# Hashiomotos and anxiety continues



## KarinStanley (Aug 26, 2012)

Hi. I posted yesterday that I am experiencing anxiety and insomnia. I went to ER this evening because of heart papilatations, the anxiety, insomnia, sudden weight loss, diahrea vomiting. They did a TSh on blood work and it came back at 2.68. They rest were other panels. The doctor said everything was fine and that have anxiety. I just feel as if something is wrong. I have not had anxiety issues before. Can that number show if there was some hyperthyroid going on or trouble with dosage? I have hashiomotos and taking 75 lethothyroxine. I was given anxiety medication but ont want to depend on it so have not taken it. But also not sleeping again.


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## markwillplay (May 12, 2012)

I can't offer much for sure, but I will say that I had much of the same on synthroid. I still have anxiety but it is brought about by other things having to do with withdrawal from Cymbalta over 7 mnths ago. I definately believe hashi contribut, but with a TSH of over 2.0, I would highl doubt that you are going hyper. Have you ever checked your pulse rate in the middle of the night when you feel like ift is racing? I used to do that and discovered that it was not. Just beating out of my chest, but not fast at all. Yup, that is anxiety and I think it can be caused by many things as your body is getting used to taking a synthetic drug to replace what is natural (that is my own theary anyway). I wish you luck, and recommend that if you really think anxiety is the issue (and it in fact could be) that you see a psychiatrist. Do not stop short. I have learned that the hard way.


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## Octavia (Aug 1, 2011)

Karin, you may be reacting to the drug itself (the ingredients in it), and not to the effects of the drug. I wonder if you could try a different synthetic, such as Tirosint, to see if your body accepts that better.

I know sometimes we can't really tell, but what's your gut feel on whether it's anxiety or something else?


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## KarinStanley (Aug 26, 2012)

I have never had anxiety issues before. Now it has come on so suddenly that I feel like something must be going on. All my symptoms: difficulty to swallow, rapid weight loss alternating with weight gain, anxiety, insomnia, heart papilatations seem to indicate something with my thyroid with the hashiomotos. I don't know what to do? Shoud I go to therapy to address anxiety? I can get into general doctor today but endo will weeks.


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## Andros (Aug 26, 2009)

KarinStanley said:


> Hi. I posted yesterday that I am experiencing anxiety and insomnia. I went to ER this evening because of heart papilatations, the anxiety, insomnia, sudden weight loss, diahrea vomiting. They did a TSh on blood work and it came back at 2.68. They rest were other panels. The doctor said everything was fine and that have anxiety. I just feel as if something is wrong. I have not had anxiety issues before. Can that number show if there was some hyperthyroid going on or trouble with dosage? I have hashiomotos and taking 75 lethothyroxine. I was given anxiety medication but ont want to depend on it so have not taken it. But also not sleeping again.


TSH is not reliable for diagnosing hypo or hyper because there are binding, blocking and stimulating antibodies to the receptor sites.

Please get your FREE T3 and FREE T4 done w/TSH.

Also, the tests below will help sort things out.

How did the doctor decide that you had Hashimoto's?

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism. 
http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html

Trab
http://www.ncbi.nlm.nih.gov/pubmed/17684583

TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/

This will explain your labs to you .......

Understanding your labs.
Here is a good place to learn how to interpret your labs.
http://www.stopthethyroidmadness.com/lab-values/#

Also, check your ferritin. If low, that can cause anxiety as well.


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## Octavia (Aug 1, 2011)

Okay...I think you have two issues going on...one is the swallowing issue, and the other is the anxiety, or whatever it ends up being.

For the swallowing, I would insist on a neck ultrasound so you and your doc can get a better look at what's going on in there, at least as a starting point. You might want to consider going to an ENT (Ear, Nose, Throat doctor, also known as otolaryngologist), especially if you feel like you're at a dead end with your regular doctor.

For the "anxiety," I do wonder if, despite what your labs are showing, you may be slightly overmedicated for your own requirements. I don't know. One way to find out is to cut back and see if you start to feel better, but this is something you would want to discuss with your doctor. Another possibility is that you are just not reacting well to the medication itself...but from your other thread, it looks like you've been on it for several months. If that's the case, I'm less inclined to think it's a "reaction" because the "anxiety" probably would have happened sooner. I'm more inclined to think overmedicated, IF you've been on this for several months.

