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June 05, 2023 7 min read

Are you concerned about how levothyroxine might affect your mood or possibly cause nervousness? As someone with thyroid disorders like hypothyroidism, it's natural to wonder about the potential side effects of the medications that you take. So, let's discuss the relationship between levothyroxine and nervousness and how you can manage this unfortunate side effect.

First thing first: The thyroid gland

The thyroid gland is a small, butterfly-shaped organ located in the neck, playing a critical role in regulating our body's metabolism. It produces two main hormones, thyroxine (T4) and triiodothyronine (T3), which are involved in managing the pace at which our cells convert food into energy. The pituitary gland, sometimes called the "master gland," controls the thyroid gland by releasing the thyroid-stimulating hormone (TSH), signaling the thyroid to produce more or fewer hormones as necessary.

Various issues can affect the thyroid gland, but the most common thyroid disease is hypothyroidism. Also known as an underactive thyroid, hypothyroidism occurs when your body does not produce enough thyroid hormones to meet its needs. Some of the primary causes of hypothyroidism include autoimmune diseases, such as Hashimoto's thyroiditis, surgical removal of the thyroid gland, certain medications, and radiation treatments. Hypothyroidism can result in symptoms like fatigue, weight gain, sensitivity to colds, constipation, and dry skin.

Can hypothyroidism cause nervousness and anxiety?

An imbalance in thyroid hormone levels has the potential to cause various symptoms, including those resembling anxiety symptoms and depressive disorders, such as nervousness. The connection between thyroid dysfunction and these emotional symptoms can be attributed to the crucial role thyroid hormones play in producing and regulating neurotransmitters, particularly serotonin. That's why low thyroid hormone levels are associated with symptoms of anxiety and depression, as well as other mood disorders.

What is levothyroxine?

Now that we have a basic understanding of the thyroid gland and hypothyroidism let's explore further the main medication used for treatment: levothyroxine.

Levothyroxine, also known as L-thyroxine, is the synthetic version of the hormone thyroxine (T4). This medication acts to replace or provide more thyroid hormones. Thus, you'll have enough thyroid hormone to regulate your body's energy levels and metabolism. As a result, your symptoms, including symptoms similar to anxiety disorders, will be eased. Levothyroxine is typically taken as a daily oral medication and is closely monitored by doctors to ensure optimal dosage levels. Doctors usually determine levothyroxine doses based on blood test results.

Can levothyroxine cause nervousness?

While many patients with hypothyroidism benefit significantly from levothyroxine therapy, some individuals may experience side effects. Nervousness is among those potential side effects that can be bothersome for some patients.

Here are some reasons why levothyroxine might cause nervousness in some people:

1. Overdosage

Nervousness or anxiety-related symptoms may occur due to an excessive dose of levothyroxine. In such cases, the body is receiving more thyroid hormone than it requires, which can result in symptoms that resemble hyperthyroidism or overactive thyroid (having too much thyroid hormone). These symptoms may include increased heart rate, tremors, irritability, difficulty sleeping, or feelings of nervousness.

2. Individual sensitivity

Each person's body reacts differently to medications, and some individuals might be more sensitive to changes in thyroid hormone levels than others. This heightened sensitivity could make them more prone to experience nervousness as a side effect of levothyroxine therapy.

3. Adjustment period

When people first start taking levothyroxine, their bodies may need time to adjust to the new hormone levels. During this initial adjustment period, some individuals might experience temporary side effects, such as nervousness, until they achieve a stable and optimal dosage.

4. Drug interaction

In some cases, nervousness may be the result of interactions between levothyroxine and other medications or substances. For example, the combination of levothyroxine and certain asthma medications, antidepressants, or stimulants might cause or exacerbate nervousness.

5. Underlying anxiety disorders

For individuals with pre-existing anxiety disorders, the introduction of levothyroxine might temporarily exacerbate their anxiety symptoms, including nervousness. In such instances, working closely with a doctor to manage both hypothyroidism and anxiety disorder is of utmost importance.

6. Misattribution of symptoms

Sometimes, the nervousness experienced by individuals taking levothyroxine might not be directly caused by the medication. Instead, the symptoms could be the result of unrelated factors, such as external stressors or other health issues, which may be mistakenly attributed to levothyroxine treatment.

7. Inability to convert T4 to T3 properly

Levothyroxine might not be the ideal treatment for everyone due to variations in how well the body converts T4 to T3. The thyroid hormone T4 is mostly inactive and requires conversion to the active form, T3, to exert its effects on the body's metabolism. This conversion primarily occurs in the liver, kidneys, and other peripheral tissues.

Not everyone can efficiently convert T4 to T3, which could lead to a surplus of T4 circulating in their system. This excess T4 may cause symptoms similar to those of an overly high dosage of levothyroxine, such as nervousness or anxiety. Furthermore, these individuals may still experience symptoms of hypothyroidism due to insufficient levels of active T3.

What can you do if levothyroxine causes nervousness?

Experiencing nervousness as a result of taking levothyroxine can be disheartening, especially since the medication is intended to alleviate hypothyroidism symptoms and improve your overall well-being. However, there are methods and strategies available to help you cope with this issue.

1. Communicate with your doctor

If you suspect that your levothyroxine dosage is causing nervousness, it's essential to discuss this with your doctor They may decide to adjust your dosage or explore alternative treatment options.

