Been feeling off for a while almost a year). Butterflies in stomach and constant anxiety. Plus really bad sweats. Loss of appetite in recent weeks. Racing thoughts.
My GP wanted to start me on anti depressants but I insisted on blood tests to include thyroid and T4 came back as 25.5.
My GP says it’s mild hyperthyroidism. so has started me on propranolol. Thought it would be carbimazole.
I have all the symptoms and wondered if anyone else has experienced this - will it get better as sometimes I think I’m losing my mind with the anxiety. I’m not sleeping as worried I’ll wake up with the anxiety. It’s a vicious cycle.
Then all once the feelings ‘lift’ and I feel normal for a few hours.
It’s worse in the mornings.
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Madders14
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So we can offer better advice, can you tell us more about your thyroid condition, eg when you were diagnosed, ongoing symptoms- in addition to anxiety/ sweats, plus blood test results (with ranges in brackets) for:
TSH
FT3
FT4
Plus any antibody and key vitamin tests (ferritin, folate, vitamins D and B12)
In the first instance, do ask your GP for the above tests. We don’t recommend supplementing key vitamins without testing first (and sharing results with us).
If your GP is unable to complete all the above (eg if TSH is within range, some surgeries may not be able to access FT4 and FT3 tests), you could look to do this privately, as many forum members do, for a better picture of your thyroid health:
Carbimazole is the usual treatment for hyperthyroidism, but your GP is likely adopting a watch & see approach, awaiting results of your next blood tests.Propranolol is a beta blocker and should help with palpitations/ fast pulse etc.
I was initially diagnosed as hyperthyroid, with Graves and presented with similar symptoms to yourself, but subsequent antibody tests showed I’m actually hypothyroid with Hashimotos. I would definitely push for correct antibody tests.
Graves Disease (hyperthyroidism) needs to be confirmed via positive TRab or TSI:
All other tests ok (creatine & electrolytes, serum urea, HBA1c, B12/folate, serum free triiodothyronine, Vitamin d, liver function, lipids, FBC, bone profile, serum ferritin)
Diagnosed 4 days ago and started propranolol 40mg (three times a day) 3 days ago.
Increased anxiety for about 4 months.
Have had both over and under active thyroid on the past - always borderline and tipping from one to the other. Discharged from consultant 2 years ago and taken off carbimazole.
Vitamin B12 (Total B12 at top of range or for Active B12 100 or above)
Folate (at least half way through range)
Ferritin (half way through range) Although some point to 90-110ug as optimal.
I managed to improve B12 and folate by taking a good B Complex (eg ingenus Super B or Thorne Basic B) and am improving my ferritin by introducing more iron rich foods/ taking vit C with my main meal, to aid iron absorption (tips from dailyiron.net). SlowDragon has great links to improve key vitamins, so will tag her to reply. humanbean may also be able to offer support with ferritin. I’ve personally learned so much by reading their posts.
Another question- when were above vitamins and thyroid bloods tested? All a week ago or some longer?
I presented with similar symptoms to yourself- and that’s why my endo was convinced I had Graves (plus positive for Thyroid Eye Disease, more usually attributed to Graves). However, thanks to members here, SlowDragon and greygoose , I pushed for correct antibodies to be tested and found that my ‘hyper symptoms’ were transient and I was actually hypothyroid with Hashimotos. Obviously endo still thinks I had Graves and then this developed into Hashis, but that’s a different story!
The other thing I wanted to share is that increased anxiety has been the worst symptom of having a thyroid condition for me and it is always worse if key vitamins (ferritin, folate, vitamins B12 and D) are not optimal. I would definitely look to improve these as your ‘next step’ to improving your health and wellbeing.
Oh, and when a doctor says that a test results is "fine" it is meaningless. For example, a ferritin result of 15 when the range is 15 - 300 is "fine", and a result of 300 is "fine". But to a patient the way they feel with a result of 15 and a result of 300 is worlds apart. And the best result with that range might be around 160 - 200 perhaps.
You are legally entitled to printed copies of your blood test results and ranges.
The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results
UK GP practices are supposed to offer everyone online access for blood test results. Easiest option is NHS app, you may need "enhanced access" to see blood results.
If you can’t currently see test results online, simply ask receptionist at GP surgery to give you access. You will need to have photo ID with you.
This currently only applies in England, not across the whole of the UK. Nether Scotland nor N.Ireland have released an NHS app for patients. (Scotland supposedly due in December '24.) Wales has an app, but only for booking appointments, repeat prescriptions and amending personal details
Well, it sounds like classic Hashi's to me - aka Autoimmune Thyroid Disease. And in that case, Carbimazole is entirely the wrong treatment.
I don't think a GP can test of Graves' (your FT4 isn't really high enough for Graves', anyway, IMHO), but he can test for Hashi's: TPO antibodies. And that's what he should have done before prescribing anything.
Propranolol is a Beta Blocker and usually prescribed for Graves' to calm the heart rate and reduce conversion of T4 to T3. You don't really want your conversion reduced at this point. So, if you do need a beta blocker, ask for one that doesn't affect conversion.
Your B12 is absolutely dire. And your GP should be testing your for Pernicious Anemia. If you have one autoimmune disease - Hashi's - you're very likely to have another one - PA. And low B12 can cause terrible symptoms. So that needs to be sorted ASAP. Your folate is also low, but don't start supplementing that until you've been tested for PA because it will skew the results.
2 weeks after starting vitamin D look at adding a separate B12 supplement
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement
A week later add a separate vitamin B Complex
Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.
If Vegetarian or vegan likely to need ongoing separate B12 few times a week
Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose and may need 2 per day and/or may need separate methyl folate couple times a week
Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) Thorne can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12 if last test result serum B12 was below 500 or active B12 (private test) under 70
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