Increased anxiety on dose increase

[Dressagelovr]

Endo upped levo from 57 to 75 mcg five weeks ago. I am happy to report that my my hypo symptoms of tingling, lightheaded, and achiness are pretty much much gone. However, anxiety is up. Does anyone know if my system might adjust to this side effect?

[Lalatoot]

It is early days yet so things will settle. Anxiety is also a symptom of under medication so don't be surprised if you need to increase again. Hormones are terrible things when they get in a mix up and when you change doses, boy does that give the hormone pot a stir!

[Dressagelovr in reply to Lalatoot]

Thank you. I've had anxiety on. insufficient dose as well. Do you have a you have an idea of how long it takes to settle out?

[Lalatoot in reply to Dressagelovr]

It depends on the person. 6 - 12 weeks. But if you are still undermedicated it may require a further dose increase. Hang in there. I was undermedicated for 4 years. on and of throughout that time I had anxiety and panic attacks. What my body was lacking in thyroid hormones it made up for with adrenalin. It was not a comfortable ride.

[Dressagelovr in reply to Lalatoot]

Pretty sobering. Thanks for your input.

[SlowDragon Administrator]

You need vitamin D, folate, ferritin and B12 levels tested f not been done for a while

Good vitamin levels help Thyroid hormones work better

[Dressagelovr in reply to SlowDragon]

I'm ok in those departments. Thanx for your reply.

[jamesal0]

I doubt you will get better on 75, you are pooling, back it down to 50. I need exception B12 levels 600-900 and some extra Testosterone to process/convert T4 Levo fully.

[Dressagelovr in reply to jamesal0]

I was hypothyroid on 57 mcg so needed to go up. Cud be 75 is too much...time will tell.

[LAHs in reply to Dressagelovr]

Measure your FT3. You may be a good converter (of T4 to T3) in which case you could step things down just a little at a time, like taking a 50mcg one day a week instead of 7 days of 100mcg, that will give you a very slight decrease of your T4. But only do that if your FT3 is pushing the upper limit. As others have said, find out if your anxiety is hypo or hyper first, your FT3 level will let you know. (So too will your TSH - but look to your FT3 first, it's more diagnostic)

[McPammy]

What brand of Levothyroxine are you on. Some people don’t get along with Teva and people say Teva can cause anxiety.

[Dressagelovr in reply to McPammy]

Synthroid

[McPammy in reply to Dressagelovr]

I’m not familiar with that brand sorry.

[LAHs in reply to McPammy]

It's American for Levo. Levo and Synthroid are the same thing, a synthetic T4.

[waveylines]

I would stick it out as you will be due a blood test in another week or so. Anxiety is not a good predictor of being over treated as it can occur when under treated. Other symtoms of being over treated are temperature above normal, sweating, shaking, loose stools. Do you have any of these?

[Dressagelovr in reply to waveylines]

A couple of episodes of loose stools nut no other hyper symptoms as of yet. Looks like I need to stick it out. Blood test id this week. I've been on this merry go round for six years, and it does wear me down.

[Kim327]

Are you getting rechecked soon? I do blood work every 5 weeks after med change

I wish I had advice on the medication affects, but I can tell you have have anxiety all the time since I was diagnosed in February with Graves. I also may be going through menopause now to add to it all!

I see above you said your vitamin levels are good. Not sure if you’re feeling unwell or it’s just your emotions? Do you feel like you are going more hyper? I was hyper and now heading more then other way while I wean off meds. I find the adjustments always cause new side affects. Our thyroid affects everything. Our hormones especially!

Meditation, yoga and relaxing time for yourself is important. Also, good nights sleep! I know it’s hard (I have 3 kids so I fight for this). Hopefully you can find something to help you relax and make it part of your routine to help with your anxiety.

Best of luck!

[Dressagelovr in reply to Kim327]

Getting checked this week, which will be 6 weeks

[shelbydaws10]

Try Ashwaghanda for calming effect, it is an excellent supplement for theThyroid issues.

[Dressagelovr]

Didn't realize this was calming?

[humanbean]

Adrenal and thyroid function are linked.

Read this link :

holtorfmed.com/how-the-adre...

If the thyroid starts to fail and hypothyroidism develops, this stresses the body. The adrenals respond by taking up the slack and producing more cortisol to keep the body going.

Cortisol isn't a great substitute for thyroid hormone, but it does keep humans alive. They may not feel great but they are alive.

In an ideal world, if thyroid treatment is begun promptly, starting treatment with thyroid hormones will calm the adrenals down and cortisol will drop as the thyroid hormone dose is gradually raised.

In a less than ideal world, like the one we live in, thyroid treatment is frequently delayed... and delayed... and delayed... for years, and even when treatment is started the dose is often too low. So the adrenals take up the slack and produce more cortisol for so long that the over-production of cortisol becomes the patient's "normal" condition. Once the new "normal" for cortisol has been set, shifting it back down again can be very difficult.

So, when the patient with hypothyroidism is treated after many years of delay, they may end up in the situation that they have more thyroid hormone (because of their thyroid hormone treatment) but they still have too much cortisol. The two things combined produce anxiety, which doctors usually decide is a mental health problem and they prescribe anti-depressants. This does nothing to fix the underlying condition at all, but the doctor is happy that they have done their job, which is nice for them but not the patient, and the patient is sent away with a new diagnosis, allegedly compromised mental health, and the possibility they will be on anti-depressants for life - and they will still feel dreadful.

