results any comments please - having such anxiety - cant breathe

[Sarahpoppe232]

results on 125 Levo- TSH 0.73) 0.27-4.2), free T3 4.1(3.3-6.8), F thyr 17.8(12-22) thyroid pO 9(0-34) CRP 1.71(0-3) folate serum 45.1(8-60) Ferritin 67.9(30-150)Vit B12- 150 (37-168)

[Buddy195 Administrator]

I read from your previous post that you’ve recently started HRT. Until my dosage of HRT was optimal, I had a massive anxiety spike. My Endo recommended that I adjusted the utrogestan element (from 2 tablets for a fortnight each month to 1 tablet daily) and this worked so much better for me. It could be that you need to try an alternative product or dosing regime to see if it’s the HRT element causing the issue.

How long have you been on 125mcg Levo? Again, my anxiety levels increase if I increase (or decrease) thyroid medication too quickly. I now only adjust by 12.5mcg a day (alternate days at first until tolerated).

[Sarahpoppe232 in reply to Buddy195]

hi buddy yes started HRT 4 weeks ago but was already anxious so hard to tell what is going on - it looks like my thyroid is ok now - so need to get bloods back for HRT and try to sort that out I guess

Did you mean you reduced oestrogen by half - I have started now doing only one pump in the morning and progesterone morning and night - is that what you did ?

I was doing one pump Am and one PM

How long did it take until you got HRT optimised please ?

Been on 125 levo for 6 weeks now so will stay at that dose I think

I am finally seeing an endo - took me 16 years as doctor would not refer me until I stopped Levo and TSH went up to 18 or so - anyway thanks for your time - I really appreciate it -

I may have to get something for anxiety tomorrow not SSRI just for now as feels like heart will go through chest

Feel so bad not being at work not not sure what to do 1 really trying to get to the bottom of it - have a good evening.

[Buddy195 Administrator in reply to Sarahpoppe232]

I reduced the progesterone dosage from 2x utrogestan tablets daily (which were prescribed for 2 weeks on, 2 weeks off) to a single progesterone tablet daily. I initially tried oestrogen patches along with the progesterone, but found the pump better, as could alter the amount more easily to find an optimal. It took around 4 months for me to get the HRT working for me. I use the gel on a morning and take the progesterone on a night.

I didn’t need anxiety medication, as (for me) optimal dosing of thyroid medication reduced my symptoms massively . When I had an anxiety flare again in peri menopause, getting the HRT meds optimal also alleviated the overwhelming anxiety i experienced.

Some members report needing an increase in Levothyroxine whilst taking HRT, but I actually found I needed a slight reduction.

Looking back, Increased anxiety has been the worst symptom of having a thyroid condition for me and it is always worse if thyroid medication or key vitamins (ferritin, folate, vitamins B12 and D) are not optimal.

My GP initially diagnosed me with ‘ health anxiety’, suggested I saw a psychotherapist & offered me anti depressants. Joining this forum helped me realise that my symptoms were related to being under medicated and I followed forum advice to improve this.

The psychotherapist encouraged me to take up mindfulness, which I find helpful. I followed guided meditations by Danny Penman/ Mark Williams (Mindfulness in a Frantic World). Mark Williams also has an app with short guided meditations, which is great if you need reminders to practice daily. I was also encouraged to use a ‘guided journal’ to practice positive thinking.

When I have an anxiety flare, I try to limit sugar and avoid caffeine in an afternoon, as this can make my anxiety worse. I eat an anti inflammatory diet, avoid gluten & I supplement with turmeric, omega 3 & magnesium.

Most importantly, keep reaching out if you need further advice or support; we are here to help! 🦋

[Sarahpoppe232 in reply to Buddy195]

ok I am taking Oestrogen once a day progesterone 2 x a day was on 2 and 2 bit maybe I need to reduce the P also to once a day ?

Glad you have optimised now - gives me hope as only a month in

[FancyPants54 in reply to Sarahpoppe232]

You are using Oestrogel? 2 pumps (now 1 pump?) and what is the name of your progesterone?

Did your doctor say you were perimenopause or menopause?

Did they discus with you if you should still be having a bleed once a month and therefore you take your progesterone for part of the month and have part of the month without progesterone in order for the bleed to occur? or if you should take your progesterone every day continuously so that you don't bleed again?

These are important differentiations.

[Sarahpoppe232 in reply to FancyPants54]

hi there so it’s esteadiol 0.25 mg twice a day and not got progesterone package with me so will get back to you. I have not had a period on over 6 months so no bleed ?

[J972]

Hi there,

I’m sorry you’re feeling so poorly. I see from a previous post that you’ve been diagnosed with high cortisol and have been experiencing chest pains. How are you feeling in that respect now?

