Guest Author - Jim Lowrance
Hypothyroidism related anxiety, is a subject I’ve addressed in other articles and the number of e-mails I get from patients who suffer anxiety from their hypothyroidism, especially the newer diagnosed patients with “Hashimoto’s thyroiditis” as the cause, is the highest percentage of any I receive. Anxiety with hypothyroidism, is also a very common subject on thyroid disease forums.
Below, is an e-mail response I made to a women who wrote me sometime ago on this subject that is similar to my responses to many other hypothyroid patients who suffer anxiety as a symptom.
“I would almost bet your hypothyroidism is caused by "Hashimoto's thyroiditis" because it is the autoimmune type and by far the most common cause. It is confirmed by positive blood tests of "thyroid antibodies". These are the "TPO and TG" antibodies and these are what attack a person’s thyroid and kill off its cells over time. The immune system mistakenly recognizes your thyroid as an invader, like it does with viruses, allergens and bacteria.
With Hashimoto's, you can go through a period of "Hashitoxicosis" (actual medical term), especially early into the onset of hypothyroidism that it causes because the thyroid will waiver back and forth between producing low hormone and having surges of increased hormone, as it tries to avoid hypothyroidism and spurts back to life. This is a real condition and I've seen the testimonies of literally 100s of patients that experience panic attacks from it and I am one of them who also experienced it when I was newly diagnosed. Some medical sources state that Hashitoxicosis is rare, while I believe it is very common in milder forms.
Strangely Doctors sometimes do not seem to know about this condition that goes with autoimmune hypothyroidism and I cannot explain why. They will actually tell patients their anxiety is not caused by the diagnosed thyroid disease but is a separate issue and many times will prescribe additional medications for it, before giving thyroid hormone medication a chance to work.
There is a Dr. Richard Hall MD, also a professor of psychiatry, who has been involved in research studies at major medical universities, such as John Hopkins University and in his studies on the relationship of anxiety to endocrine disorders, it was found that in patients with “Hashimoto’s thyroiditis”, anxiety was a common symptom at the time patients were diagnosed.
There are also studies that have been published on the “PubMed” website, which is provided by the National Institutes of Health and the National Library of Medicine, that state that anxiety symptoms and anxiety disorders are associated with Hashimoto’s disease, which is also the most common cause of hypothyroidism in our nation.
It is important that your diagnosed thyroid disease be treated optimally because some Doctors believe just getting your TSH and thyroid hormone levels anywhere into the normal range is adequate treatment with thyroid hormone replacement medication, when the truth is, your better Endocrinologists and Thyroid Specialists have more targeted therapeutic treatment goals. They will for example have a TSH treatment goal of getting it to the "1.0" target range and according to symptoms, they might even go down to the lower normal with TSH of from 0.3 to 0.5, to see if a patient has better resolution of symptoms.
These are just some points I thought I would share with you because over time, adequate treatment will help a great deal in resolving anxiety and other symptoms because thyroid medication serves to take over and supply your thyroid hormone, while causing your own thyroid to be suppressed (TSH suppression). You then have more level thyroid hormones in your body, rather than the erratic changes in levels, a dying thyroid produces.
Please go to my website and read from my two articles pages, looking for titles such as "Diagnostic TSH And Treatment TSH, Are Not The Same". Also read my articles on anxiety that will also give you some good pointers. Learning not to fear anxiety symptoms is an aspect of Cognitive Behavioral Therapy (CBT) and I have information in my articles on this method.
In the mean time, help with medication for anxiety, is nothing to be ashamed of or afraid of, if you need it while your thyroid treatment is being optimized, which can actually take several months. Some medical sources imply that thyroid hormone replacement therapy for thyroid, takes only 4 to 6 weeks to do its job but this simply is not true with a large percent of patients, who may need several dosage adjustments over several months, before they reach their optimal treatment level.
If the antidepressant you're taking, is not working as it should (they are also prescribed for anxiety) or it is causing unwanted side effects, you might discuss with your Doctor, slowly weaning off of it and also discussing an "as-needed" anti-anxiety medication, you can take short-term, rather than the type that must be built-up in your system and maintained. Some patients do fine with the antidepressant types, while others do not. Some Doctors seem to believe SSRI and other types antidepressants work well for everyone but this simply is not true. I have corresponded with dozens of thyroid patients, who simply could not adjust well to them even after several months of trying to benefit, while many others do very well on them. People are individuals and nothing works exactly the same for everyone and is a common sense approach that even Doctors should take with these.