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June 17, 2023 8 min read

Feeling more anxious since you started taking levothyroxine? Wondering if there's a link between this medication and your anxiety symptoms? We know how important it is to balance our mental and physical health, so let's dig deeper and explore the possible connection between levothyroxine and anxiety.

What is levothyroxine?

Levothyroxine is a synthetic version of thyroxine (T4) used to treat hypothyroidism, a condition in which the thyroid gland does not produce enough thyroid hormone. It's also used to treat goiter (enlarged thyroid gland) and certain types of thyroid cancer. Levothyroxine is available as a tablet or injection and works by replacing or supplementing the body's natural thyroid hormone.

Levothyroxine is typically taken once a day in the morning on an empty stomach, at least 30 minutes before eating. Taking the medication simultaneously every day for consistent thyroid hormone levels is essential. The dosage of levothyroxine may need to be adjusted over time based on blood tests and symptoms.

What is anxiety?

Could levothyroxine be the culprit behind your anxiety?

According to the American Psychiatric Association, anxiety is a typical response to stressful situations. For example, you may feel anxious when you face a difficult situation, before a job interview, or before making an important decision. However, anxiety can become a problem if it starts to occur too frequently and become a consistent pattern in our lives. In this case, it might be a sign of an anxiety disorder.

Anxiety disorders are the most prevalent mental disorders, affecting people of all ages across the globe. There are several types of anxiety disorders, including generalized anxiety disorder, separation anxiety disorder, social anxiety disorder, and panic disorder. Some symptoms of anxiety disorders include intense fear, being irritable, difficulty concentrating, headaches and unexplained pains, and sleep problems. These complex emotional states often have deep-rooted causes. Hence, it's essential to understand the contributing factors to effective management and treatment.

What is the connection between levothyroxine and anxiety?

In some cases, anxiety might be worsened or even triggered by certain medications. One drug that has been reported to be connected with increased anxiety is levothyroxine.

While the relationship between levothyroxine and anxiety is not entirely understood, it is believed that the drug might lead to an overstimulation of the nervous system in some individuals. This overstimulation might manifest as physical symptoms, such as an increased heart rate and shakiness, which can snowball into feelings of anxiety, panic attacks, and even the development of panic disorders.

Other reasons why levothyroxine may cause anxiety in some people

1. Adjustment period

Yup, the adjustment period of using levothyroxine can affect your mood. When starting levothyroxine, it can take several weeks for the medication to reach optimal levels in the body. During this time, some people may experience mood changes such as anxiety, irritability, or depression. These mood changes are temporary and should improve as the body adjusts to the medication.

2. Incorrect dosage

Any drug, even vitamins or supplements, will have a negative effect or will not even work according to your expectations when the dosage is inappropriate, as does levothyroxine. When the dosage is too low, the body may not receive enough thyroid hormone, so your hypothyroidism is essentially untreated.

On the other hand, when the dosage is too high, the body may receive too much thyroid hormone, leading to symptoms such as anxiety, nervousness, and irritability. Moreover, the incorrect dosage of levothyroxine might cause or exacerbate existing anxiety symptoms. People with pre-existing anxiety disorders, such as generalized anxiety disorder or social anxiety disorder, might find that taking levothyroxine amplifies their symptoms, making it difficult to manage their mental health. Therefore, it is essential to regularly monitor thyroid hormone levels and adjust the dosage as necessary to ensure optimal mood and overall health.

3. Inability to properly convert T4 to T3

The inability to properly convert T4 (thyroxine) to T3 (triiodothyronine) can potentially contribute to anxiety in individuals taking levothyroxine. Levothyroxine is a synthetic form of the T4 hormone, which, under normal circumstances, is converted into the active T3 hormone by the body.

However, some individuals may have difficulty converting T4 to T3, either due to genetic factors, nutrient deficiencies, or other medical conditions. This can result in a state of functional hypothyroidism, despite having normal or even elevated T4 levels. Since thyroid hormones play a key role in regulating mood, energy, and overall well-being, imbalances in T3 levels can lead to a variety of symptoms, including anxiety.

Could anxiety be caused by hypothyroidism itself?

Yes, a thyroid that isn't working well, particularly hypothyroidism, can lead to an imbalance in brain chemicals like serotonin. Although this usually results in feelings of sadness, anxiety is another common side effect. That's why if your dosage of levothyroxine is too low, you might be experiencing anxiety because your hypothyroidism is undertreated.

According to a study, women with hypothyroidism who are being treated with levothyroxine are more likely to experience anxiety and depression compared to women without a thyroid condition.

Some anxiety symptoms that might appear in people with thyroid issues include:

  • Fast heartbeat

  • Trouble sleeping

  • Feeling irritable

  • Difficulty concentrating

  • Sweating a lot

  • Feeling nervous

  • Shaking or trembling

  • Losing weight.

It's crucial to spot and manage these symptoms in people with thyroid problems, as having a balanced mental and emotional state is important for overall health and happiness.

What can you do if levothyroxine affects your mood and cause anxiety?

There are ways to combat anxiety

Suppose you experience mood changes and anxiety as a side effect of levothyroxine. In that case, there are a few things you can do:

1. Ask your doctor to adjust your dose

While the potential connection between levothyroxine and anxiety disorders can be concerning, it's important to remember that many individuals take this medication without experiencing increased anxiety. Sometimes, the key is finding the correct dosage and working closely with a healthcare professional to monitor symptoms and adjust treatment as needed.

If you think that you're dose of levothyroxine is not optimal, talk to your doctor. They'll likely take thyroid function tests to assess your thyroid hormone levels. They may reduce or increase your dose of levothyroxine.

