Hi, Looking for some advice. I have had anxiety for most of my life but managed it until the last few years . I’ve had some big family issues arose plus perimenopausal in the last two years. Since these things have occurred my anxiety has become heightened and i’m trying to manage it with diet , supplements and herbal things. i’ve tried citalopram and couldn’t bare the psychological side effects the first two weeks so stopped. I tried setraline a few years back but only lasted one tablet because the nausea was so bad i couldn’t leave the bathroom or stand up. I still consider retrying sertraline at a lower dose but haven’t had the guts because i’m a working parent and can’t just be really sick for weeks while my body adjusts . So instead i use sleep teas, chamomile teas, no caffeine, a dr vegan sleep supplement with 5htp, a bachs supplement with saffron and low dose of l theanine , then the usual b vitamins and magnesium glycinate , vitamin d and omega 3. . i have hashimotos so i havent tried Ashwaghanda yet because i read it can make my hashimotos flare ups worse . Any suggestions would be great because i just want to feel a bit better and able to keep more of a lid on my anxiety and low mood. i have considered upping 5 htp because i feel more positive in the morning when i take it . However, ashwaganda appears to have good results for anxiety so if anyone with hashimotos is using it it would be good to hear your experience . Also if anyone has any other opinions or suggestions i’d welcome them . My anxiety is present every day now but definitely much worse when i have something to worry about or when it’s a few days before my period is due . I’m on hrt and this has helped reduce symptoms but i’ve no idea if i should up the dose and neither do the gps .
i’m also on 40mg of propanolol each morning , specifically for a eye pain i have , but it has also helped to slightly reduce the physical effects of anxiety , but i’m not keen on increasing the dose more than necessary.
i am also doing a bit of cbt online, reading and i use sleep stories when needed but probably need to try to get some proper counselling.
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WeeB
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Thanks for your reply, unfortunately this past year has been difficult for many reasons so i haven’t gone gluten free or dairy free. i always get almac levothyroxine now . I don’t have any recent thyroid measurements and despite quite a few uncomfortable conversations with my gp, they have refused to test my t3 or refer me back to endocrinology. i have been going through multiple other tests and scans and starting hrt over the last year so to be honest my constant fight to manage my thyroid has taken a back seat because results usually come back around tsh 1.0 and t4 right at the top of the normal scale. they’ve refused to put me back on my b12 injections too. to be honest, this year i was just grateful to be getting the hrt and ent and neurology appointments i got . constantly going back to persuade them to look deeper in to my thyroid has been too difficult and anxiety provoking with everything else i’ve had going on. I will have to go back though or find some cash for private tests . although i did get my t3 done privately about a year ago and it was good results but that was before i was taking propanolol every day and i felt awful back then ( i think my most of my symptoms have been due perimenopause and anxiety or a combo of those things and thyroid , but how do you ever pin point exactly what one needs your focus and time when they all have the same symptoms ) . I think if i could find way to lower the anxiety , it would make me more able to do the other things like diet changes and more focus on tests etc
i will have a look back at test results and post if i can find them , i can’t honestly remember when they were last done ( not like me , but this last year has left me a bit all over the place )
i just read back your reply from a year ago . just to update on that , im taking 40mg propanolol once per day . i’m reluctant to stop it because it has greatly reduced right sided eye pain and ear pain and neck pain i was getting . my nausea has also greatly reduced but that may be the hrt that did that as well as the propanolol. but now my main issues are moderate and occasionally severe anxiety , plus total exhaustion and breathlessness . in addition to that i have lack of focus, brain fog, motivation, joint and muscle pain . when the anxiety is lower i have more energy and i’m less breathless . i agree i need to find out what is causing the anxiety to be so high but my guess is is that i’ve always had anxiety and the thyroid and menopause hormones are both likely antagonising it . if i had the money i’d see private doctors for both.
I’ve ordered the thyroid panel and vitamin d tonight. i’m not going to order iron studies because i get full ones done every 6-9 nine months by haematology and although i don’t have the results to hand , the consultants do seem to be very thorough and explain the ins and outs of it whenever they call with my results. so that’s why i’m not taking much notice of the june gp test because it hadn’t tested full panel and the iron is same as it was last january and the june before when i spoke to haematology .
it’s frustrating to think i need to go gluten free before looking to reduce propanolol but i can see the reason behind it , to hopefully have reduced my flare ups to better prepare my body to come off propanolol . but yea , i’ll need to dig deep to try to go gluten free . it just feels like such a big feat in amongst everything else but i know it’s the right thing to do . thanks for all your instructions .
