# Panic attacks related to thyroid disease or thyroid hormone replacement?



## I DClaire (Jul 31, 2011)

On Monday, July 16, my endocrinologist told me my test results with Armour were good then she gave me her blessing to experiment with another 15 mg.

T4Free - 1.0 (range 0.8-1.5)

T3Free - 3.0 (range 2.0-3.6)

TSH - 0.012 (range 0.37-4.55) Dr. said TSH is unreliable for Armour patients

The FOLLOWING morning I was taken to the ER with what appeared to be heart symptoms but later believed to be a fullblown anxiety attack after numerous heart tests. I was kept overnight - the following morning the same thing happened again. Later that afternoon I was sent home with a prescription for Xanax.

For a week or two I seemed to feel O.K. - even returned to exercizing, socializing, etc.

Then, on Thursday morning, August 16, I awoke excruciatingly nauseated, sweating, weak, felt like I couldn't breathe, palpitations, etc. My husband insisted we go back to the ER and I was moving in that direction when I decided to take a Xanax...and the symptoms stopped.

I had to wait an agonizing four mornings before seeing my doctor. He scheduled a gallbladder ultrasound for this coming Tuesday. EVERY MORNING IS THE SAME - NAUSEA, then I take Xanax and I'm O.K. Even I believe this is all about anxiety/panic attacks.

O.K., all that being said, today I'm reading about two issues: (1.) Anxiety attacks related to thyroid problems and (2.) anxiety attacks related to Armour. Some articles say the correlation is higher between anxiety/panic attacks and hyperthyroidism - some say they go hand in hand with both hyperthyroidism and hypothyroidism.

I'm not scheduled for new labs for a month.

Some reports suggest Armour itself (the new formula) may contribute to anxiety/panic attacks - others suggest Armour is prescribed to help with anxiety/panic attacks. Some say Naturethroid (?) stopped their thyroid panic attacks.

Has anyone experienced anxiety/panic attacks they have reason to believe are related to either hypothyroidism or hyperthyroidism OR their thyroid hormone replacement? I am feeling worse every day and, as usual, feel like I've got to take the initiative to at least have some better idea about what's going on than having an U/S next week and seeing the doctor a month from now.

When I am sick (nausea-no vomiting), I am paralyzed with nausea...Xanax works but I can't get it out of my mind that something else has triggered the sudden onset of such debilitating symptoms.

I never added the additional 15 mg Armour to my morning dose - simply because I didn't want to throw in another variable. EVERY test result I have had has come back normal, including new ones last Tuesday.

Any ideas or experiences would mean a lot.


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## Lovlkn (Dec 20, 2009)

Can you add a 7.5mg dose rather than the full 15mg?


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## I DClaire (Jul 31, 2011)

Lovlkn said:


> Can you add a 7.5mg dose rather than the full 15mg?


I don't know! The 15 mg tablet is so tiny I have trouble handling it.

I decided to try another one of my test cases today. I dropped back from 120 mg to 105 mg. I figured I'd rather err on the side of less Armour and, while I cannot believe the result would happen this quickly, I enjoyed a good lunch today for the first time in over a week.

The real test seems to come every morning and there may or may not be any change tomorrow but we'll see.

I just have to believe if this was my gallbladder, it would hurt constantly or fairly constantly. I'm pretty much only nauseated every morning. By 10:00 A.M., I fix myself a cup of coffee and a piece of toast and nausea passes...with the help of Xanax.

I don't see how anything seriously wrong can be happening with the perfect lab tests I got this week...everything was normal. Everything was normal will the extensive lab tests my endocrinologist ordered a month ago except my Vitamin D and B-12.


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## nikkij0814 (Jul 13, 2011)

I DClaire said:


> On Monday, July 16, my endocrinologist told me my test results with Armour were good then she gave me her blessing to experiment with another 15 mg.
> 
> T4Free - 1.0 (range 0.8-1.5)
> 
> ...


I was overmedicated to the point of being hyperthyroid for years... I slowly lost more and more weight, slowly had symptoms of not being able to sleep, lighter periods, etc... then the bottom fell out and I spiraled into a nightmare of anxiety. My TSH was .002. It was awful. I now am on the opposite end of the spectrum, with my TSH being too high and I'm exhausted and lethargic.

I've been bouncing back and forth for about a year and a half - my moods, whether it be more depressed-feeling or more anxious is directly related to my being hyper (anxious) or hypothyroid (depressed) at any given point in time. I may have some underlying issues with depression or anxiety - I'm not really sure because I haven't been able to stabilize my thyroid levels yet. They keep changing and it's been really hard. But, it did start with being overmedicated, and yes it can cause anxiety. I was overmedicated on Synthroid.

Anyway, point being, most endocrinologists will probably tell you that it's both a thyroid medication/function issue plus a mood disorder. Mine has told me that a thyroid problem will exacerbate a mood disorder, or cause the symptoms of one - but he claims it wouldn't cause something as extreme as what I've experienced. Once my hormones are ironed out I'll have a better sense of what, if any, depression/anxiety is left.