How about antibodies...have those been tested? They can mess with the body and the lab results. (Sorry if you included this in your other thread...hard to keep track when it's not all in one place.)


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## KarinStanley (Aug 26, 2012)

Thank you for all your replies. I think I will make appointment with new endocrinologist today. Also see primary maybe he will order the labs and ultrasound. Do you think I should try the anxiety meds tonight so can get some sleep? I really wanted to fight this on my own but feel so miserable.


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## Andros (Aug 26, 2009)

KarinStanley said:


> Thank you for all your replies. I think I will make appointment with new endocrinologist today. Also see primary maybe he will order the labs and ultrasound. Do you think I should try the anxiety meds tonight so can get some sleep? I really wanted to fight this on my own but feel so miserable.


I would not take any other meds at this time as they could skew future testing that you are trying to set up.


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## markwillplay (May 12, 2012)

I would absolutely not take any anxiety meds yet. But, again, my view is skewed. I was very much like you and had never suffered from anxiety before. Find out what is going on with your thyroid condition or auto immune conditio as I should say) and then go from there. YOu will get it worked out. I had many of the same symptoms but no longer have them too much . Mine is a confused case becaue of Cymbalta issue, but I did feel better once I switched to armour all things relative. No doubt about it. Get a good endo that has experience with these things if possible. They are all very different.


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## KarinStanley (Aug 26, 2012)

Thank you for your posts. The support and information means alot. I was not able to switch endocrinologists today but did switch my general doctor and got an appointment for today. I am hoping he will order the blood work and ultrasound. I am wondering if trying to switch medication may help. My sister had anxiety before medication and while on Levothryroxine with Hashiomotos and felt better when switched to synthroid.


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## Andros (Aug 26, 2009)

KarinStanley said:


> Thank you for your posts. The support and information means alot. I was not able to switch endocrinologists today but did switch my general doctor and got an appointment for today. I am hoping he will order the blood work and ultrasound. I am wondering if trying to switch medication may help. My sister had anxiety before medication and while on Levothryroxine with Hashiomotos and felt better when switched to synthroid.


What criteria was used to diagnose Hashimoto's in your case?


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## KarinStanley (Aug 26, 2012)

I went to a new general doctor yesterday. He ordered labs. I showed him the list of recommended that was posted previously. He included them all and also ordered an ultrasound. I am going to have it done today. I am hoping to get some answers.


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## Octavia (Aug 1, 2011)

That's great!!! Keep us posted.


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## KarinStanley (Aug 26, 2012)

I got my ultrasound results back. I do have a nodule and some changes to the thyroid from hashimotos. My blood work is not back yet. I am being referred to another endocrinologist. The internist who ordered the ultrasound agrees I should not go back to my previous endocrinologist. I still am having some trouble swallowing and my throat feels very sore and tight. Does anyone else have that feeling? The anxiety is lessening- thank God. I was able to get about 4 hours of sleep last night so things are improving that way.


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## surge (Aug 15, 2012)

Hi, Karin-- I just turned in a holter monitor after wearing it for 24 hours, so I identify with you about the crazy heart feeling. This all started for me when I felt like my heart was racing, but like markwillpay mentions, if I took it, the rate wasn't outrageous (for me, though, it WAS elevated-- 70 or 80 instead of 63-65 like my heart rate used to be). Sometimes, though my heartrate does go up-- to over 120 while I'm just standing around. I also have the diarrhea and sudden weight drop and tons and tons and tons of hair loss.

In early August, I was diagnosed with hashis and have high antibodies, though my numbers (except TSH) look okay. I take a low dose of levoxyl, b/c my endo thought I was just reacting to a filler or something in the generic (before she knew about the antibodies). I wish. It's hard, I totally empathize, I don't know if it is actually anxiety, but I do know I take ambien to help me sleep at night because of heart-banging feeling and that's the one thing that's make life doable. I don't feel great, but at least I get some rest...

