# Agoraphobic??



## Jo853 (Aug 16, 2013)

Hi all

I'm starting to think I have psychological problems and that they are not thyroid-related at all but I would just like some reassurance that they are thyroid-related.

I was first shown to have a subclinically underactive thyroid back in November 2011 but because it was subclinical I was not prescribed any medication. Around about this time I started to hate getting on public transport and that I would get annoyed if someone jumped the queue if I were before them. It sounds pretty minor really and I feel daft writing this...

During January/February 2012 I developed a goiter - I didn't know what had caused it at the time and so I did not seek help. To the best of my knowledge I considered it to be a throat infection. Some throat infections cause throats to swell up and so it made sense. I had a hoarse voice too and it hurt to swallow. To counteract the visible deformity of my neck I wrapped scarves around it to cover it up. If I did not, strangers in the street would stare at me and give me worried looks and I knew why.

Now my problems are much, much worse and I don't know if it's the progression of the illness or if I am not medicated enough, but I get very panicky and jumpy around strangers. I come over tense, agitated, snappy and the muscles in my face begin to spasm. I feel like I'm the only one in the world with this as it only ever happens when I am on a plane, a bus, a train, a boat, in a small compact shop or a crowded public place like a shopping mall.

I even hate walking on the same side of the road as a stranger coming the other way because of having to make room for them to get by/possibly interact with them. I have had bad experiences in the past where men have stopped me in the street asking me out and I am wondering if this is stemming from that.

What has made me come on here today and post, is that I got very uptight in our local shop and I got quite tense, agitated and twitchy when lots of people were in the same aisle as us. It didn't help that my partner was taking his time in deciding what to get for dinner and because of the increasing crowd of people I came out with some rather snippy replies to him which I later felt bad about.

My grandfather has also made a few comments about me. He recently said things like:

"I think you should be sent to a mental home" - said in 2009 during an argument between me and my grandmother, which he has since apologised for saying but it still sticks out in my mind even now.

"Have you heard back about any of the jobs you applied for?" - said this week since I have been signed off sick with the hypothyroidism and was getting too bored to stay at home all day.

"Have you seen the nutritionist for your follow-up?" - said this week also, to which I replied, "I feel as though I need to give everything more time to work and I have not stuck to everything on the elimination diet as I felt too much too soon wouldn't work."

Am I going crazy? I feel as though I am and it's not helping when I have my grandparents asking me questions about me as I feel as though I'm being interrogated. They must care about me as I'm the only grandchild they see and talk to but it's frustrating and it depresses me at times. :sad0049:

Jo xxx


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## Octavia (Aug 1, 2011)

Interesting. It sounds more like anxiety than agoraphobia to me, and we have MANY members here who deal with anxiety along with their thyroid problems...then when they get their thyroid issues under control, the anxiety often subsides. It wouldn't hurt to see a psychiatrist. Or at the very least, get some counseling to talk these things through. But I suspect a more physical connection versus purely a mental health issue.


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## Octavia (Aug 1, 2011)

Jo, take a look at this thread:

http://thyroidboards.com/forums/topic/10370-hypothyroidism-does-anyone-else-have-high-anxiety/

It's a little different from what you're describing, but it may help to see that others are struggling with similar issues.


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## Jo853 (Aug 16, 2013)

Hi thanks for your reply.

I see a counsellor at present for depression and anxiety but because he has been made aware of me being hypothyroid/hashi's he is finding it hard to differentiate between what is being caused by the hypo or if there's a mental element involved.

I don't understand what is going on since I am on 100mcg Levothyroxine - which I have been on since February this year - the anxiety/depression is still bad and my levels are normal!

Jo xxx


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## Jo853 (Aug 16, 2013)

Hi thanks for referring me to this thread.

Most of the things this poster describes ring true but I'm wondering why I feel like this despite normal levels of everything.