Some people have found ways of dealing with this appalling situation by doing everything they possibly can to coax the adrenals to produce more normal amounts of cortisol.

One other fly in the ointment is that some people have adrenals that can produce more cortisol fairly readily and keep doing it for a long time. Others have adrenals that can't over-produce for very long. Eventually their cortisol output drops and drops and drops. In people with apparently healthy adrenals the process of ending up with low cortisol can take a very long time. But I think everyone with untreated or inadequately treated hypothyroidism will end up with low cortisol eventually. And low cortisol produces anxiety just like high cortisol does.

So, I'm basically saying that your anxiety is caused by a problem with your cortisol rather than your thyroid treatment. Fixing that, if you can, might allow you to cope with the raise in dose of thyroid hormones that you need. And to do that there are several things you need to do, which all boil down to removing as many stresses from your life as possible.

The kind of things that help (in no particular order) are :

1) Get into a good sleeping routine and stick to it. (I know this is very difficult for anyone with insomnia, but just do your best.)

2) Don't over-exercise or under-exercise. Swimming, yoga, light gardening, and walking are good. Crossfit, mountain climbing and running marathons are not.

3) Eat enough. For many people it turns out that breakfast really is the most important meal of the day. Lots of people with thyroid disease put on lots of weight and they get into the habit of almost perpetually being under-nourished because they want to lose weight. What actually happens is that the body seems to go into famine mode and makes the body hang on to calories and fat to keep people alive, and reduces energy available for use.

Hypothyroidism also often causes deposits of mucin in the body. Mucin is often mistaken for fat, but it isn't fat, and dieting doesn't get rid of it. en.wikipedia.org/wiki/Mucin

4) Make sure you eat food which is nutrient-dense, preferably something that people living in the 18th century might have recognised, somewhere in the world. Highly processed modern foods that are partially or completely made in something resembling a laboratory are not good for people at all.

5) Don't eat a low-salt diet. The dangers of salt have been massively over-hyped, and the adrenals need decent amounts of salt to function properly.

6) Try to get into a routine which allows some relaxation every day.

7) Optimise as many nutrients as you can. Low nutrients reduce conversion of T4 to T3. And since T3 is the active hormone, poor conversion is a major cause of poor health in treated hypothyroidism. The nutrients to worry about are vitamin D, vitamin B12, folate, ferritin, iron.

8) Try to prevent your doctor from treating you on the basis of just your TSH. TSH doesn't make you feel anything. What makes you feel ill is low Free T3 in hypothyroidism (or high Free T3 in hyperthyroidism).

9) Look up "adrenal cocktail". This is a drink that contains three basic ingredients - sodium (or salt), potassium, and vitamin C. For more info read these links :

stopthethyroidmadness.com/a...

therootcauseprotocol.com/fa...

10) Adaptogens are often used by or mentioned by or recommended for people with cortisol / adrenal issues. Be very, very wary. Read this link :

healthunlocked.com/thyroidu...

11) Going completely, 100%, no-cheating, gluten-free is helpful for lots of people who have thyroid disease. If there is a chance you could be coeliac get that tested before you give up gluten. If a coeliac test comes back negative then it is still worth trying going gluten-free for a few months. There is no test for gluten intolerance, but it is a common condition in people with thyroid and adrenal problems.

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If you ask your doctor to test your cortisol they will do (if you are lucky) a 9am blood test. If you are unlucky they will do the test at completely the wrong time of day, or they won't do it at all. The time is important because cortisol is at its peak at roughly 8am to 9am, and the test is supposed to capture that maximum level.

The blood test for cortisol will measure the total of bound and unbound cortisol. Bound cortisol is cortisol attached to transport proteins that move cortisol through the bloodstream. The body can only make immediate use of cortisol which is unbound.

Another alternative way of testing is to use a saliva test. Saliva has the virtue of only containing unbound cortisol, and is therefore more informative. The patient spits into a tiny test tube four times a day (it is possible to get tests that require five or six saliva samples but the extra tests are rarely helpful and they cost more). Any saliva cortisol test should also include a measure of DHEA.

Doctors rarely pay any attention to saliva cortisol testing, but people can do their best to help themselves when they know what they need to treat.

To get saliva cortisol tests done privately without involving a doctor or a health insurance company (and obviously you have to pay for it yourself), see these links :

stopthethyroidmadness.com/r...

stopthethyroidmadness.com/s...

Look for this line :

PLACES TO ORDER YOUR OWN TESTS–The first five are US-based.

It is possible, with non-prescription supplements, to either lower cortisol or raise it.

To raise low cortisol people use adrenal glandular or adrenal cortex supplements such as Adrenavive. I'm sure there are others, but I've never had to raise my own cortisol so I'm not that knowledgeable on what works.

To lower high cortisol some adaptogens help, but it is a case of trial and error to find out which one(s) you tolerate and which ones work for you. Personally I've found Holy Basil works to lower my cortisol.

I've run out of steam now, you'll be pleased to hear....

Hope this helps.

Good luck.

[Dressagelovr in reply to humanbean]

I so appreciate your reply with so many good points to consider. I plan to. into cortisol labs. I am especially curious since anxiety is the worst in the morning. Many thanx.