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## webster2 (May 19, 2011)

IDC, I am on Nature-throid and have had no problems at all with it. TG. I don't know how closely their formulas are or where they differ. My guess is that it is the fillers. You are still with in the "honeymoon" phase for life without a thyroid. I am not sure how long it really takes the body to adjust.

The feelings of nausea etc. are happening to you every morning? I wonder if that is the T3 kicking in? I have thought that I never felt that but lately between 8-9 in the morning I feel kind of warm. Do you take the Armour at night?

Best to you


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## I DClaire (Jul 31, 2011)

Guys, you do not know how much I appreciate your input and encouragement. I take my Armour around 6:00 A.M., as a rule. Recently, because I've been so nauseated early in the morning, I may take it a little later but not much. Yesterday morning I cut back from 120 mg to 105 mg (90mg + a 15 mg tablet) and I woke up at 4:00 this morning not nauseated but definitely not well. Every morning I seem to wake from a very deep sleep then I start feeling ill. This morning it was more a mental thing - I could not settle down and go back to sleep until around 6:00 A.M., then I slept until 8:30. I woke up the second time not nauseated but with a feeling that my stomach is sore and a little bit swollen. I fixed my coffee and toast but had no appetite and didn't eat. I tried to read the paper but can't concentrate. I feel so strange - I can't even think of a word to describe how I feel...but I did not take Xanax.

The doctor last Monday told me to take 2 Prilosec so I've been doing that, I took another 105 mg Armour and later I'll take my Toprol XL and Vitamin D. That's all I intend to take until I figure out what's going on.

I really don't know what's getting to me worse right now, whether it's the nausea/stomach pain OR this overwhelming lethargic fatigue. I don't ordinarily sleep well at night - the past few weeks I've been asleep when my head hits the pillow at night. Then, I fall asleep watching TV, taking a bath, or trying to read. I cannot stay awake! I have not driven my car in over a week. My husband is taking care of everything around the house.

I'm curious if anyone else has ever been told that TSH doesn't mean anything for a patient on Armour? I'd had blood tests on 2/22/12, 3/21/12, 4/4/12, 4/27/23, and 5/31/12 before my doctor ever mentioned that after my tests on 7/6/12. If TSH isn't reliable for a patient on Armour then why test it?

Nikki, I have to say it sounds like you and I are on the same plane! I felt fine when I initially started taking 125 mcg Synthroid in September, 2011, but most definitely was spiraling into major panic/anxiety when taken off it the end of December, 2011, and switched to 60 mg Armour. I've been on a physical/mental/emotional roller-coaster ever since.

Anybody who does not have a pre-existing problem with depression and/or anxiety is going to probably develop one after months and months of dealing with debilitating symptoms.


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## CA-Lynn (Apr 29, 2010)

I DCLAIRE, I am sorry for your troubles, but the final statement in your last post is way off tangent. You wrote:

"Anybody who does not have a pre-existing problem with depression and/or anxiety is going to probably develop one after months and months of dealing with debilitating symptoms."

This is not likely at all. First of all, what's debilitating to one is not debilitating to another. Sure, there maybe some lethargy with thyroid disease, but there is an extraordinary number of people who have thyroid disease and are feeling EXCELLENT......and do not post here on these boards/forums. You cannot assume that the people who post here are the sum total of what thyroid disease is all about. Nor can you assume that the symptoms are debilitating. Talk to a cancer patient who's had amputation....now THAT'S debilitating. And yet many do very well afterwards.

That said, anyone with a psychological issue should get it taken care of. Don't assume that thyroid medication will be the answer.


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## bigfoot (May 13, 2011)

I DClaire said:


> I don't see how anything seriously wrong can be happening with the perfect lab tests I got this week...everything was normal. Everything was normal will the extensive lab tests my endocrinologist ordered a month ago except my Vitamin D and B-12.


Did the endo happen to test your adrenals by any chance? Mine tested my total cortisol level around 8:00 a.m. and it was "normal", yet a 24-hour saliva adrenal test run by my ND clearly shows a wacky profile: low cortisol in the AM, elevated later in the day, and too high at night. I also get nausea some days in the AM, and seemingly more anxiety or nervousness in the morning -- versus the afternoon and later when it pretty much vanishes and my energy level picks up. Less brain fog in the afternoon and evening, too.

One catch to testing adrenals is that even the lead-up time to visiting the lab, if you aren't fond of needles (who is?), can spike your cortisol, giving an artificially elevated reading for that single point in time. So you are looking at a snapshot in time of how your adrenals are working, versus an overall view of them with the 24-hour testing.


