Panic attacks in early hours. Not nice!

[MissDemeanour191]

Hi I take 125mcg Levothyroxine. Mercury pharma as only brand I seem to tolerate, early hours in morning before I get up. Do this, as HAVE to have coffee when I get up! And know you cant take with caffeine. However, find when still in bed am getting quite severe panicky thoughts & feelings. Is it the Levo? Like most of us, sleep is valuable and this is annoying!! Any advice please?

[Tristy]

I used to get these when I was under medicated. It’s not nice at all. As soon as I got to the right dose of levothyroxine they disappeared.

[SlowDragon Administrator]

Your previous post a year ago GP had reduced dose to 125mcg

This is frequently incorrect and based solely on low TSH

Many people need higher dose and suppressed TSH in order to have high enough FT3

Panic attacks are frequently hypothyroid symptom

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Ask GP to test vitamin levels and thyroid if not been tested recently

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test.

(taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Is this how you do your tests?

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

thyroiduk.org.uk/tuk/testin...

For thyroid including antibodies and vitamins

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

Cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )

monitormyhealth.org.uk/thyr...

Add most recent blood test results and ranges if you have any

Or come back with new post once you get results

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

please email Dionne at

[e-mail]

[shaws Administrator]

You could try taking your dose at bedtime, with one full glass of water and see if this works for you. Your stomach, of course, would have to be empty. If it works for you, miss night dose if having a blood test next a.m. and take it afterwards and night dose as usual.

[shaws Administrator]

The following link may be helpful as it takes into account clinical symptoms.

naturalthyroidsolutions.com...

[Vrboska in reply to shaws]

Thank you Shaws, in this article I found so much wanted answers abt Nutri-Thyroid supplements and much more.

[humanbean]

However, find when still in bed am getting quite severe panicky thoughts & feelings. Is it the Levo?

This could be one of a number of things - being under-medicated or wrongly medicated and/or having low levels of vitamins and minerals and/or having too high or too low levels of cortisol.

I would suggest as a first step, and without changing anything, that you follow shaws suggestion and experiment with taking your Levo at different times of day.