I have haemachromatosis, haematology told me not to take iron supplements despite this being low. they told me i could take them for a week but if i didn’t notice a difference after that then to stop because it will build up in my body to quick . so i did they end felt nothing and stopped them .
It’s exhausting , last winter, i finally , after much back and forth , got my gp to agree to check my ft3 if i went on propanolol daily and started to have worse symptoms , She agreed and then 6 months later, no gp in the surgery will actually agree to follow through on what they promised . I really struggle with anxiety after i have stood up for myself at the surgery . i always plan my conversations and stay calm and get it all said clearly and still feel horrific after it . to get a win and then have them go back on what they agreed just makes me give up with them sometimes . However , having this forum really does help to refocus and makes me more determined again to advocate for my care. however , im not faffing about with them just now and i’ve just ordered the blood test online just now . Thanks for the push, i needed it.
You're welcome. I gave up on doctors long ago, and self-treat - if you want a job done properly, do it yourself! I live in France where they do test for FT3 but most doctors here admit they don't know what it is, what it does, nor how to interpret the results. And although Liothyronine is very cheap - same price as levo, I think - it can still be hard to get it prescribed because they don't know anything about it. It's an international problem, I'm afraid.
Your so right GG. I find that the lab ranges don't agree with my well-being at leat in my case. In my case in order for me to feel optimal I need my FT4's higher than what the ranges show. Most people do well with FT 4 at 1 .1 -1.2. I feel my best at FT 4 at 1.4- 1.5. And some T3 in the mix. I had TT and because my Dr's always dosed me by TSH and sometimes FT4. FT3 was *Never* checked.Medical Academia needs to rethink and train Dr's how to really dose patients the right way. It's not one size fits all.
But they don't want to dose patients the right way. That's the whole problem. All this knowledge is out there, and some of it has been out there for a long time, but it is medical policy to ignore it. Because it's more convenient for them! Imagine the work it would make for them if they had to treat every patient as an individual! Poor darlings - I don't think!
Hello, I wanted to suggest your HRT blood levels are checked,. I went on HRT mainly because my anxiety was through the roof, it immediately lowered with optimally elevating my oestrogen. However, I've just gone through the absolute worst 10 days of anxiety, slow heart rate at times heart rate of 52 but hanging around 60 giving me breathlessness and a weak feeling if passing out. I've been unable to function. Reading your post here has hrought to light that it is likely my t3 is (despite my tsh is 1 or under) always only just at the lower end of the range. I've no idea how to add t3 in along with levothytoxine but am very keen to investigate this. If your oestrogen is less than 250 that could be adding to your anxiety. Good luck.
i’m only at 50 patch started at 25 in november and saw a huge lowering of my night anxiety and cold sweats within weeks . went up to 50 in march. i just didn’t know how to high to take it and the gps leave it up to me to decide and don’t do blood tests . there is so much mixed info out there. by the sounds of what your saying , my oestrogen patch could be too low. i’ll organise a blood test , thanks
It's worth, if you can, getting set up with a menopause specialist as they are way more knowledgeable than gp's who invariably have completed zero training in menopause unless they chose to which is nuts!
Aside from getting all the recommended tests done , and possibly adding T3 ( the most wonderful help for my anxiety ) I do think you have barely given the antidepressants a chance . You say that one tablet alone made you nauseous? Is there a chance you are suffering from health anxiety? This can make everything you take feel threatening and dangerous . It just seems to me you are rushing around trying everything under the sun to ‘fix’ a problem which in my option could possibly be resolved by a course of specially designed medication in combination with the resolving of your Thyroid issues. Just my opinion .
