This is following on from my last post. I just got my results through. I’m a little confused because I haven’t changed dose since around November ish but December my TSH was 2.83 FT4 15, in January it was 1.5 FT4 19 and now it’s 1.14 FT4 14.2. I’m having awful anxiety and depression and with the anxiety I get really cold and shaky. The last sort of 3-4 months I’ve really struggled with my anxiety and now I’ve suddenly started getting full on panic attacks. Where as before I would get intense anxiety but it wouldn’t go as far as a panic attack. I used to say I wish I’d just have a panic attack so I could go back to being chilled but today I nearly took myself into a&e because I really thought I was gonna have a heart attack. I was taking quite high doses of vitamins which I’ve now gone down to RDA on all of them but I think maybe I need to up my magnesium to at least 200mg and maybe vitamin d to 1000iu? I just feel so off balance at the moment and I feel like I have such little tolerance anxiety wise like it doesn’t take much for me to feel anxious anymore it’s horrendous, it just seems to be getting worse and worse and I honestly felt like I was gonna get to the point where I’m just gonna have panic attack after panic attack until I’m dead or lose my mind. I don’t feel good at all. I mean I have just broke up with my fiancé moved back to my home town and had surgery in the last 2 months. It was a very stressful relationship hence why I broke up. Maybe it’s only just starting to come out so to speak? Who knows. I always do my tests first thing in the morning fasted before medication. I’m not strictly gluten free although I’m willing to try if it helps. I just never know what to have for breakfast cause I normally have oats or toast. I was diagnosed with Chronic fatigue syndrome couple years ago and I have been doing a lot more than usual last couple weeks. I was hoping the CFS would be more to do with my thyroid though than being CFS. I’m just really out of sorts at the moment and really don’t know what to do about my blood test results. I feel like I’m losing my mind like literally.
Test results and extreme anxiety : This is... - Thyroid UK
Others will be more equipped to answer your test results questions. I just wanted to encourage you to get some sort of talking therapy. You’ve been through a lot there and sometimes chronic fatigue can be linked to some past trauma too. Usually that can put us into our heads too much and in worry.
I had to approach everything in a holistic way which meant meditation, yoga, food (gluten free) and supplements, therapy and medicine.
Sending hugs to you
Hi Cade, sorry to hear you are struggling. Have you changed your brand of Levothyroxine at all?
Hi, have you tried CBD products? I’ve found skin patches from Cannacares really helpful and calming.
Holland & Barrett do a range and I just bought online a mouth spray much reduced from TKMaxx.
Also remember that the Samaritans have volunteers waiting to chat if you need someone to listen to you about your difficulties. It’s always good to share your worries.
Also have you tried writing down all your anxieties and worries? It helps to clear your mind.
Wishing you well, you’re not alone in struggling at the moment.
By the way did you know you can buy gluten free oats for your breakfast?
I’m always weary of trying CBD products I just associate it with being illegal and freak out using them. I’ll look into it though.
I have so much going on and past trauma that sharing it all only to have to go through it again with someone else later puts me off. I’d rather find a therapist who I can stick to and go through things once. It’s exhausting talking about things.
Maybe a good idea to write things down.
I’ll look up gf oats.
Good morning Cade83,
I really feel for you. After several years of high stress, I too was always in a state of high anxiety. Constant stressors that continue over a sustained period of time, such as break ups and surgery, deplete your body's fight and flight hormone, cortisol.
As a result, all the body's vitamins and minerals become low too, including thyroid. Without vitamins being optimum, I found my thyroid medication didn't lift levels. A short synacthen test came back saying although levels low I did not have Addisons so no treatment given.
So I had to repair myself.
Worth really working in yourself, mindfulness and a healthy diet, being kind to yourself and not over doing exercise may help. I bought a book, ' Adrenal Fatigue The 21st Century Stress Syndrome' by James Wilson and followed the advice in there. It helped greatly. Three years on and my levels are gradually returning to more 'normal' ranges. Maybe this approach might help you too?
Good luck and take care.
