Thyroid UK
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Has anyone had an increase in anxiety/panic attacks when taking Cytomel?

Hello, I am new to this group. I went to a hormone specialist last year when my menopausal symptoms were giving me grief. I was prescribed progesterone, Estridot patch and DHEA as well as cytomel, which I've been taking for the past 1.5 years. In November, my doctor increased my dosage from one 5 mcg tab to two 5 mcg tabs/day. This was due to my still having hypothyroid symptoms, mainly awful fatigue, inability to lose weight, thinning hair and cold hands and feet. Neither my weight nor fatigue improved much after the increase in Cytomel. In January of this year, I went for a sleep test which revealed that I have severe silent (non-snoring) sleep apnea (30 apneas/hour). My GP was shocked as I did not fit the profile. I started on CPAP therapy mid-February and have been feeling a lot better. With sleep apnea, your body isn't able to go into deep restorative sleep. From what I understand, when you stop breathing, your reduced oxygen level causes your body to increase your cortisol levels which elevates your heart rate - so you wake up enough to gasp for air. All of these sleep interruptions do not produce a restful sleep and your hormones do not balance, your body doesn't regenerate the way it should. This would explain a lot of my symptoms with fatigue, weight gain and adrenal fatigue (my adrenals didn't have a chance to heal) and general hormone issues. It has taken a while to adapt to the CPAP and get my pressure levels comfortable, but effective. I do feel like I am getting proper rest now.

So my main concern is, that I have had extreme anxiety, with heart palpitations, over the past month and have had two work stress related panic attacks. I am an anxiety prone person, but I have never before had a panic attack, so I believe it must be related to my thyroid levels changing from my now restorative sleep, which is reducing my need for the cytomel. I didn't take any cytomel over the weekend and my symptoms were much better. I took one tablet this am, while I don't feel anxious, my heart palpitations are back. Thankfully, I have a blood test this week and an appointment with the hormone doctor next week. Has anyone else in the group had issues with anxiety linked to taking cytomel?

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Anxiety, panic attacks and sleep apnea are all hypo symptoms. So, it's possible that that 10 mcg T3 just wasn't enough for you, and you were under-medicated.

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Sorry, I was not aware that hypo caused anxiety, panic attacks and sleep apnea. I had always thought that anxiety and panic attacks were hyper symptoms, not hypo. Does hypo-thyroid cause sleep apnea due to swelling of the thyroid, may this cause the breathing obstructions during sleep? Pardon lack of knowledge. (-:

It also seems unusual that I had been taking 10 mcg for 3 months without anxiety symptoms and then when I started to get restorative sleep, I seem to be reacting to the cytomel. This is the only change that I can think of that might have caused this surge in anxiety (apart from my job that is, LOL). Anyhow, my lab results will hopefully shed some light on what is going on.

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Yes, we'll know more when we see the results. :)

Anxiety and panic attacks can be hypo or hyper symptoms. So many of them cross over that it's difficult to rely on symptoms alone.

Swelling of the thyroid may be one of the things that causes sleep apnea, but there could be others. Hypo can cause all sorts of breathing problems to do with the diaphragm, lungs, throat, nose and sinuses.

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5mcg of T3 is very small indeed. If you now take 10mcg that's also not very high if you are not taking levothyroxine along with Cytomel.

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Yes, I will have to see what my hormone doctor says next week after viewing my lab results. Maybe I'm just sensitive to the medication, now that my thyroid may be responding well to the correction of my sleep apnea - my endocrine system may be recovering from many years of not resting. I had subclinical hypothyroidism, so perhaps I won't require as much? We shall see...

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Has your doctor done a basic check for vitamin and nutritional levels, for example, hair loss can be due to low iron levels and anxiety, panic attacks can be due to nutrient deficiencies.

This article explains how some nutrient deficiencies can cause a number of symptoms and links calcium deficiency to thyroid disease. news-medical.net/health/Cal...

This article suggests a link between low calcium and anxiety.

tranquilitylabs.com/calcium...

It's worth checking basic vitamin levels such as vitamin D, B12, folate and ferritin which can be done through a blood test. Many people with thyroid conditions find they are deficient in these. I wonder if it's possible for these deficiencies to exacerbate sleep apnea?

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Thank you Nanaedake. I do go for annual blood tests (including vitamins and iron levels) - last one was in December 2017, and none of my levels were flagged as low. Good to keep this all in mind though! I'll ask for a copy of my results next time I see my GP.

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Yes, good, get copies of results. If you're in the UK, NHS will not flag results if in NHS range, however, bumping along the bottom of the range will not make us feel well, especially when we already have thyroid disease. NHS range simply tells doc that you're not going to keel over immediately or get rickets, it doesn't mean things are optimal. NHS isn't really bothered about hair loss. Your ferritin level needs to be around 70 or mid range to help hair regrowth. That's nowhere near bottom of NHS range. Low calcium levels won't show in blood test as your body robs bone of calcium to maintain levels. You won't know you're low in calcium until you get osteoporosis.

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For me, it wasn't the T3 that was the problem. It was keeping free T4 too high while on T3 (Cytomel). The result was too much hormone all around (hyper/hyper). I really need free T4 down around 1.0 when I am on Cytomel.

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