[SueAndHerZoo]

#1059967

I’ve been having a bad couple of days (both with my thyroid and anxiety) and have been trying to get through the days and nights with occasional BB’s and low dose tranqs. For the past two days that combination has put me into a “zombie” state. Are we not supposed to take those within a few hours of each other? I’m pretty sure my doc told me to use them but Propranalol and Tranxene has really put me in a fog the past two days, even though it never has before. To the point I had to leave the office. So it’s been a bad two days, and last night I hit an all-time low.

I fell asleep about midnight and at 5:00 a.m. woke up in a panic attack. I don’t think I’ve ever done that before…. usually when I’m asleep, I’m asleep. This one scared the crap out of me, I reached for my BP monitor and my BP and heart were high. I took a betablocker and tried to go to sleep but the panic was overwhelming…. just wanted to be in a fetal position and cry. I must have dozed on and off a little but woke up again at 9:00 feeling the same panic. I asked my husband to go get me a half of a Xanax (which a doc had just given me a few days earlier when I said the Tranxene wasn’t cutting it anymore.) I’m always afraid of trying a new drug but I knew that if I was to keep any sanity I needed to try something. I took 2.5 mg. and calmed down enough to fall asleep. Weird dreams, though!

So now I’m defeated and depressed, foggy and tired, and trying to figure out what happened last night. Did the thyroid cause the middle of night wake up and anxiety or did my anxiety cause it and elevate my BP and heartrate?

It’s probably a matter of which came first (chicken or egg) but I, of course, will analyze this to death in the hopes of finding the cause and fixing it.

I know people on the anxiety forums wake up often in panic attacks, but do Graves patients, too, or should I chalk this one up to anxiety?

Sorry for rambling but I know you all understand the need to understand what’s happening to us in the hopes of controlling it.
Sue

[Kimberly]

#1179186

Hi Sue – The question on beta blockers and tranquilizers would be a great one for your pharmacist. My guess, though, is that the two drugs likely have a cumulative effect if taken too close together, which is what caused your “zombie” state.

As for the panic attacks vs. Graves’, that is just really difficult to sort out. Hopefully, you will get some other responses, but I don’t think there is a way to know for *sure* until you get your levels to a point where they are normal and stable. I would definitely keep a diary of all of these episodes, though, and share this information with your doctor at your next visit.

Take care – hope that tonight is a better night for you!

[SueAndHerZoo]

#1179187

Thanks for always replying, Kimberly….. it’s the one thing in life right now that I can truly count on.
Sue

[Raspberry]

#1179188

That does sound difficult sorry you are having such a hard time! My non-doctor guess, is that you aren’t taking the beta-blocker at the right dose frequently enough to keep it steady in your bloodstream. I had the very same things happen when the beta-blocker would wear off in the middle of the night, of course my heart rate and blood pressure would go up, waking me up and of course triggering major anxiety. My doctor advised me that metoprolol and atenolol should be taken twice a day and propranolol four times a day due to their differing half-lives while things are still touch and go. I have my own blood pressure kit and during that time I took it many times a day checking pulse too to make sure I got into the sweet spot and stayed there and that my bp wasn’t getting too low. So that’s my best guess! Now I can’t swear that’s what is happening with you but it could be…hope you feel better soon.

[SueAndHerZoo]

#1179189

Hi Raspberry.

You may very well have hit it right on the head. I have NOT been taking propranolol regularly at all but instead have been taking it only “as needed”. I probably “need” it 3 or 4 times a day but since I already take so many meds I try to skip meds unless absolutely necessary. So when I have felt palpitations or found my resting heart rate to be 110 or higher I take one, but once my heartrate goes down, I don’t take one again until I notice symptoms.

I believe when I first got diagnosed with Graves 6 years ago I probably was taking one on schedule but this time when I was diagnosed as being out of remission the doc said I was only very slightly hyper and asked if I needed a BB. I told him I thought I still had plenty left over from last time and that was it. A few weeks later when I ended up in the ER with a very fast heartrate the ER doc wrote me a scrip and that’s what I use now “as needed”. Perhaps I SHOULD take at least 2 or 3 a day instead of waiting till things get bad. Oh, and the “slightly hyper” diagnosis a couple months ago has resulted in 3 dose increases of Methimazole and I think it’s still too fast. Bloodwork is Monday.

