Anxiety/panic attacks 75mcg Levothyroxine

[Cade83]

Hi, I’ve been on increased dose of 75mcg for 3 weeks and the past week I’ve had a mixture of feeling nauseous, bloated and anxiety last 2 days is through the roof. I even had a panic attack half 3 this morning and the anxiety has been up and down all day and now I’m in bed again it’s really bad. I know it’s worse night time because I’ve stopped and thinking about it but I can’t help feel like maybe I made a mistake going up to 75mcg. I’m going away for the weekend from early Saturday and I’m worried I’m going to have a really rubbish time if this doesn’t sort itself out. I was tempted to go A&E last night or even now just to get my bloods checked but I know they won’t do it. They’ll just send me home as I’m not an emergency. It could just be me going away and feeling anxious about that but I’d be able to control it more. I know if I ring my doctors tomorrow they will just tell me to drop to 50mcg without even checking what my levels are and that’s not useful to know if it’s just me or the levo. I’m thinking of getting private bloods done for after the weekend but this doesn’t help me while I’m away. Any suggestions would be greatly received.

TIA

[Timsywhimsy]

Maybe if you tell them how you’re feeling they’ll run a test. Three weeks should be enough to show free t4 right, even if l tsh may not be accurate. You could also try 5 or 5.5 pills a week instead of seven if you think 75 is too much but 50 not enough.

[greygoose]

Did you have a change of brand with the increase?

What were your levels before the increase? Rather doubtful that you're now over-medicated. Anxiety can be an under-medicated symptom, too.

[Cade83 in reply to greygoose]

No I’ve stuck to the same brand Wockhardt.

My levels before increase were,

TSH 3.1 mIU/L 0.27-4.3 mIU/L

FT3 5.22 pmol/L 3.1-6.8 pmol/L

FT4 13.1 pmol/L 12-22 pmol/L

T4 72.6 nmol/L 66-181 nmol/L

Thyroglobulin antibodies (TgAB)

611 kU/L 0-115 kU/L

Thyroid peroxidase antibodies

209 kIU/L 0-34 kIU/L

[greygoose in reply to Cade83]

OK, so you did need that increase. You TSH is much too high for someone on thyroid hormone replacement. And, your FT4 is very low. However, maybe it was too much of an increase for you as an individual. Do you have any of the 50s left that you could alternate 75/50 on alternate days? That might help.

Did you know you have Hashi's? Do you know how Hashi's works?

[Cade83 in reply to greygoose]

At the moment I’m taking 3 25mcg tablets a day. Will alternating not cause it to fluctuate though and cause symptoms that way?

I don’t know a great deal about hashi’s and how it works.

[Angel_of_the_North in reply to Cade83]

No. Technically you could take a whole week's dose in one go - which is what doctors do with people who they think are not taking their meds. Levo doesn't really do much on its own - it has to be converted to T3 to have an effect - so it works quite slowly and leaves the body slowly. Lots of people take alternate day doses.

[SlowDragon Administrator]

Previous post with Full Thyroid and vitamin results here

healthunlocked.com/thyroidu...

Sometimes we need to increase at slower rate than 25mcg steps, even though you actually need the increase

So you could drop dose slightly to 50mcg / 75 mcg alternare days for 3-4 weeks. See how that goes. Then in few weeks try increase to 75mcg daily

Are you now supplementing vitamin D?

Plus magnesium supplements can help and can be calming too.

If anxiety becomes totally debilitating, taking small 10mg dose propranolol may help. Propranolol is a beta blocker and reduces need for adrenaline and allows adrenals to rest..(regularly prescribed for hyperthyroid patients)

[Cade83 in reply to SlowDragon]

I may try that, it’s really quite bad anxiety. I really would like to see bloods after the weekend. So may wait until weekend is over and hope I can control anxiety.

I’m taking solgar 1000 iu vitamin D daily. I’m also taking 200mg magnesium citrate, B complex extra high strength and ive also been taking on alternate days 20mg of gentle iron.

[SlowDragon Administrator in reply to Cade83]

Did you start all these supplements at once?

Best to only add one supplement at a time and wait at least ten days to assess before adding another

B complex may be upsetting you. Perhaps cut that out for few weeks

[Cade83 in reply to SlowDragon]

Yeah I started them all at once. I’ll do the same tests again next week and go from there. Anxiety is up and down but I think I can just about deal with it until I can get tested again.