Results show you are under medicated
Ft4 is only 22% through range
Helpful calculator for working out percentage through range
You need 25mcg dose increase in levothyroxine
Anxiety and panic attacks are extremely common hypothyroid symptoms
Bloods should be retested 6-8 weeks after each dose increase
Do you always get same brand of levothyroxine
Vitamins need improving too
Yes strictly gluten free diet likely to be beneficial
Oats are fine if you buy from Free from section of supermarket
Some Gluten free bread makes great toast
Must use separate GF toaster
High cholesterol is linked to being under medicated
It’s difficult because when I had my thyroid check at my pre op my FT4 was 19. I was going to increase by 12.5mcg because when I increased by 25mcg before it was too much and my TSH went down to 0.14. I always get same brand but normally always 2 different ones. Wockhardt and Mercury. I’ll get some gf oats and bread.
Well you could initially increase by 12.5mcg, taking 75mcg and 100mcg alternate days
But it’s possible that last test coincided with temporary Hashimoto’s flare and after each flare (temporary high thyroid levels) we become a little bit more hypothyroid
Panic attacks are usually low thyroid levels (not too much levothyroxine)
Strictly gluten free diet frequently reduces anxiety
Vitamin D, likely to need at least 2000iu daily, possibly higher
Aiming to maintain vitamin D around 100nmol
Test twice year
NHS easy postal kit vitamin D test £29 via
Are you currently taking a daily vitamin B complex?
I’m currently on 75mcg so I was going to increase to 87.5mcg daily. It’s hard cause I don’t wanna go up and then be too much only to have to come down. I certainly don’t want to live like this though so I have to try something.
I will go gluten free see if that helps.
I was taking super strength B complex but decided to go back down to RDA so a lot smaller dose. Like B6 from 50mg to 1.4mg. I was also taking 4000iu vitamin D but went down to 5ug but I did buy some 1000iu so maybe I’ll start on those for now or take 2.
Oh the reason I went down is because I was getting really bad teeth clenching and this was affecting my neck. So one of them was effecting that but don’t know which one.
Teeth clenching and grinding common hypothyroid symptom. Recommend getting dentist to make you mouth guard (I was extremely sceptical.....but it’s brilliant)
supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial. This can help keep all B vitamins in balance and will help improve B12 levels too
Difference between folate and folic acid
Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.
B vitamins best taken after breakfast
Igennus Super B is good quality and cheap vitamin B complex. Contains folate. Full dose is two tablets per day. Many/most people may only need one tablet per day. Certainly only start on one per day (or even half tablet per day for first couple of weeks)
Or Thorne Basic B is another option that contain folate, but is large capsule
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
Awe I forgot about Biotin, the multivitamin has 50ug of biotin. Will that decrease or increase TSH? Oh just read the first link, so my last 2 TSH tests would have been falsely lower than normal. 🙄 so I need to retest my TFT’s again. Do the other vitamins have biotin in. I’ll change to one of those as this one has 200mcg folic acid. I normally take vitamins at bed time with my sertraline because it leaves a gap for thyroid meds or is it ok to take multivitamins with them?
50 micrograms of biotin is the sort of level you could get from your diet - depending what you eat.
I don't think it will make any difference.
At the start of the reports of interference from biotin, the issue was discussed regarding Multiple Sclerosis patients who were taking absolutely massive doses of biotin. Like "three daily doses of 100mg".
The maximum dose of biotin available from a UK chain is 5000 micrograms. That is, 5 milligrams. Just 5% of the dose being used for MS - and probably only taken once a day!
Most "B complex" and other multi-ingredient supplements will have far less.
Our actual established daily requirements are as low as 35 micrograms a day. We might get that much from our diets.
There has never been evidence of interference with tests from the sort of dose we get in our diet.
To begin with, the advice was that two days was plenty of time without biotin. This is very likely plenty for low dose biotin - somewhere near daily requirement level.
To be absolutely sure, it is often suggested laying off biotin for a week. It is a short, easy to remember, safe and probably universally acceptable time. But almost certainly excessively long for people who just get a little biotin in a multivitamin or B-complex.
I feel that while everyone should be aware of the issue, it is getting people excessively worried.
Never take levothyroxine with anything else
Exactly what vitamin supplements are you currently taking
You could swap medications around. Take levothyroxine at bedtime
Take antidepressant after breakfast with vitamins
Vitamin D mouth spray works well as avoids poor gut function of thyroid
Magnesium supplements best taken afternoon or evening, but must be minimum of 4 hours away from levothyroxine
I’m currently taking nutravita multivitamins and minerals off amazon.
