Thyroid and Generalized Anxiety Disorder

[chipdouglas]

I keep hearing that a TSH above 2.0 is suspicious of hypothyroid (Hashimoto's) and mine is consistently 2.0 and slightly above at times.

Now I've been having severe anxiety and panic attacks (though less frequently now) ever since I tried Deprenyl 2 years ago. Well on DPR I felt fine, but the day after I went off cold turkey (after being on it for 3 weeks) I ate a square of dark chocolate and there's where in time my anxiety became crazy and wound up in the ER a number of times with panic attacks.

Now I can post my last digits on thyroid panel so you can better see where it's at, but for now, does anyone know whether a TSH of 2.0 is sufficient to cause full blown panic attacks and severe chronic anxiety ?

In fact I was diagnosed with ADHD and GAD as some here already know. I'm trying to find out medical texts that can back up whether hypothyoid might be at the root of the above or not. I'd then print out those medical references and bring it to my pcp as evidence.

What knowledge I have about thyroid has me thinking that 2.0 on a TSH isn't enough of a suspicious test result to account for the severe anxiety, but I prefer to run it by you guys first.

IIRC It would have more to do with E2 or Adrenals.

The reason I'm investigating this is I had TSH done on a number of occasions, but only FT4 was done whereas I'd made it clear I also wanted FT3 to be peroformed too. Lab then told me they don't do FT3 whenever FT4 is fine, so I'll have to have FT3 done over.


TSH 2.27 (euthyr. : 0.27-5.0) mUI/L
( hypothyr. : > 5.00)
(hyperthyr. : <0.01)




FT4 20.3 ( 12.0-22.0) pmol/L


The one above isn't my last TSH, my last TSH came in at : 2.06

Thanks

P.S. I'm trying to find out whether the Generalized anxiety Disorder is purely neurological or hormone imbalance driven !

[pmgamer18]

You need to run this test also.
Thyroid Antibodies (anti-TPO and TgAb. YOU NEED BOTH.)
* Ferritin (and do stress FERRITIN, not just RBC)
A lot of people have Anxiety with a low thyroid.

[bgnb]

start simple: most cases of anxiety are related to low levels of B-12 ...

if you have been hospitalized for panic attacks they should have
done that on the blood test ... find out!

Second: high(er) levels of estrogen will cause anxiety and panic attacks ...
its very simple in that 'estrogen' is our evolutionary 'caution' hormone
and 'testosterone' is our evolutionary 'stress/excitement' hormone.

The craving for chocolate is EXACTLY the type of behaviour that indicates
your estrogen is high and should be investigated.

Finally, you may also have hypoglycemia ... also estrogen related,
but it can be controlled through diet ... frequent small meals help
your blood sugar stabilize ... low blood sugar will OFTEN trigger
anxiety attacks, particularly if your estrogen is driving a carb craving.

Get some methyl B-12, get your blood sugar stable and get your
estrogen down and your panic attacks will be gone.

[pmgamer18]

Some dam good point bgnb high E2 was the reasion I had panic attacks after all this yrs. just getting E2 down fixed this. If I remember right Chip has good E2 levels.

start simple: most cases of anxiety are related to low levels of B-12 ...

if you have been hospitalized for panic attacks they should have
done that on the blood test ... find out!

Second: high(er) levels of estrogen will cause anxiety and panic attacks ...
its very simple in that 'estrogen' is our evolutionary 'caution' hormone
and 'testosterone' is our evolutionary 'stress/excitement' hormone.

The craving for chocolate is EXACTLY the type of behaviour that indicates
your estrogen is high and should be investigated.

Finally, you may also have hypoglycemia ... also estrogen related,
but it can be controlled through diet ... frequent small meals help
your blood sugar stabilize ... low blood sugar will OFTEN trigger
anxiety attacks, particularly if your estrogen is driving a carb craving.

Get some methyl B-12, get your blood sugar stable and get your
estrogen down and your panic attacks will be gone.

[chipdouglas]

You need to run this test also.
Thyroid Antibodies (anti-TPO and TgAb. YOU NEED BOTH.)
* Ferritin (and do stress FERRITIN, not just RBC)
A lot of people have Anxiety with a low thyroid.


Anti-TPO was done for the last time in December 2006 :

antibody anti-TPO : 12 (negative : <45) kU/L
(anti-thyroperoxydase) (suspicious :45-65)
(positive : >65)


Estradiol-17B : 122 (42 - 151) pmol/L If converted to U.S. units it reads : 33 pg/ml which according to many on here is elevated, but I've found no M.D. to corroborate that--I'd like to have a medical text or study to show my PCP that my E2 may very be or at least largely contributes to my severe anxiety. If anyone has any paper that'd be acknowledged by any M.D., please let me know.


Ferritin was tested April of 2007 :

229 (50 - 250) ug/L


It gets SO frustrating, cause everytime I talk to M.D.s about what I read here about E2, thyroid etc...they look at me as though I don't even know what I'm talking about--how can I argue with a doctor......they discard what I say or worse laugh at me from their self-sufficient position and condescending air. In the meantime, I'm still stuck with my health issues.

Both my hands are cold pretty much all of the time come winter.

[chipdouglas]

start simple: most cases of anxiety are related to low levels of B-12 ...

if you have been hospitalized for panic attacks they should have
done that on the blood test ... find out!

Second: high(er) levels of estrogen will cause anxiety and panic attacks ...
its very simple in that 'estrogen' is our evolutionary 'caution' hormone
and 'testosterone' is our evolutionary 'stress/excitement' hormone.