Jo xxx


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## bigfoot (May 13, 2011)

Dr. Richard Hall has an excellent free article available online that you should read, titled "Anxiety and Endocrine Disease". Here is a link: http://www.drrichardhall.com/anxiety.htm

Basically, the short story is that, yes, endocrine problems (of which the thyroid is one) can most certainly cause anxiety. And like Octavia mentioned, when things are under control and stabilized for a while, it can clear up on its own. Heck, I've experienced this firsthand myself as well as many other folks here.

Your grandparents mean well, and try not to take it too personally if you can. I know that's a lot easier said than done. It might be worth it to unplug for a day or two, not get too caught up in what's going on, and spend a little time on yourself, doing something you enjoy.

Oh and "normal" levels don't really mean much. A specific number on a piece of paper isn't going to directly translate into you feeling well. Especially with hormones. It's more about optimizing for what you need individually.

hugs3


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## Jo853 (Aug 16, 2013)

Thanks for the link. 

If only the doctors and consultants could see that normal levels don't really mean much!

Jo xxx


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## anxietysoldier (Apr 2, 2014)

From what I have learned so far in my research that you want your tsh closer to a 1, the t4 toward the higher end of the scale and a t3 around the middle. So that could mean you need a small increase of medication. Sometimes the medication size on the next level up might be too much and you need to split that into half doses. Keep your chin up


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## Jo853 (Aug 16, 2013)

anxietysoldier said:


> From what I have learned so far in my research that you want your tsh closer to a 1, the t4 toward the higher end of the scale and a t3 around the middle. So that could mean you need a small increase of medication. Sometimes the medication size on the next level up might be too much and you need to split that into half doses. Keep your chin up


Hi thanks for your reply.

With the T3 and T4 ranges here in the UK that would mean my T3 would need to be 5 something (3.1-6.8) and my T4 would need to be at 20-21 (10-22), have I got that right?

My medication is currently 100mcg but even when my dose was up at 125mcg my TSH had increased from 4 to 4.6.

Here are how my medication doses have been set out since starting the T4:

*May 2013 - TSH: 22 (0.2-4.2), FT4: 10.9 (10-22)*

25mcg - 3 weeks
50mcg - 3 weeks
75mcg - 2 months onwards

*August 2013 - TSH: 4 (0.2-4.2)*

125mcg
(Doctor increased the T4 as I did not feel any better)

*November 2013 - TSH: 4.3 (0.2-4.2), FT4: 16.3 (10-22)*

150mcg
(Doctor increased the T4 based on bloods)

*December 2013 - TSH: 4.6 (0.2-4.2), FT4: 16.6 (10-22)*

(Doctor kept the T4 dose the same - why, I am not sure)

*January 2014 - TSH: 2.7 (0.2-4.2)*

(Doctor reduced my dose to 100mcg)

*February 2014 - TSH: 3.6 (0.2-4.2)*

(Doctor kept my dose the same)

*March 2014 - TSH: 1.87 (0.2-4.2), FT4: 16.6 (10-22), FT3: 4 (3.1-6.8)*

(Doctor still kept my dose the same and did not put me on T3)

Jo xxx


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## anxietysoldier (Apr 2, 2014)

Doctors have to learn to dose by symptoms not by labs, I am not an expert but you might want to get stop the thyroid madness book and high light some key parts for your doctor, it has a chapter in the book for doctors and if he won't listen maybe it's time to find a new doctor.


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## Jo853 (Aug 16, 2013)

anxietysoldier said:


> Doctors have to learn to dose by symptoms not by labs, I am not an expert but you might want to get stop the thyroid madness book and high light some key parts for your doctor, it has a chapter in the book for doctors and if he won't listen maybe it's time to find a new doctor.


Hi thanks for your reply.

Thanks for mentioning the stop the thyroid madness book.  I've looked into buying it and it's very expensive! I do have another book a friend sent me regarding hypothyroidism and it briefly mentions T3 - I can't remember exactly what it says but I may take that along to my next appointment if the points in the book are relevant to me.

Changing doctors is a good idea as long as I know the doctors will listen to me and do what I want them to. I had this problem with the first practice I was with and so I moved to the current doctor practice I am with now.