I'm curious about you and if you have a high antibody count happening.

I'm currently trying to figure out what's going on with me, but my primary thinks it's a volatile thyroiditis. She's all for me getting my thyroid out. I've been exploring other possible options. One that keeps surfacing is to try higher doses of T4 (though that makes me so nauseous to even think about) to try and communicate to the thyroid that it can relax a little. Bleech. Good luck Karin.


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## bigfoot (May 13, 2011)

It could just be your body still adjusting to things. When I was initially diagnosed with hypothyroidism, I was put on 50 mcg of levothyroxine. Those first few months were a total mess. The following year antibodies were checked and Hashi's was discovered; my dose was raised up a couple of times. Somewhere in there bad anxiety showed up and just going to the grocery store or walking the aisles resulted in near-panic attacks.

These things are all inter-connected. Anxiety doesn't just happen in a vacuum. There is a reason it surfaces. My guess is that even though your doctors are testing the antibodies (which is awesome), they may be overlooking lots of other things. For example: Vitamin D-25 levels, Vitamin B-12, testosterone and/or estrogen, iron levels, gluten sensitivity or Celiac disease, liver issues, cortisol and adrenal issues, any low-lying infections, viruses, or bacteria, chronic Candida (yeast), nodules in the thyroid, stress, electrolyte levels, diet & nutrition, etc.

It's just too easy to throw some random prescription at you and tell you it's in your head. While some of those prescriptions might help in the short-term, they need to focus on and address long-term solutions, otherwise the underlying problem(s) will never be fixed. The key is finding a doctor that understands that.

As I read somewhere, if the "check engine" light comes in your car, you don't just pull over and clip the wire, then keep driving. You take it in to get checked out and fixed. Perfect analogy.


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## KarinStanley (Aug 26, 2012)

Another night of little sleep. My throat feels very tight still and somewhat painful. I am going back to work today. The job is new and stressful. I feel like it is harder to concentrate on getting better because I am worried about the job. The anxiety and insomnia not helping. Is it wrong to want to stop working so can focus on feeling better?


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## SFLHashi (Mar 5, 2012)

KarinStanley said:


> Another night of little sleep. My throat feels very tight still and somewhat painful. I am going back to work today. The job is new and stressful. I feel like it is harder to concentrate on getting better because I am worried about the job. The anxiety and insomnia not helping. Is it wrong to want to stop working so can focus on feeling better?


Better to get better than do poorly at work and have a medical condition that many can not understand. I lost a job I should still be doing had I taken the steps with HR and focused on getting better. And explaining to my boss my plan and why I was the way I I was at the time.

Think and consult about taking a 3mg dose of melatonin. You can by at cvs for 3 bucks for 100 when in sale. Take 45 min before you want to be sleeping.

Post your labs on ce you have them back. The free T's are the most important.

Good luck. I have posted my 5 year experience in another post. Keep focusing on your health first and the rest will fall into place.


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## KarinStanley (Aug 26, 2012)

Well I made it through a day of work. The job went well but I am very tired from no sleep and my throat hurts alot and I am hoarse. I was able to get in to an endocrinologist on Tuesday. Is there any way to treat a nodule that is causing problems or is treatment surgery?


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## Octavia (Aug 1, 2011)

If it's solid, I believe surgery may be the only option. Then again, I suppose some have had success getting their nodules to shrink a little by calming down the gland. If it's liquid-filled, it can be drained...but sometimes it fills right back up again (and sometimes it doesn't).


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## Brucergoldberg (May 23, 2011)

OK gang...... I am going to chime in at this point.....

Karin - the anxiety is more than likely being caused by you being low thyroid. Its one of the main symptoms. You need to post your labs on here. freet3, freet4 and tsh are the most important. ALso did he run your labs for TPO, TGAB and TSA (hashimotos and graves)>?

If you have a nodule, it needs to be studied. If its hot or has cancer cells in it, it needs to come out.

Your pain in the thyroid area may be from pain from the thryoid itself, not from the nodule. You may have what is called "acute thyroiditis". This is what i had. Did your symptoms come on rapidly? Is the pain so bad you cannot swallow?