2. Consider alternatives

If you experience nervousness because your body is unable to properly convert T4 to T3, you may consider alternative therapies, such as combination therapy with both synthetic T4 and T3 medications or a natural desiccated thyroid (NDT). These options might help to address the individual's unique conversion challenges, ensuring optimal thyroid hormone levels and minimizing the potential for nervousness or other adverse side effects.

Natural desiccated thyroid (NDT)

NDT, or Natural Desiccated Thyroid, is a type of thyroid hormone replacement therapy derived from the desiccated (dried and powdered) thyroid glands of pigs. NDT contains a combination of the natural thyroid hormones T4 (thyroxine) and T3 (triiodothyronine), along with minute amounts of T1, T2, and calcitonin. For over a century, NDT has been used to treat hypothyroidism in individuals whose thyroid glands do not produce enough hormones to meet their body's needs.

NDT offers an alternative approach to synthetic thyroid hormone replacement medications like levothyroxine, which generally only includes T4. Some patients and healthcare practitioners prefer NDT as it provides a more biologically similar hormone replacement, leading to improved symptom relief for certain individuals, particularly those who have difficulty converting T4 to the active T3 hormone.

Besides prescription NDT medications like Armour Thyroid, Nature-Throid, and NP Thyroid, you can also find NDT supplements online without a prescription. One such option is VitaliThy. This NDT supplement contains Thyroid (USP), similar to Armour Thyroid and NP Thyroid. However, it's classified as a supplement rather than a medication due to differences in law and regulations between the US and Vietnam, where VitaliThy is manufactured.

VitaliThy is a safe option for individuals with particular food sensitivities since it is free from gluten, lactose, eggs, fish, and shellfish, as well as artificial colors and flavors.

3. Monitor your thyroid levels

Regular blood tests will help your doctor determine if your levothyroxine dosage is appropriate. Keeping your thyroid hormone levels within the normal range can minimize the risk of experiencing nervousness as a side effect.

4. Practice relaxation techniques

In addition to addressing potential medication issues, implementing stress-reduction techniques may also help alleviate sensations of nervousness. Examples include practicing mindfulness, deep breathing exercises, or engaging in activities such as yoga or meditation.

5. Maintain a healthy lifestyle

Balanced nutrition, regular exercise, and sufficient sleep can positively impact your overall well-being and may help reduce feelings of nervousness.

Special precautions you need to follow before taking levothyroxine

Aside from the tips above, there are some special precautions that you should be aware of before starting levothyroxine. These precautions can help you ensure the medication is as safe and effective as possible. Here are some precautions that you should keep in mind:

  • Let your doctor know if you have any allergic reaction to levothyroxine, synthetic thyroid hormone, any other medications, or ingredients within the levothyroxine. You can ask your doctor for a list of ingredients that are on the medication.

  • Tell your doctor or pharmacist about any kind of prescription or nonprescription vitamins and other natural supplements you're taking or plan to take. This is important because many other medications or supplements can interact with levothyroxine and leave bad side effects. 

  • Please note that taking levothyroxine combined with natural or herbal remedies may affect the accuracy of thyroid function tests. Herbal medication that contains kelp (seaweed) can contain high levels of iodine, which will worsen the symptoms of your hypothyroid.

  • It is recommended to avoid taking calcium carbonate, iron supplements, or ferrous sulfate at the same time as levothyroxine. Taking these supplements at least 4 hours before or after taking levothyroxine is best. The same applies to other medicines such as cholestyramine (Prevalite), colesevelam (Welchol), colestipol (Colestid), sevelamer (Renvela, Renagel), or sodium polystyrene sulfonate (Kayexalate).

  • You will also need to tell your doctor if you have recently received radiation therapy or if you have or have ever had diabetes, hardening of the arteries, bleeding problems or anemia, porphyria (a condition in which abnormal substances build up in the blood and cause problems with the skin or nervous system), osteoporosis, pituitary gland disorders (a small gland in the brain), and any medical condition that makes it difficult for you to swallow.

  • For levothyroxine-treated hypothyroid women, inform your doctor that you are currently pregnant, plan to become pregnant, or actively breastfeeding. If you become pregnant while taking levothyroxine, quickly call your doctor so that they can adjust your dosage properly. It's important to continue taking levothyroxine during your pregnancy. Having too high or too low levels of thyroid hormone in pregnancy will cause additional problems for you and your baby. Additionally, it's alright to continue taking levothyroxine while breastfeeding, as this medication will replace what your body normally is making.

Conclusion: Addressing nervousness caused by levothyroxine and exploring alternatives

In some cases, levothyroxine may cause nervousness as a side effect, which can be challenging for individuals seeking relief from hypothyroidism symptoms. However, by working closely with your doctor, monitoring your thyroid levels, and adopting a healthy lifestyle, you can better manage any nervousness arising from levothyroxine treatment.

For those who have difficulty obtaining a prescription for NDT or finding it at local pharmacies, NDT supplements like VitaliThy present a viable alternative. As a supplement containing Thyroid (USP) without the need for a prescription, VitaliThy can be a convenient option for individuals wanting to try a natural thyroid hormone replacement therapy. It's especially beneficial for people with specific food sensitivities, as it is free from gluten, lactose, eggs, fish, shellfish, and artificial colors and flavors.

Wojciech Majda
Wojciech Majda

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