[twitchy]

#1060547

Hi,

I’m a 39 year old male, new to this forum. I’ve had anxiety issues all my adult life that have got worse the past few years. I eventually sought treatment and have been taking Lexapro 10mg for general anxiety disorder (GAD) and proponalol (10mg-20mg) on occassion for situational (professional) anxiety. I have an increasingly stressful executive role that triggered a lot of this. When i was first diagnosed with GAD, my GP did bloodwork and said my TSH was low/out of range and he asked me to come back a couple of months later. He then told me it was normal again. I have been ok for 3 or 4 years, but a few weeks ago had a major anxiety episode, shortness of breath, insomnia, heart palpitations (almost balcked out whilst driving my family). I had just had an annual physical (TSH 0.65) but went back to the doc. It asked if it might be my thyroid given the anomoly a few years back and the correlation with how I felt then and now. He said it was fine but took some more labs. He called back to say actually my TSH was now 0.35, slightly below the lab range 0.4-4.0. He told me to come back in a couple of months but I insisted on seeing an endo.

Within 5 minutes he told me that my medical records indicate my TSH has been at the low end of the ‘normal’ range or slightly below for several years and I likely have mild Graves. I have some autoimmune stuff in my family history as well. By the stage I actually felt a little better and sure enough when he tested my TSH it was up again at 0.57, still low but ‘normal’. My T3 and T4 were slightly elevated. He is awaiting results of the Graves test, but as strange as it might sound, I am actually hoping for some positive affirmation that there is a physical cause behind all this….my questions are;

1. Is it likely that I could really be experiencing hyper symptoms at slightly below or slightly above the accepted range of what is ‘normal’ TSH?

2. If the Grave’s test comes back negative, what next?? Do i go back to assuming this is all anxiety driven and the two thyroid anomolies were just that? My symptoms are transient and it seems too coincidental to me.

I was already resigned to being a stress case, so if it’s just anxiety I can focus on treating that. But I want to make sure I’m treating the cause and not the effect. Any advice on what to do, ask, think, especially with respects to 2 above gratefully received! Sorry for the long post…

[Kimberly]

#1183239

Hello and welcome! We are fellow patients here, not docs, but here are a few thoughts on your questions…

1. We hear from patients who feel symptomatic as levels are shifting towards hyper (TSH moving to the low end of the range or T3/T4 moving to the upper end of the range). So it’s certainly possible that your symptoms are related to thyroid issues.

2. When you said you are waiting on a Graves’ test, I’m guessing the doc ran an antibody test like TSI or TRAb? Antibody tests are a little tricky to interpret. Sometimes results will come back “normal” or “negative” if the value is within a pre-determined range, but a person who is truly “normal” will have *no* antibodies at all. Definitely ask the doctor for a hard copy of the results, rather than just getting the info over the phone.

Bottom line, please be persistent until you can find a doctor who will help you find some answers. In some cases, it takes more than one doctor to help people find the root cause of puzzling symptoms.

Wishing you all the best!

[snelsen]

#1183240

Hi twitchy,
I have been thinking about you a lot. How are things going for you now?
I am “just” another patient who has had Graves’s and TED, but here are my thoughts. It has been a while since you wrote. I am hoping you did continue to go to an endo, and that you have a more definitive answer. It is difficult to sort things out when there is an overlying anxiety disorder to deal with, too. And it could feasibly guide docs to waver in treatment of Graves’.

1. Yes, you can exhibit hyper symptoms with a slightly suppressed TSH.
I have the same question Kimberly asked. What Graves’ tests are you referring to??

2. I think it is very important for you to have an empathic endo who does not discount the way you feel. Continue with labs. This is just a thought, but perhaps if your labs (I am assuming TSH, T3 and T4) indicate slightly hyper, and you FEEL that way, perhaps taking an ATD for a few weeks, monitoring you very carefully, will give you the rest of the story. If you feel better,and the anxiety decreases, you may have Graves’. But this is definitely a medical decision with you and your endo working together. Are you taking propranolol for a rapid heart rate?

Looking forward to hearing from you.

Shirley

[flora]

#1183241

Hi Twitchy,
Like Shirley, I hope that you are on your way to a more settled state, and feeling much better. My symptoms were a lot like yours for years – just wrote it all off to anxiety and career stress, never even bothering to bring it up to the doctor. Finally, it all got worse to the point where sleep disturbances, shakes, jelly legs, sweats, disciplined eating to try and keep weight on, and even higher anxiety, finally made me get myself to the doctor for my diagnosis. Since then, we have been working on my “sweet spot dose” of Tapazole, and coming closer, but not without symptomatic swings along the way, as my levels move around in response to the dosage changes (and maybe also to the continuing stress in my life) – a ton of fun, but way better than how I felt back then. Post a note, when you can – people here root for each other all the way!
– flora

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