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## nikkij0814 (Jul 13, 2011)

I DClaire said:


> Nikki, I have to say it sounds like you and I are on the same plane! I felt fine when I initially started taking 125 mcg Synthroid in September, 2011, but most definitely was spiraling into major panic/anxiety when taken off it the end of December, 2011, and switched to 60 mg Armour. I've been on a physical/mental/emotional roller-coaster ever since.
> 
> Anybody who does not have a pre-existing problem with depression and/or anxiety is going to probably develop one after months and months of dealing with debilitating symptoms.


What did your bloodwork say when you were on 125 mcg Synthroid? Were your tests in range? In dealing with all of this, I've learned a great deal about depression - it's common to wake up early in the morning, about 2 hours prior to your normal time, feeling unwell.

I've been to a psychologist, and he was very helpful. After a while seeing the psychologist, he felt like what I was dealing with was chemical - whether the thyroid, chemical depression/anxiety in my brain, and/or a combination of both. It's worth considering that you may have an issue with this, even if it is worsened, caused, or contributed to by the thyroid problems.

I'm on anti-depressants now, and plan to stay on them until I've felt stable for 6 months, and my thyroid labs have come back stable and in range for 6 months. Both need to happen first. I made the mistake of 1. resisting them to begin with, 2. coming off of them when I felt better, and 3. coming off of them when my thyroid meds were regulated for a short while, then when I went hyper again I wound up having trouble and having to go back on the anti-depressants, wait for them to titrate up, etc. I should have just stayed on them!

That's just my experience though - I'm worn down, and need to live my life. It's still hard as I'm now hypo, but I think I have a little depression and a thyroid problem that for some reason isn't getting regulated very quickly.

Sorry to hear what you're going through - do stay in touch on the boards. :hugs:


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## lainey (Aug 26, 2010)

Before we had reliable thyroid tests and purified forms of T4, people took desicated pig thyroid until they felt better. rThe ultra sensitive TSH test has only been around for 20 years or so, and synthetic medications a little while longer than that. Patients read about Armour and the like on the internet and treat it like it is some new thing. Why would there be synthetic drugs in the first place? Perhaps because in practice they were better tolerated by large groups of people, easier to dose and control? Cortisol testing in order to take compounded thyroid? If this were really necessary, why isn't it done on a large scale basis to all thyroid patients? Is there a reason why T4 medication is the standard of care in most countries? Perhaps because they produce more reliable results?

Maybe it is that Armour isn't right for you. I have read about plenty of people who can't handle T3 for one reason or another, so it certainly isn't impossible. You haven't reported feeling well while on it for any extended period.

Once again, I have seen plenty of people go through forums with "ideal" numbers and residual symptoms because the bottom line is that thyroid replacement is not a cure all, there are plenty of "symptoms" that can be idiopathic and exist independently.

We can circle the idea until the end of time that if you solve the thyroid problem, the psychological problem may go away.

If the Xanax works, who cares why, and at this point why not take it? Your docs spent thousands on cardiac tests to prove to you that you didn't have a problem there. If you didn't have good insurance, would your doctor suggest hundreds more dollars of scans of gall bladder and the like, or just tell you to take it?

Parsing your labs is going nowhere. Maybe the real problem is the anxiety, and not related to thyroid. What would happen if you took the Xanax on a regular basis?

Don't mind me, I'm here to play the devils' advocate. I'm not much for "tweaking". If you have good numbers, move on to something else. Taking anti anxiety medication is no crime if it makes you feel better. That's what it's all about.


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## bluebutterfly26 (Jan 19, 2011)

i don't know about the armour, but i have graves disease, very over active thyroid. and i have horrible panic attacks and anxiety lately. its so horrible. every time i have an attack i feel like i'm dying. having hyper thyroidism, can for sure cause an increase in anxiety and panic attacks. talk to your doctor.


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## I DClaire (Jul 31, 2011)

Hi guys! I couldn't wait to get home tonight to share a couple of tidbits of good news! After only three days dropping back from 120 mg to 105 mg Armour, I have felt extremely well today. I feel like a vague tension in my body has relaxed and my mood is noticeably lighter. I thought that information might mean something to someone else who was having similar problems with anxiety and wondering about their thyroid hormone supplement.

But, I have decided to thank all those who have been so wonderfully supportive and encouraging, those who have so graciously taken the time to share their personal experiences, and say goodbye. I'll leave the site to the extraordinary number of thyroid patients who are feeling EXCELLENT! I was being somewhat facetious about months and months of frustration with thyroid symptoms making anyone depressed or anxious. Heaven forbid!

This has been a long and frustrating journey for me and nobody will ever know how much I've appreciated the friendship, encouragement and support - not to mention all the times members have graciously shared their personal experiences. When I joined this site, I did not know anything about thyroid disease - y'all have seen me through surgery, you've taught me a lot about reading test results and different options as far as treatments, etc.

But, I've overstayed my welcome - it's time to go.


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## peaches (Sep 29, 2009)

I have panic attacks when my TSH is elevated so I think it can happen when you or hyper or hypo. Getting your meds balanced is what I think is key and it sounds like you are working on that. I hope things stay on the upswing for you. Good luck


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