When I moved to my current doctor practice in 2013 I said at my first appointment that I wanted to wipe the slate clean and it looks as though I'll be doing that again if the doctor I plan to see on Tuesday refuses to see my point of view or listen. So much hassle...

Jo xxx


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## CA-Lynn (Apr 29, 2010)

What you describe is not agoraphobia.

I'm disturbed about your statement that said you would switch doctors as long as they do what you want them to do. While many of us know a lot about our disease, we are not MD's. While I understand about how many doctors treat by labs and not by symptoms, frankly I would be very concerned if any physician just prescribed for me as I directed him to. That would be very dangerous and any MD who does that would be a fool.

You mentioned that you are not working.....but are applying for other jobs? Sorry, I don't have time to read all your posts, but are you actively looking for work? if so, I think employment would be an excellent addition to your life. The less time you have to think about this disease, the better off you will be.

What kind of counselor is treating you?

At the end of the day, it does not matter how much of the "depression/anxiety" is primary or secondary because in the end they'll be treated the same way. It should be a psychiatrist prescribing any neurtrotropic drugs for you, no one else.

I think it would be in your best interests to just back off of the intense focus you have on this disease. Just go do something you truly love and that makes you smile. I wish you well.


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## ttr13 (Sep 15, 2013)

I agree with CA-Lynn doing something , whether it's part-time work or even some volunteering would be beneficial. It is very easy to let the disease become the centre of our universe and it is not healthy to do so. You are Jo not hypothyroidism or Hashimoto. Don't let it control you more than it has to. We all know that the symptoms of the disease can limit what you do in life but you should try not to let it rule what you do. I have Hashi and I've carried on working despite feeling like death some days but it has helped me immensely to distract myself from how I feel. Sure, I've had to have a few days off here and there and I've had to adapt but all in all I am really happy I am working and keeping busy. I will not be defeated by this horrid illness LOL

I read lots of thyroid support forums and I know that you posted on another one where you had admitted that you had stopped taking your medication in November and didn't restart it till a few weeks ago which totally makes your results between November and February redundant.Of course you haven't been feeling better...you stopped taking your medication. As you see when you restarted taking your meds the TSH was pushed down. I believe you might need a slightly higher dose to bring it down even further but as it's still early days on your meds it might just be that your body hasn't adjusted yet. Everyone is different but it can take a few weeks and some times months to find the dose that works for you. There is a chance you need T3 but then again you might not...I think you need to give it a bit longer on the levo to see if it is what your body needs.

Be patient Jo, if you are not ready for work then find a hobby that you like and concentrate on that. Keep your chin up and keep smiling


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## Jo853 (Aug 16, 2013)

ttr13 said:


> I agree with CA-Lynn doing something , whether it's part-time work or even some volunteering would be beneficial. It is very easy to let the disease become the centre of our universe and it is not healthy to do so. You are Jo not hypothyroidism or Hashimoto. Don't let it control you more than it has to. We all know that the symptoms of the disease can limit what you do in life but you should try not to let it rule what you do. I have Hashi and I've carried on working despite feeling like death some days but it has helped me immensely to distract myself from how I feel. Sure, I've had to have a few days off here and there and I've had to adapt but all in all I am really happy I am working and keeping busy. I will not be defeated by this horrid illness LOL
> 
> I read lots of thyroid support forums and I know that you posted on another one where you had admitted that you had stopped taking your medication in November and didn't restart it till a few weeks ago which totally makes your results between November and February redundant.Of course you haven't been feeling better...you stopped taking your medication. As you see when you restarted taking your meds the TSH was pushed down. I believe you might need a slightly higher dose to bring it down even further but as it's still early days on your meds it might just be that your body hasn't adjusted yet. Everyone is different but it can take a few weeks and some times months to find the dose that works for you. There is a chance you need T3 but then again you might not...I think you need to give it a bit longer on the levo to see if it is what your body needs.
> 
> Be patient Jo, if you are not ready for work then find a hobby that you like and concentrate on that. Keep your chin up and keep smiling


Hi thanks for your reply.

