By Dr. Nicole Cain, ND, MA
You suffer from intense feelings of panic. Heart racing, trembling, flushes of heat, and sweating. Your doctors have told you it’s just anxiety and that you’ll have to learn to manage it. To curb the symptoms, you were prescribed an antidepressant (Zoloft), sleep aide (trazodone), and a benzodiazepine (Xanax).
Now, in addition to anxiety, you have a low libido, you’ve gained weight from the sugar cravings driving you to double size your morning pick-me-up, and you feel zoned out during the day which is starting to negatively impact your work.
There is another solution. You don’t have to feel like this.
With every symptom, it is absolutely essential to consider the root cause. Without investigating the root cause we cannot find comfort in a cure. Just like if you kick the dresser and stub your toe every morning, no matter how much aspirin you take, you will never enjoy a pain-free toe—that is, unless you stop kicking the dresser.
Similarly, if you do not look for the root cause of your anxiety, you may never enjoy the possibility of freedom until you investigate the cause.
While causes vary from person to person, for example: Trauma, medication side effect, stress in the home or work place, there may biological causes of your symptoms.
Can thyroid problems cause anxiety?
Today I want to focus on the thyroid-anxiety link.
There are two main types of thyroid disorders: Hypothyroidism, and hyperthyroidism. Hypothyroidism is where your thyroid is under-active, or under-functioning. In contrast, hyperthyroidism is where your thyroid is over-active, and over-functioning. An autoimmune condition called Hashimoto’s Thyroiditis can cause the thyroid to alternate between hypo-and hyper states.
QUIZ: Should I have my thyroid checked?
- I have dry skin
- I experience constipation
- I have heat or cold intolerance
- I am fatigued
- I have palpitations
- I have irritability
- I have brain fog, poor memory, concentration issues
- I have joint pain
- I have hair loss/ hair thinning
- I have irregular menstrual periods
- I have a slowed heart rate
- I have insomnia
- I have weight gain
- I have high cholesterol
- I have dry mouth
If you answered “yes” to 3 or more of these, it is time to get your thyroid checked.
What labs should I have done?
The thyroid labs I run on my patients include: TSH, Free T3, Reverse T3, Free T4, Anti TPO antibodies, anti TG antibodies.
It is important to understand what these names mean, and what your labs are telling you so that you can ensure your doctor is running all of the proper labs, and so that your doctor can employ a proper treatment.
Demystifying The Thyroid
Your brain releases a hormone called TSH (thyroid stimulating hormone) that communicates with your thyroid gland (which lives in your neck). TSH does just what the name implies—it stimulates your thyroid gland to release thyroid hormone. In response, your thyroid gland will release T3 and T4 thyroid hormone.
T3 is the active form of thyroid hormone that helps you have energy and is involved in almost every metabolic process in your body. 99% of total T4 is bound quite tightly to a protein and is not very metabolically active. T4 converts into T3 when needed so that the body has proper amounts of thyroid hormone to work with.
It gets even trickier than this: If your body does not have the right nutrients, it will make something called reverse T3. Reverse T3 is not an active form of thyroid. When we do a T3 thyroid test it bundles together both regular T3 and reverse T3. Therefore unless we test them separately we do not actually know if you have enough active thyroid hormone.
This means that your T3 thyroid test can look perfectly normal and you could actually have a thyroid problem!
Hashimoto’s Thyroiditis is an autoimmune disease that is often seen in people with vitamin D deficiency, heavy metal exposure, gluten sensitivity (even if they are not celiac), gut dysbiosis, and other diseases with autoimmunity.
Hashimoto’s Thyroiditis can cause your thyroid to spike up and become overly active, and then drop down and become underactive. The tests we run for this are Anti Thyroid Peroxidase (TPO) and anti Thyroglobulin (TG). Hashimoto’s Thyroiditis can cause you to alternate between hyperthyroidism, and hypothyroidism.
In a glance:
- Thyroid autoimmunity can cause panic attacks, alternating with depression
- High TSH means your brain is having to repeatedly remind the thyroid gland to make thyroid hormone. This is like when you are telling your kid/ spouse/ coworker/ pet/ friend to do something and they do not listen and so you have to telling them over and over again.
- TSH should always be run with both T3 tests and T4 so that you know not only what the brain is doing, but what the thyroid is doing, as well.
- Your doctor should run both free T3 and reverse T3
- T4 is less bio-available, meaning it is less active, so it should always be run with your T3 tests.
Tips for success:
- Converting reverse T3 (rT3) back into active T3: Through supplementation of selenium and zinc; dietary changes utilizing fasting or a low carbohydrate diet, and the elimination of oxidative stress (through the intake of antioxidants).
- Make sure you have enough iodine in your system (you can test this with a serum iodine test).
- Healthy liver functioning will help your thyroid functioning
- Consider running a heavy metal toxicity test to rule out heavy metals as a cause of your thyroid disease, and therefore your panic attacks.
- Cortisol is a stress hormone released by your adrenal glands, which can impair thyroid function. Consider getting your blood cortisol levels checked.
This is just one example of how to investigate the root cause of your anxiety. By getting to the cause of your symptoms you will be empowered to stop kicking the dresser and start on the road to a new life.
Feel like yourself again. There is hope.
Dr. Cain is your expert for integrative treatments of bipolar disorder, anxiety, depression, postpartum depression and anxiety, PTSD and other mental health conditions. Dr. Cain is an internationally recognized physician and treats patients on over 3 continents. To learn more about how you can become a patient of Dr. Cain, go to www.DrNicoleCain.com and click on Getting Started.
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