Thanks for replying. Sometimes we are so involved in our own situations that we can’t see what’s so obvious. Thank God you’re all here.
Sue

[vanillasky]

#1179190

Hi Sue: from personal experience I can tell you that those 2 don’t mix.

I use Atenolol and Klonopin.

Atenolol makes me drowsy. Klonopin makes me drowsy. Together, I get the “Zombie Effect.”

I sometimes wake up with panic attacks but it’s usually because of having a bad dream about my father’s death or something like that.

Karen

[SueAndHerZoo]

#1179191

Thanks, Karen. I’m pretty sure I used to be able to take both and I know my doc told me it was OK to take both (one helps the physical symptoms and the other helps the mental issues) but these past two days it was really not a good combo.

In Googling it I find that lots of people take both together right before a public speaking event, etc. but maybe they take a lot of coffee, too, who knows.

So I guess the answer is that it is SAFE to take them both, but how you feel will depend on the individual. Trial and error I guess, and as much as I keep wishing I could feel un-hyper for a while, the zombie affect wasn’t so great, either.
Sue

[Raspberry]

#1179192

I’m so glad I could help! I bet you will feel much better once your bp/pulse are steady. The propranol wears off at six hours for most people. The metoprolol and atenolol are longer lasting….I take metoprolol once a day because I find it sedating, but back when I was running hyper I needed it twice a day. These days I think I need it just because of straight up high bp because of all the dratted weight I’ve gained. Let us know how it goes!

[vanillasky]

#1179193

Did you guys know that beta blockers are weight gain drugs? I found that out. Now that my thyroid is in normal range, I stopped it and I feel better.

Still take the Klonopin now. I think my anxiety comes from a variety of places so I can’t blame it all on thyroid issues. I think I just have a difficult life and health scares and a nauseating husband. That’s what gives me anxiety.

Also, menopause has been linked to anxiety too and lots of my hot flashes comes from just getting tied in a knot and nervous.

[Boomer]

#1179194

I’m wondering the same thing.

The BB I’m on (propronalol 40mg 3x/day) has indeed calmed my tremors and racing heart but I wake up early (3:00amish) in a full blown panic mode. This morning, in fact, I awoke with a feeling of near-rage. And true to form I attribute(d) it to the stress of being diagnosed rather than a symtom.

The truth of the matter is that is NOT a normal stress reaction. Thinking back on my life I’ve had many stressful periods: College was incredibly stressful. Raising my daughter had many stressful times. Buying new homes and moving, carreer issues, self-employment, etc., ALL stressors. Not one of them ever caused me to wake up like I was shot out of a cannon in full fight or flight mode let alone a feeling of internal rage. It’s not right and I’m DONE pretending things like this are “normal” any more.

Speaking for myself only, I need to stop pretending that the things I’ve been experiencing with this lousy disease are due to normal everyday life stressors. It was this same denial of reality that kept me from seeing a doctor a loooooong time ago and instead waiting, telling myself “it’s okay- it’s just stress blah blah blah ad nauseum” and letting things go too long. I need to address these things ASAP from now on.

I’m sorry for the rant/ramble here Sue and friends. I’ve read this thread twice today and only now am I accepting the fact that things aren’t as great as I wish they were and that I need to face the facts of this godforsaken disease and the effects it’s having on my body, mind, and spirit.

My Endo is a top-dollar specialist so from this point forward I’m going to make a list of ANYTHING that doesn’t seem right. He’s gonna earn his money when I’m in his office!

I’ve lived in this body a long time so I know deep down when something is amiss. I’m going in with a list and I’m going to expect answers and suggested solutions.

No more playing around.

Sorry for the hijack and thanks for all of your straightforward awesomeness.

Peace to all,

Boomer

[SueAndHerZoo]

#1179195

If you’re going to apologize for ranting you’re going to have to do MUCH better than that! That was barely a whine, let alone a rant.

