It’s Not in your Head


Panic Attacks and Heart Palpitations From Hyperthyroidism

Many people don’t realize that panic attacks and palpitations can be symptoms of hyperthyroidism, an overactive thyroid, or autoimmune Graves’ disease. Some patients are even misdiagnosed as having panic disorder or heart problems when they are actually hyperthyroid. Once treated for their overactive thyroid, they go on to be free of these symptoms.

When you are hyperthyroid, your body produces too much thyroid hormone. This release of hormones can speed up your heart rate dramatically, increase blood pressure, and generally put your body into overdrive. In other words, excess thyroid hormone may kick in your body’s fight-or-flee adrenaline response.

In addition to autoimmune Graves’ disease, in Hashimoto’s disease, the up and down activity of the thyroid can sometimes cause excess thyroid hormone to be is released erratically.

A toxic multinodular goiter can also cause sporadic periods of hyperthyroidism. In turn, these episodes can be a trigger for panic attacks or cause heart palpitations.

Most people who have a thyroid disorder will find that once properly treated, their panic attacks and palpitations become a thing of the past.

That said, often times in addition to treating the actual thyroid disorder, a beta blocker (a type of blood pressure medication) is also prescribed to ease symptoms like a fast heart rate and nervousness.

Treatment of Panic Attacks and Heart Palpitations

But what if you’ve been treated and are still experiencing these episodes? At that point, you will need to explore further diagnosis with your practitioner.

One key possibility to investigate is whether or not you have a mitral valve prolapse, a heart valve irregularity that is more common in thyroid patients and can produce symptoms such as a pounding, fast heartbeat, palpitations, panic attacks, dizziness, shortness of breath, and other symptoms.

Another thing to consider with your doctor is your TSH level. Once treated for hyperthyroidism, most people become hypothyroid, due to radioactive iodine (RAI), antithyroid drugs, or surgery.

At that point, you will be on thyroid hormone replacement. But if you are on too high a dosage of thyroid hormone replacement, and your TSH is at the lower end of the normal range, you may be borderline hyperthyroid due to overmedication. In this case, it’s worth discussing a slight reduction in your dosage with your doctor to see if that alleviates your symptoms.

Similarly, if you are having periods of hyperthyroidism due to Hashimoto’s disease or toxic nodules, better treatment for your condition may resolve your panic and heart symptoms.

Very Well Health August 2018

It’s not in your head! I’ve seen many patients over the years pushed off by their medical doctors when they can’t find out what’s going on with their symptoms. I had to blog about this topic because of a case I had yesterday. I had a 38 year old female, being treated for bipolar based on her symptoms of heart racing, sweating, anxiety, and mood fluctuations. Come to find out on her blood labs I ran, she has a hyperthyroid that everyone else has overlooked. I stress the importance of running a full thyroid panel with the antibodies being checked because of similar cases I’ve had in the past. Very common with Hashimoto’s disease too. Adrenal health is very important to address as well when trying to balance thyroid function. See my previously lecture on the adrenal-thyroid connection.

Dr. J


2 Comments Add yours

  1. Julie says:

    I have ALL of the symptoms of Hypothyroid disorder, but my regular doctor had me do blood work and all my levels came back as “within normal range”. He blew me off after that. I cannot lose weight, I have palpitations, hot flashes, trouble sleeping, raspy/hoarse voice, dry skin, thinning hair, trouble concentrating, changes in taste, dry eyes, irregular menstruations, etc. I know this could also be caused by the onset of Menapause, but I know it’s not all the same condition. My doctor would not take it further and give me a referral to a Thyroid specialist for additional testing. Apparently I need a referral to see one. Frustrated!!!


  2. KIM HUTCHESON says:

    If I were you, I would find another primary care Dr. I had to myself as my symptoms weren’t getting better, but worse, and “well, you know Kim, you are getting older”, well, I had Rocky Mtn Spotted Tick Fever and almost died. I now changed my PCP to the one who found that AND CMV, Mono, Epstein Barr, and already diagnosed with Fibromyalgia.
    An endocrinologist is who you need to see for the thyroid issues. My little grandson was born with congenitial hyprothyroism, and thankfully they caught, and it is very damaging to the brain


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