Yes, I did post on another forum and I admitted to stopping the medication as I didn't believe it was doing anything and then there was all this talk about adrenal issues. Even though the lab results were normal I did not feel normal.
I also had relationship problems with my grandparents as they kept on at me to find work and made me feel like a layabout. When I saw the nutritionist I've felt as though I've been pulled to one direction and then another regarding blood tests and nutritional advice.

Everything is so confusing and this nutritionist was recommending me products I cannot afford. The total price was going to amount to something like £60-£70! As a result I haven't bought them and now I feel as though I've gone against the nutritionist advice. One product was called T-Convert which helps the thyroid convert T4 to T3 but I felt I would be better placed to either buy T3 privately or ask for it through the doctor.

I haven't spoken to the woman who runs thyroid support group meetings for 2 months as she is friends with this nutritionist and I remember her saying that the nutritionist is one of those people that wants her clients to do what she tells them. So in a way I haven't and I now feel like I cannot go back for a follow-up appointment.

I don't know how much time I need for the medication to work. I thought since I'd been restarted on the medication back in February that was long enough....maybe not. 

I do have a hobby where I draw/write in my spare time but I only do this when I'm inspired. :ashamed0006:

Jo xxx


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## Octavia (Aug 1, 2011)

Jo, if you can't afford the supplements suggested by the nutritionist, it's not worth "losing sleep over." Supplements are expensive, and I'm sure she's had clients in the past (or present) who simply aren't able to do everything she suggests. Give yourself permission to re-enter the conversation with the thyroid support group, regardless of whether you've been able to follow the nutritionist's advice. It's not like you're ignoring her advice...you simply are unable to follow it right now.

I'm curious though...is the nutritionist selling these supplements herself? Is she suggesting that you buy them from a certain place? Or is she simply giving you a list of supplements to try, and you can get them wherever you want?

Time will tell whether you genuinely need any or all of the supplements (my guess is no, not all of them), but I truly think you should concentrate on the thyroid meds AND your Ferritin result for right now. Your Ferritin is painfully low and really needs to be addressed. I know others here have had the same issue...hopefully they'll share their treatment approaches. Did the nutritionist or your doctor suggest anything for the Ferritin?


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## Octavia (Aug 1, 2011)

Jo, here's a link to some information on Ferritin:

http://www.healthline.com/health/ferritin#Overview

And another:

http://labtestsonline.org/understanding/analytes/ferritin/tab/test/

I think you'll find these helpful. No matter how good your thyroid results are, without addressing your Ferritin level, you are likely to continue to feel bad.

I notice your Folate level is also low. I don't know anything about that one, so I'll refrain from commenting, but perhaps it's something you need to look into as well.


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## Andros (Aug 26, 2009)

Depression
http://www.mdlinx.com/endocrinology/newsl-article.cfm/4050030/ZZ5052128790304906121963/?news_id=811&newsdt=050412&subspec_id=419
(Copy and paste into your browser)

Psychiatric Manifestations of Hashimoto's Thyroiditis
http://www.drrichardhall.com/Articles/hashimoto.pdf
(Copy and paste into your browser)

Identifying hypothyroidism's psychiatric presentations
http://www.jfponline.com/Pages.asp?AID=4570
(Copy and paste into your browser)

bipolar/thyroid disease
http://www.psycheducation.org/thyroid/introduction.htm
(Copy and paste into your browser)

Your thyroid produces hormones and when that is out of whack, the other hormones are greatly affected and that can lead to some emotional instability. It's not your fault . I am enclosing some info for you.

Many of us here have experienced strange emotions while so sick from an unhealthy thyroid. Several of us got counseling to help us through. Many psychologists are highly skilled in helping a person through illness whether it be chronic or acute.