I said the same thing to my therapist the other night: I have been through many, MANY stressful situations in my life, (so many that I could probably write a book) but none of those caused the panic I’m feeling now. I’ve had panic attacks (mostly controlled by meds) for 40 years and hadn’t had one for probably the past 20 years until my thyroid went bad in February.

So yes, this is panic and anxiety I’m having, but is it from the stressors of life? i don’t think so. I think it’s the thyroid that has every organ in my body in hypermode, most especially my nervous system.

I’m ready to have this thing yanked out. Right now, being tired and cold (but calmer) is starting to sound pretty good. It’s the “fat and happy” part that still bothers me, though.
Sue

[Harpy]

#1179196

The anxiety may or may not be GD related, the actual effect is likely to be an upset in your circadian rhythms, there are various hormonal cycles that govern our daily operation, morning anxiety is very common and usually starts with a circadian upset, but then can continue as a pattern of behaviour, the first thing is to get your sleep cycles back in tune.

With regards to hormones 3 major players, melatonin your sleep hormone starts to rise about 9pm and makes you sleepy and then it peaks about 4am and starts to fall, cortisol your stress hormone starts to rise from about midnight and peaks between 6-8am, this is your wake up kick start and then it falls throughout the day, there is also a release of thyroid hormones at about 3-4am causing a peak particularly in T3 levels.

In a normal situation the melatonin being high in the early morning hours 2-6am overides the effects of the elevated cortisol and T3 so you sleep through it, but if there is a circadian disturbance and these cycles are not aligned and the melatonin peak is delayed, then it is quite likely you may find yourself waking up startled at 3 am, then falling asleep again, but still waking up tired and sore, good sleep is crucial to the healing process, low vitamin D levels also play some role in disordered sleep patterns.

The major sleep disturbance issues in modern life are night time lighting and late night TV & computer use as these emanate predominantly blue light wavelengths sending our bodies the wrong message of it is still daytime, so the melatonin release is delayed. Evenings should be a quiet time, winding down with casual conversation, reading a book, some contemplation of the day, not the suspense, anticipation and excitement blaring out of the TV screen. Lighting should be in amber tones, like the old incandescent globes or candle light, anything in the soft amber hues. The switch nowdays to compact flouro’s and energy efficient lights will only agravate these problems as they all seem to come with the cold blue/grey tones.

Try to maintain regular sleep wake cycles, get up and go to sleep at the same times, go to bed early with a book and just wind down for an hour or so, then roll over and go to sleep, try some relaxing herbal teas like chamomile and if you are splitting your ATD dose, then taking one dose just before sleep will help to minimise the thyroid release hormones.

Have a bit of a search around on sleep disorders, correction and circadian rhythms, improving your sleep patterns can have a major effect on your well being.

[SueAndHerZoo]

#1179197

Wow, that was an amazing amount of information and food for thought…. thank you.

I do a lot of things “wrong” regarding the quality of my sleep, my patterns and my cycles, but fortunately it has never caused me problems before (at least not obvious problems). But as with everything else, once Graves has raised its ugly head, all things are effected, and almost always negatively.

Thanks for sharing all that.
Sue

[Raspberry]

#1179198

Yes, very helpful post Harpy – in fact it inspired me to go to bed last night as I was staying up too late

[Harpy]

#1179199

Sleep quality and quantity is highly underrated in it’s value to the healing process, even if we sleep through the night this does not mean it was complete, there are a number of different levels and although we may remain unconscious, this does not necesarily mean we have reached the depp sleep stages to fully complete the process.
Often people will sleep right through the night, but still wake up tired, sore and irritable, like many other aspects of good health, improving your sleep patterns takes time and dedication, but like so many other health issues like diet and lifestyle, the modern world is structured in the opposite way, so no you can’t have it all.
If you choose all the modern conveniences, world at your fingertips all the time etc., then something has to give i.e. health.
There is a time to engage and there is a time to be still, this was never an issue when the sun ruled our world, but now days we need to make some personal choices on how we manage these conflicts. Personally I rarely watch TV anyway, but the computer is a problem for me and I do try to shut down by 8pm at the latest as much as possible and then pick up a book and do some easy reading before bed.

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