Just spent another anxiety ridden weekend and feeling a bit despondent. Got my blood results last Thursday:
TSH 12.5 (0.27 - 4.20)
Free Thyroxine 11.9 (12.00 - 22.00)
Free T3 2.86 (3.10 - 6.80)
Total Thyroxine (T4) 69.2 (59.00 - 154.00)
Increased my dose from 100mcg Levothyroxine to 125mcg on Thursday after I got my results.
Has anyone else experienced bad anxiety when they're hypothyroid? Was it really bad, and how long did it take to stop?? Sorry, but just looking for some understanding and reassurance!! Hope someone out there identifies.
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Judthepud
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How adequate your levo dose is, depends on weight. The levo dose necessary to do "full replacement" is in the range 1.5-1.7 micrograms/kg body weight; this is for a person who is otherwise healthy and can effectively do T4->T3 conversion. But looking at the numbers above, particularly the high TSH and low FT3 while at 100mcg levo, I suspect you will end up needing a bit of T3 to feel well.
I was very (VERY!) anxious while hypothyroid. Early on, while I was very sick, taking T4 would actually make me MORE anxious because I had other things going on: Hashimoto's antibodies, a gut whose villi had been destroyed by gluten, lots of nutritional deficiencies. My anxiety was esp. made worse by hypoproteinemia; my body wasn't processing protein from food efficiently, which meant I didn't have enough amino acids in my system to make neurotransmitters like serotonin and dopamine.
Yes I had anxiety it was horrible although I'm not sure now if I was hypo at time or if I started off hyper as I have hashimotos. Not sure what to suggest but have you tried accupunture? I did find that quite calming. Good luck you will get there!
Thanks for your reply. I think my anxiety may have started off coz I had increased my doze to to 150mcg as my TSH had crept up from the 1s to the 2s. A couple of months later I started having horrible anxiety and I presumed it was due to over-medication, so I dropped back down to 100mcg in the hope that the anxiety would stop and I would then re-dose. However the anxiety didn't stop and my recent blood results showed that I was hypo instead of hyper. As I say, feeling a bit despondent coz I didn't expect hypothyroidism to cause anxiety, but apparently it can, although if I'm honest I'm a bit worried that my anxiety is here to stay with nothing to do with my thyroid. Thanks for your support
Like most symptoms anxiety can be a symptom of both hyper and hypo. I had it along with paranoia which was a real barrel of laughs having never suffered with either. Once i got my TSH right down it faded away and recognising its return now prompts blood tests to figure out if raise or drop is needed.
Did you drop 50 in one go? If so that is too big in one go and would certainly magnify the effects, only ever do 25 every 6-8 weeks whether up or down as it takes time for the body to adjust. Also big jumps can allow you to miss your sweet spot. I get identical symptoms when slightly over medicated but was convinced I needed another raise til I got my bloods back, if you need to you can always halve a 25 to fine tune.
Do you have hashi, you may have had a flare and just needed a small drop for a few weeks til it was over.
Thanks for your reply. I think my hypothyroidism is because I dropped down from 150mcg to 100mcg because of my anxiety which I presumed was due to over-medication. It may be that I was over-medicated but instead of hitting the right dose, I've dropped too low. I never knew that hypo could cause anxiety - I suppose my fear is that my anxiety is unrelated to my thyroid and that it's here to stay. I suppose I want someone to tell me categorically that my thyroid's to blame, which I know no one can be sure of. Anyway thanks for taking the time to reply
Your dose has nothing to do with your weight. The weight calculation is for people who are starting thyroid hormone replacement after a total thyroidectomy.
It's impossible to tell how well you convert at the moment. You won't be able to see that until your TSH comes down to around 1. At the moment it's far too high and your Frees are far too low.
And they're incredibly low considering your dose. It's not a high dose, by any means, but I would have expected your FT4 to be at least in range on that dose. How do you take your levo? On an empty stomach and leaving at least an hour before eating and drinking? Do you take any other medication or supplements at the same time?
Yes I take my levothyroxine first thing in the morning on an empty stomach and don't eat until much later in the morning. I also take low doze aspirin (75mg), a multivitamin, and 25mcg of vitamin D3. In the evening I take atorvastatin.
2) you're wasting your money on a multi-vitamin. So many things wrong with them. You'd be much better getting your vit D, vit B12, folate and ferritin tested, and just taking what you need, in quantities suggested by the results, plus their cofactors.
3) that's quite a low dose of vit D3. Did you get it tested before starting it?
4) why are you taking a statin??? If you have high cholesterol, it will be because of your very low FT3. It will lower your cholesterol as levels rise. You do not need, nor should you be taking, a statin.
Hello again, thanks for taking the trouble to reply. Here's my response to your questions
1) I take aspirin cause I was diagnosed with a raised cardiolipin after a series of early miscarriages in my late 30s. I've more-or-less been on it ever since just to keep my blood from clotting and I have a family history of early heart disease/stroke (I'm now 62).