Hugs,


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## Jo853 (Aug 16, 2013)

Octavia said:


> Jo, if you can't afford the supplements suggested by the nutritionist, it's not worth "losing sleep over." Supplements are expensive, and I'm sure she's had clients in the past (or present) who simply aren't able to do everything she suggests. Give yourself permission to re-enter the conversation with the thyroid support group, regardless of whether you've been able to follow the nutritionist's advice. It's not like you're ignoring her advice...you simply are unable to follow it right now.
> 
> I'm curious though...is the nutritionist selling these supplements herself? Is she suggesting that you buy them from a certain place? Or is she simply giving you a list of supplements to try, and you can get them wherever you want?
> 
> Time will tell whether you genuinely need any or all of the supplements (my guess is no, not all of them), but I truly think you should concentrate on the thyroid meds AND your Ferritin result for right now. Your Ferritin is painfully low and really needs to be addressed. I know others here have had the same issue...hopefully they'll share their treatment approaches. Did the nutritionist or your doctor suggest anything for the Ferritin?


Hi Octavia thanks for your reply.

The nutritionist didn't suggest I buy the supplements from anywhere in particular. She gave me a list of supplements that she advised me to take and that was it. So I presume she wanted me to get them wherever I wanted.

I don't know if I can give myself permission to re-enter the UK thyroid support group I left as I caused a bit of a debate amongst some people and unfortunately this confused me as to what I ought to be doing. I am sure that none of the people will want to reply to me again.

The nutritionist suggested I take wholefood iron (which when I looked into it was expensive) and so I have been taking a liquid supplement of iron that contains 40% RDA iron. The doctor did put me on Ferrous Fumerate at 210mg but I didn't like it so I then moved to the liquid supplement. This has risen my iron levels but not by very much so I've been looking at other iron supplements such as Ferroglobin and Floradix (these are not easy to get hold of however wherever I go)

Jo xxx


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## Jo853 (Aug 16, 2013)

CA-Lynn said:


> What you describe is not agoraphobia.
> 
> I'm disturbed about your statement that said you would switch doctors as long as they do what you want them to do. While many of us know a lot about our disease, we are not MD's. While I understand about how many doctors treat by labs and not by symptoms, frankly I would be very concerned if any physician just prescribed for me as I directed him to. That would be very dangerous and any MD who does that would be a fool.
> 
> ...


Hi yes I am applying for jobs but because I'm spending so much time off sick, it's making me bored.

The counselor treating me is NHS-based but not one arranged with my doctor. He is one I arranged to see through the health park I attend for art classes.

Jo xxx


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## Jo853 (Aug 16, 2013)

Octavia said:


> Jo, here's a link to some information on Ferritin:
> 
> http://www.healthline.com/health/ferritin#Overview
> 
> ...


Hi thanks for the links.  Yes they are helpful.

My ferritin level was addressed in August 2013 when I took 210mg Ferrous Fumerate. I didn't like this medication and I switched to a liquid supplement that contains 40% RDA iron. Because my nutritionist advised me to take a wholefood iron supplement I then stopped the liquid one.
What I didn't realise was how expensive this wholefood iron was and I don't know how to get back into taking the liquid iron again.

Jo xxx

Jo xxx


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## Jo853 (Aug 16, 2013)

Andros said:


> Depression
> http://www.mdlinx.com/endocrinology/newsl-article.cfm/4050030/ZZ5052128790304906121963/?news_id=811&newsdt=050412&subspec_id=419
> (Copy and paste into your browser)
> 
> ...


Hi Andros thanks for your reply. Hugs back.

I'll look at this info now. 

Jo xxx


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## CA-Lynn (Apr 29, 2010)

Sorry, but I don't understand. What kind of degree does your "counselor" have? What you call a "counselor" in your country and what we in the US call a counselor may be two different things.

Thanks.


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## Jo853 (Aug 16, 2013)

CA-Lynn said:


> Sorry, but I don't understand. What kind of degree does your "counselor" have? What you call a "counselor" in your country and what we in the US call a counselor may be two different things.
> 
> Thanks.


Thanks for your reply.

I don't think I know what degree my counselor has. So far as I know he doesn't have any in his name/title. I know that the health centre I go to employ voluntary workers as my thyroid support leader works voluntarily. So I take it he is not a counselor at all.

Jo xxx


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## CA-Lynn (Apr 29, 2010)

That's what I was worried about.


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