[Hidden in reply to SlowDragon]

Hi. Propanolol was what put me in hypothiroidism. It was prescribed without even checking thyroid levels for heart palpitations. Just wanted to share that information. Thank you.

[Valarian in reply to Hidden]

I'm a bit surprised they prescribe propanolol to people who are hypo when there are other options available. Although not usually enough of an effect to make a major difference to those who are well above range, it does apparently inhibit T4/T3 conversion.

thyroiduk.org.uk/tuk/treatm...

ebmconsult.com/articles/pro...

[SlowDragon Administrator in reply to Valarian]

Yes I was stuck on propranolol for almost 20 years, yet it was only way I could tolerate taking Levothyroxine

Turned out that was due to severe undiagnosed gluten intolerance, multiple vitamin deficiencies and DIO2 gene variation....classic case of NHS prescribing multiple medications instead of finding the root cause

Only with help on here, was I able unravel it all. Weening off propranolol very very slowly once on strictly gluten free diet and addressing vitamin deficiencies

Carolyn Dean, book The magnesium Miracle was key info on how propranolol lowers magnesium

[Hidden in reply to Valarian]

Thank you. I was not hypo, then.

[mountaingoat83]

I have to increase very slowly as well - it took me about 5 years to figure that out though! A large increase in one go causes similar issues for me. I last increased my dose about 9 months ago (up from 75mcg), by literally one 25mcg tablet per week and it decreased my TSH from 2.6 to 1.7. It seems like the lower the dose (and 50 is pretty low) the smaller incremental increases you need because the increase is a bigger percentage of what you are taking than if you were already on a higher dose. I hope that makes sense!

[helsyf]

my daughter experienced these symptoms when under medicated, but even as they started to settle down as her medication started to work, each time she raised her dose she would feel like this at 2-3 week mark. For her it settled down at about 5-6 weeks after starting on each increased dose and then she felt the benefits. Anxiety breeds anxiety though, so if you can have any tests to put your mind at rest, that would probably be good...oh, and she took cyclizine for the nausea...it helped a bit. If in doubt, chat to your doctor and get a test.

[Cade83 in reply to helsyf]

Thank you this reassures me so much. I do find if I’m using energy and busy it does tend to go down a bit and I do suffer with health anxiety so it’s hard not to spiral into negative thinking and catastrophizing everything.

[magsyh in reply to Cade83]

That is because exercise uses and lowers adrenaline

[helsyf in reply to Cade83]

it is hard not to worry at times because it is quite a slow road to recovery and there are bumps along the way, so inevitably there will be times when you don't feel as good as you would like to. Be kind to yourself and don't be afraid to seek reassurance from the medical profession when you need it. You are still on a journey to get your medication balanced and deserve some TLC along the way. Good luck

[magsyh]

I go through this and it's worse at night. I'm having a problem raising from 50 too. I discovered that the raise lowers my TSH too quickly. Which means your thyroid shuts down a bit with the feedback loop. Your body produces adrenaline to compensate. It calms down when your body balances what your thyroid produces and what your thyroxine provides. I now have to raise in very small amounts to stop the adrenaline kicking in. 25mcg raise is probably too much for you right now. I'm adding 12.5 mcg every second day at the moment and so far so good. Try slow you may feel better.

[Cade83 in reply to magsyh]

Ugh night time is the worst 😬 it’s like sitting on the edge of ya seat constantly. Maybe I’ll cut a 25mcg tablet in half then.

[jgelliss]

It might have been a big jump for you . You might want to try alternating 50 with the 75 mcg T4 and see how that feels . Some thyroid patients are more sensitive and need to raise /lower thyroid doses low and slow .

[HashiFedUp]

Maybe you just need to increase more slowly. So for example 50 one day, 50 the next then 75, then back to 50 for two days, then 75 again. Do you see what I mean? You can even do one 75 tablet once a week then twice a week the next week, so on and so forth. So it’s a really gradual upping of the dose. I would get your bloods checked though and go back to the GP. Maybe go back down to 50 until you see your doc. Try not to worry (!) it’ll get right in the end. We’ve most of us been there! X

[Myro]

If you don't sleep well. And have other symptoms of hipertiroidis go down with dose. No more 1/10 at time every few days. If you feel good it can be low blood sugar level. It cause psiho effects. No sugar, no bubbles nothing sweet. Low carbohydrate diet. Low GI food. 8 meals a day, caunt calofies. Chack iodine level and possible consequences. Symptoms should be prooven by tests.