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Anxiety & Heart Side Effects from Tirosint/Levothyroxine

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Thyroid Disorders
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dancemusic
Regular Member
Joined : Oct 2012
Posts : 21
Posted 2/4/2016 1:55 PM (GMT -6)
Hello, I'm hoping someone can help me with some side effects I've been having from Tirosint (Levothyroxine in gel cap form for anyone who doesn't know). I was diagnosed with Hashimoto's a little over a year ago but just started meds about a month ago. For anyone curious, here's my last set of labs:

12/30/15
TSH 4.323 (.4-4.0)
Free T3 2.81 (1.8-4.9)
Free T4 1.07 (.65-1.74)

I've been hesitant to begin medication because I am extremely sensitive to meds, but after having a severe chronic fatigue crash I decided to give it a go to see how many of my symptoms were related to my thyroid.

My doctor told me that Tirosint has a half life of 7 days, so I could start taking it infrequently to ease my body into it (I also only weigh 100 lbs if that's relevant to dosage and side effects). She recommended three times a week , but told me even once a week was ok to start due to the half life. I started with 13 mcg Tirosint every 5 days. Within a few days I started having severe physical anxiety symptoms. The symptoms are:

-Severe physical(not mental) anxiety, like I'm on the verge of a panic attack/extremely nervous
- feeling like my heart is beating out of my chest
- mild loss of appetite

The symptoms have been coming in attacks and then also existing on a milder level throughout the day. I have gone some days without the symptoms. I have now been on the medication for about a month . My doctor said the symptoms should not be from the Tirosint. However I am quite confident that the symptoms are from the Tirosint. I have experienced symptoms like these in the past , however they were much more infrequent and more mild. The only time I have experienced a similar feeling to this was trying to start Zoloft, Which is a very activating medication at first. I can endure the symptoms a little bit longer if I know they will eventually go away and as long as I know they are not serious, however considering my doctor does not believe they're related to the medication is concerning to me .

I also want to be clear that I know anxiety can be a side effect of hypothyroidism, and I do already have an anxiety disorder, but the physical symptoms are different or at least much more intense than when I normally experience.

Has anyone that has taken Tirosint, Synthroid or any other variation of Levothyroxine experienced similar side effects when beginning the medication? Were you eventually able to tolerate the medication without side effects? I'm barely even taking it at this point and I can't imagine upping my dose to get to a more normal dose. It seems crazy to me that I could swing to hyper after taking so little so I assume they are just side effects, but I'm just trying to figure out what might be going on . Thank you so much for your help! Sorry for the long post .
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jujub
Elite Member
Joined : Mar 2003
Posts : 10422
Posted 2/4/2016 2:33 PM (GMT -6)
The symptoms you're having are not side effects, but more properly symptoms that your dosage is likely too high. With the labs you presented, I'm surprised that a doctor would put put you on levothyroxine. It looks as it your doctor is treating you based on a TSH which is a tiny bit high, without regard for your free T4, which is in the optimal range. Were you on meds when that test was done?

You might want to consider getting a second opinion. Hyperthyroidism, whether natural or medication-induced, wears your body out more quickly than normal.
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dancemusic
Regular Member
Joined : Oct 2012
Posts : 21
Posted 2/4/2016 4:46 PM (GMT -6)
Thank you for your response! No I was not yet on medication when I had those labs done. My dr is treating based on the fact that I have Hashimotos and that my tsh is a bit out of range, but also by symptoms. I have been experiencing severely debilitating chronic fatigue as well as typical/possible hypo symptoms like constipation, dry mouth and eyes, irregular but bad periods/ pms, depression alternating with anxiety, nausea, chronic migraines, etc. She thought it was possible my symptoms could be correlated with my thyroid. I should say i'm seeing a regular endo, not an alternative dr or anything ( I know they can be notorious for overmedicating). I'm literally only taking one pill a week so I could not be taking a lower dose. I know that the thyroid stops producing its own hormone when you take replacement for long enough but I'm assuming I should be fine if I have to stop now considering it's only been a month? Thank you for your help.
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hypoHashimoto
Veteran Member
Joined : Jul 2012
Posts : 786
Posted 2/4/2016 11:57 PM (GMT -6)
Hello dancemusic ,

With this TSH you indeed look like being hypo, not severely though, the dose of levo your endo gave you is sufficient starting dose with this tsh.

With hashi one can develop either hypo or hyperthyroidism, anyway, it seems that right now you are hypo , the dose should not be calculated every five days but every week instead.

You should take your medication at the same time, day and dose each week on an empty stomach with a full glass of water and not to drink or eat any thing except water for at least an hour , and you could still be hypo/hyper with normal free t3/4 .

If I were you , I would continue with the current dose of levo and to repeat TSH, FT3 and FT4 six weeks after starting the 13 mcg/week dose of levo.

Another important point is that each one of us has to find the brand that works for him .

Best ,
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dancemusic
Regular Member
Joined : Oct 2012
Posts : 21
Posted 2/5/2016 10:42 AM (GMT -6)
Thanks hypohashimoto, yeah there seems to be an array of opinions even among doctors as to what levels indicate a need for treatment. My doctor does treat people that are "subclinical" if their symptoms indicate it . I have actually switched my dosing to once a week. However, I am taking it with food as to absorb as little as possible. I know this is not normal when tou're looking to treat but I seem to be responding terribly even to this little amount. What do you make of the symptoms the drug is giving me? ( feeling like i've been shot up with adrenaline basically). Will they fade with time because I definitely can't stay on this course much longer if I'm going to keep feeling this way. Thanks again!
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hypoHashimoto
Veteran Member
Joined : Jul 2012
Posts : 786
Posted 2/5/2016 9:21 PM (GMT -6)
Hi,

Just a thought, have you checked your adrenals ? if you have adrenal fatigue then you will not be able to tolerate thyroid medications, check morning cortisol to determine whether you have adrenal fatigue .

It is not recommended to take levo with food since your dose will never be the same .

Best ,
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dancemusic
Regular Member
Joined : Oct 2012
Posts : 21
Posted 2/8/2016 2:12 PM (GMT -6)
Thanks HypoHashimoto. I have heard a lot of people mention adrenals in terms of them being the cause of not tolerating thyroid meds. What's not always clear to me though is if people are referring to true adrenal insufficiency (which an Endo would diagnose) or adrenal fatigue which is more of an alternative diagnosis and not usually validated by Endos. I have had my morning cortisol checked a few times and it was always normal. My most recent morning cortisol was 17.7, and I believe the last time it was checked was about it was about 18. The labs don't give a range for this reading other than to say it's normal. I have also been thoroughly checked for adrenal insufficiency. However in terms of "adrenal fatigue", I'm not sure how alternative practitioners diagnose this but I have not been evaluated. Thanks for your help!
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dany1982
Regular Member
Joined : Jan 2012
Posts : 182
Posted 12/26/2018 3:52 PM (GMT -6)
How are u doing now?
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