That makes everything more complicated. However if it’s better that way I’ll try it.
How would I change levothyroxine to bedtime, take it tonight or miss it until the following night?
Is vitamin D spray just as effective as tablets?
I could take magnesium after dinner I guess.
Once you improve vitamin D level, very likely you will need on going maintenance dose to keep it there.
Test twice yearly via vitamindtest.org.uk
Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7
It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average
Calculator for working out dose you may need to bring level to 40ng/ml = 100nmol
Government recommends everyone supplement October to April
Taking too much vitamin D is not a good idea
Web links about taking important cofactors - magnesium and Vit K2-MK7
Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine
Vitamin K2 mk7
2 good videos on magnesium
Vitamin D and Covid
Notice how much vitamin D many of these medics are taking
Is it this one?
Multivitamins are never recommended on here. Too little of what we do need, plus most multivitamins contain iodine, not recommended for anyone with Hashimoto’s.
Are you vegan?
Yes that’s the one I’m taking. I was only taking single vitamins but changed to multi for smaller doses. But I have a feeling this might have caused this anxiety cause I’ve dropped too low.
No not vegan, I like meat too much but then I only really eat chicken. Occasionally other meats and bacon.
Early stage Hashimoto’s frequently has lots of changes in levels as your thyroid breaks down releasing excess thyroid hormones. This does settle over time. Gluten free diet may help reduce swings too
when I increased by 25mcg before it was too much and my TSH went down to 0.14.
Why did you decide 25mcg was too much? Did you feel worse or was it because your TSH dropped?
Too much Levo will give you panic attacks, too little normally you feel anxiety, get fat etc. But really either end of the spectrum's isn't much fun. I'd have a day or two off the Levo and see if you feel better. ps - ignore the blood test results, if you did the same test 2 hours later your TSH would different. Drive your Levo dose on how you feel and your body temp - use a digital maternity thermometer and take just enough Levo to give you a nice fat 36.4-6C temp. Blood test is just for the doctor, but he cant fine tune things like you can.
I would like to address your post from another angle other than thyroid-related. I recently experienced serious anxiety and panic over an issue far less extreme than your breakup, your move, and the surgery - and all within a mere two-month period no less. I added 1400 mg St. John's Wort to my daily supplements and it is amazing how quickly it relieved my severe emotional stress and even puts a smile on my face from time to time.
You might also try natural Bach Flower Remedies (Rescue Remedy) and/or Valerian tablets or tincture that have a reputation for reducing fear, anxiety, and panic. But for me, St John's Wort works the quickest.
A strictly non-gluten diet, meditation, and prayer are additionally helpful. And of course all the rest of the wonderful advice you've been given on this forum.
Good luck on your journey forward.
I’m not sure I can mix St. John’s wort with my sertraline. I’ll look it up. I would prefer something holistic though. I do have valerian incense which do actually calm me a little for a while. I’ve tried rescue remedy before and didn’t think much of it.
I’m going to try gluten free and see if that helps. I need to do more meditation but when I’m in such a high anxiety state I can’t do anything I just sit and freeze (not cold) just fear something bad is going on or something bad is going to happen to me.
Thank you for the suggestions.
Rescue Remedy does not do what taking separate remedies can do, like Minnilus, Rock Rose for fear and panic for example. But St. John's Wort works better in my opinion. And try acknowledging that what you have been through in the last few months can be at the bottom of your emotional state. Knowing causes is a big part of recovery.
Gluten can make you feel nervous and off-balance the following day.
Everyone has given you some great advice. I just wanted to point out that your ferratin levels need to increase. Hopefully you will see an improvement in your fatigue as the number increases. Also, some brands of vitamin b complex can definitely cause an increase in anxiety because of the dosages that are in them. I've had to stop taking some in the past because they caused anxiety, insomnia and heart palpitations.
Hopefully it will be beneficial. I forgot to mention that you might definitely benefit from going gluten free as the rest have suggested. It helped me improve overall. If you have difficulty completely cutting it out buy sourdough bread instead because its fermented.
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