The craving for chocolate is EXACTLY the type of behaviour that indicates
your estrogen is high and should be investigated.

Finally, you may also have hypoglycemia ... also estrogen related,
but it can be controlled through diet ... frequent small meals help
your blood sugar stabilize ... low blood sugar will OFTEN trigger
anxiety attacks, particularly if your estrogen is driving a carb craving.

Get some methyl B-12, get your blood sugar stable and get your
estrogen down and your panic attacks will be gone.

I didn't know about the B-12......let me look over my past test results, as I think it was done last year....

Ok this B-12 test result was performed spring of 2007 :

B12 : 542 Normal : (96 - 568) pmol/L

Thanks for the pointer

[wondering]

Ask them if they are so smart, how come they dont know whats wrong with you. Tell them when they know whats wrong with you, you'll stop coming in with ideas. Until then, stop acting smug and listen to what you have to say.

Good luck with that one. I feel your pain.

HardasNails put together a string of posts from Marianco that may help you on this one. Panic attacks and such is right up his alley I can dig it up if need be....I would NOT rule out Adrenals. Based on what I have read of that log of posts, I would def look there as well. Cant recall the cascades and am still digesting it, but Adrenal fatigue can cause imbalance of norepinephrine to other hormones/neurotransmitters. Hypoglycemia is another indicator. I have experienced both.

I have read and re-read that log a thousand times and each time uncover more info. Takes a bunch of reads to start to grasp it all.



Anti-TPO was done for the last time in December 2006 :

antibody anti-TPO : 12 (negative : <45) kU/L
(anti-thyroperoxydase) (suspicious :45-65)
(positive : >65)


Estradiol-17B : 122 (42 - 151) pmol/L If converted to U.S. units it reads : 33 pg/ml which according to many on here is elevated, but I've found no M.D. to corroborate that--I'd like to have a medical text or study to show my PCP that my E2 may very be or at least largely contributes to my severe anxiety. If anyone has any paper that'd be acknowledged by any M.D., please let me know.


Ferritin was tested April of 2007 :

229 (50 - 250) ug/L


It gets SO frustrating, cause everytime I talk to M.D.s about what I read here about E2, thyroid etc...they look at me as though I don't even know what I'm talking about--how can I argue with a doctor......they discard what I say or worse laugh at me from their self-sufficient position and condescending air. In the meantime, I'm still stuck with my health issues.

Both my hands are cold pretty much all of the time come winter.

[chipdouglas]

Thanks guys.

I've searched Pubmed and couldn't dig up any studies on the role of Estrogen in panic attacks except for two cases of Triphasil oral contraceptive which clearly precipitated onset of panic attacks.

Phil, do you any document on E2 and severe anxiety that I could present to my primary care provider--there's no way she's going to accept this unless I can bring forth clinically significant evidence. If you have such documents, I'd be a happy camper if you'd be so kind as to post it here.

Thanks again Phil



1: J Clin Psychiatry. 1992 May;53(5):163-5.Links
Comment in:
J Clin Psychiatry. 1995 Nov;56(11):533.
Oral contraceptives and panic disorder.Deci PA, Lydiard RB, Santos AB, Arana GW.
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston 29425.

BACKGROUND: There are no published reports of an association between triphasic oral contraceptives and the development of panic disorder. METHOD: The authors describe two cases in which the use of triphasic oral contraceptives in women appear to have precipitated panic disorder. Treatment with the triphasic oral contraceptives was stopped and the patients were followed for 2 years. RESULTS: Both subjects had rapid and total resolution of their panic disorder symptoms following cessation of triphasic oral contraceptive medications. CONCLUSION: Triphasic oral contraceptives in some predisposed women may lead to precipitation of panic disorder.

PIP: Panic disorder, a severe anxiety disorder, affects 1-2% of the general population, mostly women 20-40 years old. A 29-year-old married white women with no children presented with an 18-month history of panic attacks. Episodes of abrupt anxiety lasted 5-20 minutes and occurred 3-4 times per week accompanied by rapid heart rate, shortness of breath, dizziness, and a fear of losing control. She was evaluated by a cardiologist several months earlier for episodic tachycardia, but the tests were normal. She was taking .5 mg of lorazepam po 2-3 times per month, which relieved her anxiety. Her only other medication was 1 tablet/day of Triphasal oral contraceptive (OC). She was started on treatment with desipramine 10 mg, and the dose gradually increased to 60 mg/day which she was unable to tolerate because of marked anorexia; lorazepam .5 mg bid and 10.5-mg tablet p.r.n. was continued to address excess activation secondary to the tricyclic depressant. She had changed from a constant dose OC (Lo/Ovral) to a triphasic preparation (Triphasil) 6 months prior to the onset of her panic attacks. The OC was halted, and she has experienced no subsequent panic attacks or avoidance behaviors during 2 years of follow-up. In the 2nd case a 39-year-old married white woman with 3 children presented with a 3-year history of panic attacks. She was given Ortho-Novum 7/7/7 1 tablet/day for about 8 months prior to her 1st panic attack, which occurred while she was driving. Her medications were clorazepate 3.75 mg b.i. d. and Ortho-Novum 7/7/7 1 tablet g.d. for 21 days of each month; she had been taking both since October 1984. Her father and brother had exhibited some driving avoidance behaviors. Because the triphasic OC preparation possible precipitated her panic disorder with agoraphobia, she was changed to Ortho-Novum 1/35 OC which has markedly improved her anxiety for 2 years now.



PMID: 1592843 [PubMed - indexed for MEDLINE]