2) I know what you're saying about a multi-vitamin being a waste of money. Suppose I take it just "in case" . My recent medichecks blood test gave the following results:- Active B12 133.000 (25.10 - 165.00); Folate (Serum) 19.98 (2.91 - 50.00); Ferritin 53.9 (13.00 - 150..00). So they all look OK. Forgot to mention that I'm currently on a six week course of Ferrous Fumarate as my haemaglobin was borderline the last time I had it checked by my GP.
3) Haven't had my Vit D tested but took double that until recently when I read somewhere that the current fad for taking Vit D3 is causing some people to overdose on it, so decided to cut back over the summer.
4) I'm taking a statin because I have a family history of early death from heart attack/stroke and when tested my cholesterol was high.
Btw on your first response yesterday you said that you would expect my FT4 to be at least in range on my current doze of Levothyroxine. Checking back at my results my Free Thyroxine was 11.9 (12.00 - 22.00) which is below range, but my Total Thyroxine (T4) was within range at 69.2 (59.00 - 154.00). A bit confused by that.
Having increased my doze from 100mcg to 125mcg last Thursday (5 days ago). How soon can I be re-tested. I notice NICE guidelines say patients can be reviewed every 3 to 4 weeks. Is 3 weeks too soon? Feeling a bit desperate to get this sorted out as quickly as possible.
1) do the do regular checks on your cardiolipin to make sure you still need to take the aspirin? Because it's not a good thing for a hypo to take.
2) taking a multi-vit 'just in case' is not a very wise move, because depending on the ingredients, it might be doing you more harm than good. Have you looked at the ingredients? Which one are you taking? Your ferritin doesn't look very good at all. It should be up around 100, so good thing you're taking iron - as long as you take it at least 4 hours away from your levo.
3) I would advise you to get your vit D tested straight away. Too high levels are toxic.
4) you may very well have a family history of heart attacks, but a statin isn't going to save you, because cholesterol doesn't cause heart attacks, no matter what you're doctor's told you. But it will be lowering your sex hormones, which is a very bad thing. As I explained, your cholesterol is high because your T3 is low, which means that the body cannot use the cholesterol correctly. The solution is to raise the T3, not take statins. Cholesterol is necessary for your health, you can't live without it, and lowering it might very well lead to a heart attack!
Forget the Total T4, it doesn't give you any useful information. Not worth testing, actually, I don't know why they do it. It is the Free T4 that is used by your body.
You should get tested six weeks after starting a dose, because that's how long it takes for the increase in dose to be fully synthesized by your body.
Does the six weeks apply to me when I've already been taking Levothyroxine - I increased to 150mcg (from 125mcg) in October and by January started feeling anxious. By February I thought I must be over-medicated and reduced back to 125mcg. Then about a month ago (after no improvement in anxiety) I reduced back down to 100mcg (thinking I was over-medicated). However, after my blood results showed I was hypo, I increased back to 125mcg (last Thursday). Doesn't this mean I could titrate up quicker because I'm not just starting out on Levothyroxine? Sorry to nag!! Thanks for all your other advice btw, much appreciated
Thanks for your reply. I was put on a statin a few years ago as my cholesterol was high and I have a family history of early death from heart attack/stroke. At the time I was tested, I think my thyroid was under control. I'm finding it interesting that a few people on this forum are confirming that anxiety is a symptom of hypothyroid, cause when you go on the internet for lists of thyroid symptoms (and medical text books too), anxiety always falls into the "hyper" symptoms. Nice guidelines say that a person can be tested 3 to 4 weekly while titrating Levothyroxine. Do you think 3 weeks is too soon to take another blood test? Just desperate to get back in range in the hope of controlling this horribly debilitating anxiety
If you go on to the parent THYROID UK site their is a symptom checker list and anxiety is on there, it is a long list and you may recognise a few you hadnt considered.
Most hypo symptoms are generic and cross over both with hyper, nutrient deficiencies and unrelated conditions, hence the difficulty in getting adequate thyroid treatment. Some hypos get palpitations, are skinny or anxious when under medicated yet GPs often want to reduce levo because these are only recognise as classic hyper symptoms even in the face of clearly hypo blood results
Now I'm more educated about my condition I realize that anxiety and panic attacks were my FIRST symptom of having hypothyroidism. I read a medical article that said it was because the adrenal glands are trying to counter the extreme low energy by flooding your body with adrenalin.
I've also been over medicated and had really severe anxiety.. Awful...
For me fatigue, and anxiety are bought on by vitamin D and iron not being OPTIMAL, too. But I had to work that out for myself as my doctor said I was " in range" and didn't need to supplement. ( Even though my red blood cell count was to high, and my MCH was too low ( ie platelets are to small) indicating anemia).
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. My recent medichecks blood test gave the following results:- Active B12 133.000 (25.10 - 165.00); Folate (Serum) 19.98 (2.91 - 50.00); Ferritin 53.9 (13.00 - 150..00). So they all look OK. Forgot to mention that I'm currently on a six week course of Ferrous Fumarate as my haemaglobin was borderline the last time I had it checked by my GP. 
Anxiety 
sub clinical hypothyroid 
Advice please 
Advice on TSH Free Thyroxine and Free T3 results please
