Thyroid test results. What questions should I ask my doctor?

August 17, 2020 4:50 AM

I went for a blood test today to see if there is anything wrong with my thyroid. This is because I'm experiencing almost constant adrenaline rushes, starting at 3am in the morning. Hopefully I'll get a test result by tomorrow. I've already done too much googling of symptoms and it's exacerbating my anxiety so I'm hoping for some guidance here on what questions should I ask my doctor, once we know what the test result is. Please be gentle. I'm scared.

I started with severe anxiety about 2 months ago. My doctor prescribe Stresam, which helped a lot, and I've been going to a therapist, meditating every day, getting enough exercise, not drinking any caffeine. I improved a lot but now I have to go off the Stresam (can't take it for longer than 3 months) and have started reducing the dosage. As soon as I reduced the dosage of the Stresam, the adrenaline rushes I was already getting and thought was only due to anxiety, kicked in full steam and don't go away no matter what I do. They don't seem to be linked to events or thoughts, but start at 3am. So I'm not looking for a diagnosis please, but only what kind of questions I should ask my doctor if it turns out that there is something wrong with my thyroid.

posted by Zumbador to Health & Fitness (12 answers total)

I had severe hyperthyroidism (from Graves Disease). I took a medication for it for a while, and that worked well, but my liver values looked bad so I had my thyroid ablated and I now have hypothyroidism and take thyroid hormone. If you have any questions about what it's been like I can try to answer them.

As for what you should ask your doctor, I would say, get a "tree" of outcomes and treatments from him in possible, as in, not only what are the current options, but what do those options lead to on success or failure. It's good to know what the future holds if possible.

I would like to point out that if you have hyperthyroidism, just treating it is going to make you feel a lot better, physically and mentally. I had a lot of anxiety and irritation, made worse by inability to sleep (heart palpitations, racing thoughts, anxiety etc). After I started taking meds I was almost unable to recognize my past self.

My experience from the thyroid ablation: I mean, take the advice of your doctor, I'm not telling you to ignore that. But in my personal experience having hypothyroidism is not my favorite. It's not awful but basically I kind of suffer from a lack of motivation now, sort of an inertia that keeps me sitting down a lot, where I used to be very active. It's hard to know what normal is - was I *over* active before because of hyperthyroidism? Was I *more than normally* motivated because of it, etc.
posted by RustyBrooks at 6:12 AM on August 17, 2020 [3 favorites]

RustyBrooks I had basically the same process, but you should not feel that way due to your thyroid hormone. You might consider asking to try a slightly increased dose? I told my doctor I would prefer to err slightly on the buzzy side and he was able to do that. (I wouldn't say I feel buzzy though. My hands don't shake like they used to, etc)
posted by Glinn at 8:28 AM on August 17, 2020 [1 favorite]

RustyBrooks I had basically the same process, but you should not feel that way due to your thyroid hormone.

I've only been on thyroid hormone for about a year. We've been steadily increasing the dose over that year. I may want to see another doctor - this one is happy if the test results are in the acceptable band, but every person is different. There have been a few studies regarding depression-like symptoms from hypothyroidism, which is basically what I have, but they are not exactly mainstream yet (the recommendation for those studies is to essentially up the dose until you don't experience depressions symptoms, often in excess of recommended blood test ranges)
posted by RustyBrooks at 9:47 AM on August 17, 2020 [1 favorite]

I also have Graves disease and hypothyroidism. One thing that has greatly improved the feelings of inertia is using Armour thyroid - the natural version of thyroid meds. I take it in the morning, and it's really improved how I feel during the day. Some doctors believe that it's the same as levothyroxine, but both I and my mother have had much better results with the Armour.

