Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Panic Attacks While On Levothyroxine?
Posted on
Tue, 8 Mar 2016
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Tue, 8 Mar 2016
Answered on
Wed, 18 May 2016
Last reviewed on
Question : My husband had knee replacement in XXXXXXX 2015. 2 weeks before surgery he had a seizure brought on by a stroke ( have no idea when the stroke occurred). The neurologist prescribed levetiracetam 750 mg twice a day. In december after his physical his primary Doctor prescribed levothyroxine .05 mg. since he has been on this med he has had 4 panic attacks. Both involving not being able to stand. Twice lift assist had to be called to get him out of shower. He just gets scared says he can't do it and he sits down on the floor. The doctors each say that this side affect is not from the drugs they prescribed and yet I see anxiety listed as a possible side effect. My husband is only 65.
Brief Answer:
Dose modifications may be considered
Detailed Answer:
I read your question carefully and I understand your concern.
Thyroid hormone levels when higher then normal may cause anxiety. Levothyroxine is a substitute for the lack of production of the thyroid hormone in the body, given for low thyroid function. So in judging whether it is the cause of anxiety it's not the substance in itself which should be judged, but whether the right balance is found. If thyroid function is higher than needed it can lead to anxiety whether it is our own hormone production or given through pills. So to evaluate that hormonal levels are needed, especially the TSH, both when therapy was initiated and control measurements. Only through that it can be said whether dosage is correct or perhaps it is too high and can cause anxiety.
Generally speaking that dosage is pretty low, so it is difficult to see it as causing anxiety. However since you describe those episodes to be related so close in time with levothyroxine initiation it can't be ignored. I would perhaps try to lower the dosage to only 25 mcg (0.025mg) which is really the minimum dose. It should be discussed with your doctor though as it is hard to make recommendations when you provide no info on why was levothyroxine begun, the cause of low thyroid function and hormonal measurements.
Levetiracetam as well can cause changes in behavior, but since he was already on it for a long time without problems shouldn't be this case. However if he's had only the one single seizure which you mentioned, perhaps its dose may be lowered from the current 1500 mg to 1000 mg a day gradually as well. It is a decision though which depends on number of seizures and type, location of stroke, EEG report, so again some more info on those could be useful, photos of reports if at your possession if I may suggest.
I remain at your disposal for further questions.
Dose modifications may be considered
Detailed Answer:
I read your question carefully and I understand your concern.
Thyroid hormone levels when higher then normal may cause anxiety. Levothyroxine is a substitute for the lack of production of the thyroid hormone in the body, given for low thyroid function. So in judging whether it is the cause of anxiety it's not the substance in itself which should be judged, but whether the right balance is found. If thyroid function is higher than needed it can lead to anxiety whether it is our own hormone production or given through pills. So to evaluate that hormonal levels are needed, especially the TSH, both when therapy was initiated and control measurements. Only through that it can be said whether dosage is correct or perhaps it is too high and can cause anxiety.
Generally speaking that dosage is pretty low, so it is difficult to see it as causing anxiety. However since you describe those episodes to be related so close in time with levothyroxine initiation it can't be ignored. I would perhaps try to lower the dosage to only 25 mcg (0.025mg) which is really the minimum dose. It should be discussed with your doctor though as it is hard to make recommendations when you provide no info on why was levothyroxine begun, the cause of low thyroid function and hormonal measurements.
Levetiracetam as well can cause changes in behavior, but since he was already on it for a long time without problems shouldn't be this case. However if he's had only the one single seizure which you mentioned, perhaps its dose may be lowered from the current 1500 mg to 1000 mg a day gradually as well. It is a decision though which depends on number of seizures and type, location of stroke, EEG report, so again some more info on those could be useful, photos of reports if at your possession if I may suggest.
I remain at your disposal for further questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