Thanks Steni. You’re right that i do get health anxiety, i over worry about everything in my life so i read all the side effects in the paper and talk myself out of anti depressants yearly. I wouldn’t say i’m rushing around trying anything , im overly cautious and this has been a long process for me to even take what i’m taking and those things are helping me function and got me out of quite a severe anxious period . But i have an appointment with a mental health nurse this week and will discuss medication with them again because i didn’t give it a chance for the side effects to run their course and for my body to adjust . it’s difficult though to give in to being sick with side effects because at the time of starting sertraline i had two children that needed to be taken care off and an absence record at work that was too high already . when i say i was nauseous, i mean i couldn’t stand , i was gripping my bed and the floor , i took the tablet at night and went to sleep and when i woke up from the school run i was so ill i had to call for some one else to take my kids to school , so those side effects were definitely real . Nothing is simple with a long term illness . But i agree in general i overthink and over worry about taking antidepressants and whether they will be worth it .
I think that’s a good idea, discuss the treatment with a mental health nurse and see if you can get yourself to face taking the medication . It f you feel sick just take a travel sickness pill till it passes. You will feel better very soon, having been brave enough to endure anxiety without treatment for so long you know you can only feel better . Good luck
Hi WeeB , reading through these messages it sounds like you're exploring the physiological angles very thoroughly, but as the anxiety sounds like it's affecting you quite broadly I wondered if you'd looked into talking therapies at all? I don't know where you're based, but if you're in the UK hopefully there's an option to access the free NHS Talking Therapies (used to be called IAPT) service - they'll offer 1-1 CBT-based support for anxiety which would hopefully be more in depth and personalised to your situation than online materials. Wishing you well with this, it sounds like a really tough time.
Thanks , im scotland . i’ve been trying to get 121 therapy from nhs for 7 years and more so the last two years . They are so overly stretched that i don’t think i’ve met high enough criteria so they have been sending me the online courses. however , just reached the front of a queue this month and have an appointment with a cpn on thursday so i’m crossing my fingers i could get referred for talking therapy this time . i’ve been looking at private but just don’t know who the right person or type of therapy is to pay for . had 5 sessions of person centred through work about 5 years ago , helped a little to make sense of why i was such an over worrier but didn’t give me any tools to work through it . i think cbt or dbt or nlp is going to be more useful but not sure .
Oh that's difficult. Fingers crossed your appointment on Thursday results in more support being offered. It sounds like you've done everything you can with the online courses but they're not quite enough.
Hi WeeB, I've been reading your thread and your comment about which kind of therapy to go for. I am a counsellor, not looking for work, and evidence shows that it's the quality of the therapeutic alliance (in other words how well you and your counsellor get on, how easy and relaxed and honest you can be with the counsellor) that determines the outcome. The better the therapeutic alliance the better the outcome, regardless of which therapy. That said, Wale Oladipo of MindBodyBreakthrough runs excellent courses with information on, for instance, anxiety which cover not just which therapies and how they work, but the brain's involvement, the role of nutrition and supplements often in relation to the brain chemicals, exercise (which affects brain functioning and emotions, as I'm sure you know), affirmations etc. I would highly recommend that you do one if he's covering anxiety. I know it's a lot to do while feeling ill but even online he's great, informative, knowledgeable, understanding and calming. I would also recommend Yoga if you can find a very well qualified and experienced Yoga Teacher who knows the difference between breathing practices and Pranayama. It's marvellous for anxiety. Hope some of that helps and that you soon start to feel much better.
Just wanted to add my experience of anxiety, HRT and Ashwagandha. Ashwagandha seems to either really work for people or make things a whole lot worse depending on which immune pathway is dominant. There are previous posts about it on here. For me, it appears to have caused a huge increase in anxiety. I took it for a couple of months last Sept/October at the same time as I was changed from cyclical to continuous HRT patches. The combination was a disaster and I literally couldn't function due to crippling anxiety. My body also swelled up like a balloon. Dr decided I had taken a bad reaction to synthetic progestin and swapped me to micronised progesterone which helped a little with the anxiety and a lot with the water retention. I'm also still perimenopausal so my oestrogen levels can fluctuate wildly and when they go up, I swell up badly and my anxiety increases along with it. Like Greygoose, my anxiety also seems to increase when my T3 levels are too low but I take 20mcg T3 daily along with T4 so my TSH is suppressed and the doctor is convinced this is the cause of the anxiety. I reduced my dose slightly in Feb just to make sure and my fT3 and fT4 went below range again despite my TSH still being suppressed so I've increased again and the anxiety improved a little so I'm still working on tweaking to try to find my sweet spot while putting off going back for their test (I'm testing privately). Personally, I believe it's my oestrogen/progesterone/testosterone ratio that's causing the anxiety but the GP I've been seeing for the anxiety won't refer me to the menopause clinic because she thinks anxiety is my only symptom so instead I've been referred to the community mental health team. I'm going to go back to another GP to see about changing my oestrogen patch to the gel so that I can alter the amount every day depending on my symptoms and see if that helps my anxiety along with the water retention. I'm just fed up with not being heard but unfortunately it's nothing new. Hopefully something amongst my experience will help you. Best of luck 🙏
After reaching a certain age and having experienced anxiety as far back as I can remember, I no longer question ‘chicken or egg’. Underlying thyroid problems seem to have been my problem all along. After years of training in ‘free form anxiety’, it’s almost a given that ‘health anxiety’ will develop.