If you don't feel good, and your doctor isn't responding to that, find another doctor. Many doctors will only focus on test results and ignore how you are feeling. A good doctor will work with you to find a medication type and dose that helps you feel better. I went through a half dozen doctors to find my current doctor, who is the best. I feel better at a level well above the minimum levels of the thyroid tests, which many doctors use as their goal. If you need a higher dose, your doctor should give it to you.
posted by answergrape at 10:08 AM on August 17, 2020 [3 favorites]

Seconding everything answergrape said. I was held hostage to my test results being in the "acceptable range" for months before finding a doctor who would treat symptoms. I also take natural dessicated thyroid and have had much better results than synthetics, although doctors will claim synthetics are better.
posted by Preserver at 10:15 AM on August 17, 2020

The questions you should ask your doctor are:
1) What was tested with the blood test? This will most likely be T3, T4 and TSH.
2) What was the result of these tests? The doctor should give you these numbers. You might not be able to interpret them at that moment but they are good to have.

Most likely the first thing they will look at is TSH and see if that is in the normal range. As others have said here, "normal" varies and the range varies by country, by doctor, and is modified over time. I know this as I also had Grave's disease and have lived in different countries.

My good doctors have both looked at my numbers AND also asked how I feel - symptoms that they may decide requires an adjustment to the thyroid.

There's hyper-thyroidism and hypo-thyroidism. The latter is commonly treated with supplements. I have taken levothyroxine for over 30 years. Hyper is a bit more difficult to treat and this is where serious discussions with your doctor need to start, or possibly getting a second opinion, as treatments for this generally result in permanent alterations to the functioning of your thyroid gland. I was on tapazole for many years and when that didn't work got a radioactive iodine treatment. This made me go from hyper to hypo (a common occurrence) and I've been treating that ever since.
posted by vacapinta at 11:00 AM on August 17, 2020 [1 favorite]

Agreed with the suggestion to maybe find another doctor. I suffered from hypothyroid symptoms for years--years!!!--because my levels were "normal." I wish i had left sooner.

Also suggesting that the returned anxiety might be a rebound effect of decreasing the meds...? I was on a blood pressure pill temporarily that is also known to reduce anxiety. As they started weaning me from it, i had incredible anxiety attacks. It was probably two weeks of being off the drug entirely by the time i was back to baseline.
posted by BlueBear at 11:30 AM on August 17, 2020 [1 favorite]

Definitely find a doctor who'll tell you what's the right result for a person of your age, gender and hormonal phase. The acceptable bands are as usual set for young men and I spent ages getting shooed off by various endocrinologists before finding a doctor who pointed out that my TSH should be half of what it was.
posted by I claim sanctuary at 12:13 PM on August 17, 2020

I have had hypothyroidism for several years...a few of those undiagnosed because I didn't have the weight gain so doctor didn't test. I feel like I have fuzzy brain on levothyroxin. To original poster, are they also checking your adrenal gland? Questions to ask: what dietary restrictions are there if I take medication? What THS values does the medication elevate?
posted by DixieBaby at 1:41 PM on August 17, 2020

PRN anti-anxiety meds often cause panic symptoms as you wean off of them. IANAD but that's my guess as to what is happening here. That plus perhaps your baseline anxiety causing random uncued panic attacks. Panic symptoms, although unpleasant, are physiologically normal and harmless to your body.
posted by shadygrove at 6:39 PM on August 17, 2020

Response by poster: Thanks for all the extremely sensible advice.
I have the test results now and my thyroid is apparently normal.
My doctor wants me to continue with the Stresam at a low dosage. Am going to have a session with my therapist later today, hopefully she will help me navigate my way through this.
posted by Zumbador at 7:34 AM on August 18, 2020

Perhaps your doctor can run some tests to see if you have any issues with your adrenal glands. I have both non-classical congenital adrenal hyperplasia (a genetic mutation) and Hashimoto's thyroiditis (an autoimmune disease). Adrenal gland issues can absolutely manifest as anxiety. Here's some information from Cedars-Sinai Do not go down the rabbit hole of "adrenal fatigue" which is not really a thing.

Another medical condition that can cause anxiety is PCOS, which mimics some adrenal disorders so closely that sometimes one condition is diagnosed as the other.

These are all treated by endocrinologists. You may want to get a more complete workup, or see another endocrinologist just to rule out issues.
posted by ceejaytee at 11:30 AM on August 18, 2020 [1 favorite]