Also you need to give yourself 9-10 days when trying a new medicine or upping a dose for your body to get used to . SOmeone here mentioned tirosint. I am going to say tht if you cannot take synthroid, i doubt you will be able to take tirosint. Tirosint is much faster acting, much stronger, more direct. Most people that have absorption issues do well on tirosint, as it hits the system very fast - it is a liquid gel cap.

Also, endocrinologists are great for diagnosing your problems, but if you need to be treated, you need to partner up with a good doctor in your area that will test more than just your TSH as SLF mentioned above. ONe way to find a good doctor in your area is to call your pharmacy and ask "who in my area is prescribing armour thyroid". Or call a compounding pharmacy in your area and ask the pharmacist who he / she recommends. Im not saying that they will put you on armour or a compound, but in my own travels i have found that any doctor that does armour and compounds are usually pretty good at treating thyroids and they do a much better job at managing thyroids then an endocrinologist.

Endos- good at diagnosing and if you have cancer or the nodule needs to come out, they will help you.

DO, or thyroid doc - good at treating you, to get your numbers where they need to be and to help you feel better IF all you need is some good thyroid medication.

Bruce


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## surge (Aug 15, 2012)

Not to hijack Karin's post, but Bruce, could you speak to what not tolerating Synthroid manifest as?


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## KarinStanley (Aug 26, 2012)

Thank you for your reply. My labs should be back Monday. I had them last week and they were still pending. yes the antibody tests were done but I think the doctor did not order the free 3 and 4. The anxiety, insomnia and throat pain all came suddenly. The heart racing feeling has died down from last week but remains. Yes it is a pain in my thyroid area and it feels really tight and I feel discomfort when I swallow. Also at times I feel like food is getting stuck in my throat. I have also started getting hoarse when I use my voice alot during the day. I know I have a nodule from last weeks ultrasound but not seeing endo till Tuesday. Will have more of an idea then


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## Brucergoldberg (May 23, 2011)

sensitivity to light and sound, irritable, cranky, tired, anxious, fatigue, weird headaches, cant sleep etc


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## KarinStanley (Aug 26, 2012)

How can you tell the difference between acute thyroiditis and pain from nodule and/ or inflammation. I dont have a fever which I see is a symptom of acute thyroiditis. I did however go to the doctor for a throat infection two days before all the symptoms took off. I felt like I had strep but the rapid test was negative. It was not sent out for the culture to tell for sure.


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## KarinStanley (Aug 26, 2012)

Got my lab results. TSH 2.17
T4 total 1.8 range 8.9 range 4.5 to12.0
T4 free 1.8 range .8 to 1.8
T3 total 79 range 76-181

Thyroglobulin antibodies 53 range less than 20
Thyroid per oxidase antibodies 424 range less than 35

TSI 89

Ultrasound nodule.

Went to a new endocrinologist today. I still feel all the previously stated symptoms. Dr said none of the symptoms are due to thyroid. She switched levothyroxine to synthroid and ordered a CT scan of neck due to enlarged thyroid and swallowing issues. Otherwise no direction was given. The nodule will be rechecked in 6 months.


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## SFLHashi (Mar 5, 2012)

You have both hashi antibodies and you t4 is high and t3 is in the basement. You need a free t3 labs done.

http://endocrine.niddk.nih.gov/pubs/thyroidtests/thyroidtests_508.pdf

Classic. See bottom page 5.

I suspect the t3 needs to be reviewed and treated IMHO


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## KarinStanley (Aug 26, 2012)

Should I try and find another doctor and pay out of pocket? I have gone to both doctors that are available to me with my HMO plan. What does it mean to treat IMHO? Thank you for your help. I feel bad tonight like all the symptoms I have will never go away or when the doctor said it was not my thyroid I felt hopeless like it is all in "my head."


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## Octavia (Aug 1, 2011)

IMHO means In My Humble Opinion.

Hang on... I'm going to try to find another thread to link to, with some great advice...


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## Octavia (Aug 1, 2011)

Okay, found it. One of our members posted a great conversation he wished he'd had with his doctor years ago. You may find this helpful:

http://www.thyroidboards.com/showthread.php?t=6563


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