😊

[Sarahpoppe232 in reply to J972]

I think it’s anxiety -I still have high cortisol and chest pains - I am signed off work as a teacher - so anxious not sure how to go back - the more time I have off the more I can’t go back . I have had some adrenal tests done and heart monitor on for 6 days so will get those results - I think I just need to focus on journaling and looking at anxiety as get HRT optimised also just had labs done on that bit not got them back yet - sorry to blah on as I know you guys all have your symptoms and illness but not sure anyone else understands .

[J972 in reply to Sarahpoppe232]

You haven’t ‘blah’d’ on at all, everything you say is completely understandable and you have every right to explain yourself. And, for what it’s worth, I too am a teacher, operating under extreme stress which is not helping my health in the slightest. I foresee spending the summer holidays addressing my issues, which are not dissimilar to yours. Take good care, keep us updated. 😊

[Sarahpoppe232 in reply to J972]

yes thanks will do - will get all results and try to optimise everything and then work on stress and other issues - one thing at a time - nearly at the holidays

[Buddy195 Administrator in reply to Sarahpoppe232]

I also took time off from teaching when my anxiety was at its worst; you are not alone in needing time away from work. Do make use of any therapy sessions offered by your GP or teaching union, as you may find this helps. CBT techniques definitely helped me and I continue to practice them if I have a flare.

[Sarahpoppe232 in reply to Buddy195]

yes will do - thanks

[1tuppence]

Hello Sarah..... so sorry you're experiencing anxiety. It's absolutely horrible, isn't it? I find stress/anxiety makes me lose my appetite..... and experience has shown me how interlinked Body and Mind are. I know that not eating/eating very little is not helpful for me, so I need to ensure that "want it or not" my body needs me to eat nourishing food...and regular eating ie 3 times a day...helps my body, and that has an effect on my mind. Do you manage to eat? Eggs, bananas, etc Google foods to help anxiety? I wish you calmer times ....hugs xx

[Sarahpoppe232 in reply to 1tuppence]

yes I overeat with anxiety so that also messes uk hormones as releases more estrogen but thanks - yes it is horrible - I am trying to journal feelings

[Gingernut44]

Your thyroid results show low FT3 and your FT4 isn’t optimal. I’ve done the percentage twice for your FT3 as most ranges are 3.1 - 6.8

FT3: 4.1 pmol/l (Range 3.1 - 6.8) 27.03%

Or FT3 4.1 (3.3 - 6.8) 22.86%

FT4 17.8 (12 - 22) 58%

Your conversion isn’t good but you might do better with a higher FT4 before considering T3 especially if you’ve started HRT. Did you have your blood test around 9 am with the last dose of Levo 24 hours before?

[Sarahpoppe232 in reply to Gingernut44]

wow thank you so much for your response .

I really appreciate your help

I did test before 9 am and without taking meds before so left it 24 hours

What should my TF4 be please and how could I optimise it ?

Been on HRT a month

[Gingernut44 in reply to Sarahpoppe232]

I’ve pm you

[Beau55]

Reasons for continued symptoms or failure of treatment besides low nutrients (b vitamins, iron, etc) -

CORTISOL - cannot emphasise this enough. Cortisol is essential to get your thyroid meds working and into the cell. Prolonged hypothyroidism puts enormous stress on the Adrenal glands and in turn they eventually cannot keep up, resulting in low cortisol. This can happen before treating thyroid and also while on thyroid medication but you are not yet OPTIMALLY treated. This creates a chicken and an egg scenario, we need cortisol to get our thyroid medication to work but we also don’t produce enough due to our low t3 levels. Some of the main low cortisol symptoms experienced while on thyroid medications - intolerance symptoms to thyroid meds (even small increases), heart palpitations, anxiety/panic attacks, chest pain, fatigue, low blood or high blood pressure, depression, instability in thyroid levels and symptoms, symptoms not being resolved despite optimal thyroid results. This list is not exhaustive, there are so many symptoms and clinical presentations of low cortisol. High cortisol can also block thyroid meds from working effectively.

Testing - a 4 point saliva test to see how much free cortisol you produce and if possible a synacthen test to rule out primary adrenal insufficiency if the results are low. Treatment is usually adrenal cortex for low results, hydrocortisone for extremely low results or glandulars for high results.

RT3 - There is much deliberation over this and everyone has different opinions however, if you have failed to get well on thyroid medication it is prudent to test for this. Elevated rt3 can be found in non-thyroidal illness so it’s not cut and dry but if you have not found success on t4 containing medications despite best efforts, you could have a rt3 problem which is inhibiting you making full use of your thyroid medication.

This page on Paul Robinson website is useful and outlines in detail how this occurs paulrobinsonthyroid.com/rev...