experiencing eye problems?
Evaluating Test Results Using Tirosint