2. Consider other types of thyroid hormone replacement

If you suspect that your body's inability to convert T4 to T3 is the cause of your anxiety while taking levothyroxine, it's crucial to discuss your concerns with a healthcare professional. They may recommend testing your T3 levels and considering alternative treatments, such as a combination therapy with medications or supplements that contains both T4 and T3 thyroid hormones, such as natural desiccated thyroid (NDT).

Natural desiccated thyroid (NDT) is a medication derived from the thyroid gland of pigs that contains both T4 and T3 hormones. This makes NDT potentially more effective in treating specific hypothyroidism symptoms, such as fatigue and weight gain, compared to levothyroxine, as T3 is more biologically active than T4.

Some of the most popular NDT brands in the US are Armour Thyroid and NP Thyroid. However, NDT is also available in supplement form, which you can buy without a prescription. One great option is VitaliThy, a natural desiccated thyroid you can buy online.

3. Practice relaxation exercises

In order to counter anxious thoughts, you can practice the following relaxation techniques:

Deep breathing

Take slow, deep breaths, inhaling through your nose and exhaling through your mouth. Please focus on the sensation of your breath as it moves in and out of your body.

Mindfulness meditation

Sit comfortably and focus on your breath or a specific object. When your mind wanders, gently bring it back to your breath or object.


Close your eyes and imagine a peaceful scene, such as a beach or forest. Use all your senses to fully immerse yourself in the experience.


Practice gentle yoga poses, such as a child's pose or downward dog, while focusing on your breath. This can help release physical tension and calm the mind.

Everyone's journey with anxiety is different, so it may take some trial and error to find the relaxation techniques that work best for you.

  1. Stay active

Staying active is a proven way to manage mood and anxiety. Exercise releases endorphins, natural chemicals that improve mood and reduce stress. Regular physical activity can also help reduce symptoms of depression and anxiety by improving sleep, increasing self-confidence, and providing a sense of accomplishment.

Staying active can distract you from negative thoughts and worries. It can also provide an opportunity to socialize and connect with others, improving your overall mood and reducing feelings of isolation.

Some practical ways to stay active include going for a walk or run, practicing yoga or other forms of exercise, participating in team sports, or simply incorporating more movement into your daily routine, such as taking the stairs instead of the elevator or going for a quick walk during a break at work.

It's important to find activities that you enjoy, and that fit into your lifestyle, as this will make it more likely that you will stick with them and reap the mental health benefits.

5. Prioritize sleep

Quality sleep is essential for maintaining good mental health and managing stress. A lack of sleep can lead to negative effects such as increased anxiety levels, mood swings, and a lack of energy. By prioritizing quality sleep, you can improve your ability to cope with life's challenges, boost your energy levels, and improve cognitive function, which can lead to reduced stress and anxiety levels.

6. Seek professional help

Seek professional help: If your anxiety persists or worsens despite adjustments to your medication or lifestyle changes, it's essential to consider seeking the assistance of a mental health professional. Mental health professionals, such as therapists, psychologists, or counselors, can be invaluable in helping you manage and overcome anxiety.

They can provide support by offering a compassionate and understanding space where you can talk openly about your concerns, feelings, and experiences related to anxiety. Another important aspect is the assessment they can conduct in properly diagnosing your anxiety and determining if there are other contributing factors that may be exacerbating your symptoms.

Mental health professionals can also teach you specific coping strategies to manage your anxiety, such as cognitive-behavioral therapy (CBT), mindfulness, breathing exercises, or progressive muscle relaxation. These methods can help you break the cycle of anxious thoughts and feelings, giving you a greater sense of control.

Developing a personalized treatment plan tailored to your unique needs and circumstances is a crucial part of therapy. This might involve a combination of talk therapy, coping strategies, and, if necessary, collaborating with your healthcare provider to address any medication concerns.

Remember, anxiety can be a complex and multifaceted issue, and it's essential to seek help from a mental health professional who can provide comprehensive support, guidance, and expertise in managing and alleviating anxiety.

7. Stay connected

Social support can help reduce stress, provide emotional comfort, and improve mental health. Here are some tips for staying connected:

Maintaining healthy relationships can be challenging, especially when dealing with anxiety or mood disorders. One effective approach is to schedule regular check-ins with friends and family. Setting aside time each week to catch up via phone, video call, or in-person meet-ups can help you stay connected and provide support and comfort.

Another option is to join a support group, either locally or online, that focuses on mental health or anxiety management. These groups offer a safe space to share experiences, learn coping strategies, and feel less isolated.

When communicating with loved ones, it's important to practice active listening. This involves giving them your full attention, asking questions, and validating their feelings. By being present and engaged, you can strengthen your relationships and build a sense of trust and understanding.

Additionally, sharing your own experiences with anxiety or mood management can be helpful. It can help others feel less alone and allow you to receive support in return.

Do you need anti-anxiety medications?

If anxiety is a result of a thyroid disorder, anti-anxiety medications might not always provide long-lasting relief. Doctors might consider prescribing traditional anxiety treatments like selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs).

However, if the anxiety stems from hypothyroidism, the proper solution would be thyroid hormone replacement therapy, including options like levothyroxine and natural desiccated thyroid. By finding the right medication and dosage, the symptoms caused by hypothyroidism, including anxiety, should be reduced and managed more effectively.

Conclusion: Anxiety can be a side effect of levothyroxine

While anxiety can be a symptom of hypothyroidism, it can also be caused by levothyroxine, especially during the adjustment period or when the dosage is incorrect. If your anxiety persists, consider switching to natural desiccated thyroid (NDT), which contains both T4 and T3 thyroid hormones. To begin your journey with NDT, you might want to consider a supplement like VitaliThy. Not only does this NDT supplement offer a complete thyroid hormone, but it is also free from lactose, gluten, eggs, fish, and shellfish.

Wojciech Majda
Wojciech Majda

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