You have been given good advice above. I see your T4 levels are above range. I felt at my most ill when that happened to me. As others have said your vital T3 info is missing.
You are dealing with lots of stuff and you sound totally overwhelmed. It’s difficult to think anything like straight when you feel like that. Maybe picking on one thing only (eg getting your thyroid testing done) might be helpful. Honestly messing about with new medications, up or down medications, will all add to your anxiety.
I would definitely recommend absolutely strictly gluten free diet……my underlying anxiety just melted away and then very slowly over 4-6 months I then very slowly reduced then stopped propranolol
Magnesium supplement at bedtime is extremely relaxing and calming (or 4 hours before if you take levothyroxine at bedtime)
Obviously you need to test TSH, Ft4, Ft3 and especially vitamin D, folate, ferritin and B12
Hello. I am so sorry to hear about your anxiety. It is not very nice to experience. I myself had experienced this and I found Dr Harry Barry on you tube and he has also written several books on the subject. He explains exactly what it is and all the symptoms you have and says you can get rid of it for the rest of your life if you try his technique which is called flooding. Instead of trying to avoid the symptoms you embrace them and let it flood over you. Instead of being frightened of it you tell your body you are not and it does work. It worked for me and I no longer have it. It takes s couple of times but then it’s gone for good. It’s not easy and scary at the time but it does work. We are supposed to feel a certain amount of fear in our lives it is natural but sometimes it becomes heightened like yourself. Also there is specific yoga routines that help which are on YouTube Counselling also helps like you said. You are doing all the right things with the sleep meditation etc I hope this helps
It might be worth thinking about giving tapping a try? It's quick and easy to do. I remember reading that a GP surgery, I think in the midlands, tried it with their patients and it worked as well as or superior to antidepressants in 31 out of 32 if I remember rightly - much to the GPs surprise. You can watch videos here: theeftcentre-s-school.think...
I know we aren't all the same, but I discovered that my anxiety disappeared when I improved my iron and ferritin (iron stores).
Doctors kept prescribing me SSRIs / anti-depressants and none of them did anything much, apart from make me feel worse.
Unfortunately improving my iron / ferritin took a very long time because I absorb it poorly. My serum iron didn't improve at all for several years, but I got my ferritin up to mid-range in just under two years, and then I switched to a maintenance dose. If I took too little as maintenance my ferritin dropped dramatically.
From starting iron supplements to stopping iron supplements took me seven years - and oddly enough my serum iron is now better than my ferritin.
I still monitor my iron and ferritin regularly (about twice a year) just to make sure that my iron and ferritin don't go too high or drop too low.
As well as eliminating my anxiety the supplements also dramatically reduced my depression too.
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Although my bugbear turned out to be iron other people may find that theirs is something different e.g. low vitamin B12 is very common. Low vitamin D and low folate could also affect mood. Low magnesium, low zinc, high copper, low selenium and others could also be a trigger for anxiety or depression too.
We always suggest concentrating on vitamin B12, folate, vitamin D and ferritin to begin with. You could worry about the others later. People should always test before supplementing the things I've mentioned because levels of nutrients which are too high aren't helpful at all.
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I gave up on doctors long ago, and self-treat - if you want a job done properly, do it yourself! I live in France where they do test for FT3 but most doctors here admit they don't know what it is, what it does, nor how to interpret the results. And although Liothyronine is very cheap - same price as levo, I think - it can still be hard to get it prescribed because they don't know anything about it. It's an international problem, I'm afraid. 
Is it thyroid or anxiety.
Anxiety
Fluctuating T4 pre-treatment
Anxiety and palpitations
thyriod removed and anxiety 
