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What Causes Panic Attacks And Anxiety?
Question: I am a 44yr old female. Mainly quite healthy. About 12 months ago I had a blood test after advising the GP that I was experiencing panic attacks/anxiety. The test showed an over active thyroid. After being referred to a thyroid specialist & after further tests, including a throid biopsy. No further treatment was recommended, as the thyroid appeared to 'fix' itself. I also have a FNH tumour in my liver, which was found when I had scans on my gall bladder (now removed). The tumour is completely benign (per liver specialist) & no treatment is required at this stage. I am no longer on the pill, as this may be the cause of, or may cause the tumour to grow. My periods are 'fairly' regular, however I recently skipped 2 months. I got my period yesterday. For the last 2-3 weeks, I have had anxiety. My GP has diagnosed me with depression & prescribed me 45mg mirtazapine at night & 200mg epilim x 2 per day. I am thinking that the anxiety/panic attacks may be a symptom of an underlying medical problem & not depression?
Brief Answer:
Anxiety
Detailed Answer:
I am sorry to learn about your panic attacks.
I agree with you that it is important to rule out a potentially treatable medical condition before ascribing your symptoms to depression.
I noted the thyroid history you shared above but it would be worthwhile knowing the current thyroid function status by running a simple blood test. I will mention it at the end along with other tests.
There is condition called pheochromocytoma that mimics panic attacks. It is very important to rule out.
So when I see someone with anxiety/panic attacks, I order the following tests
1 Complete hemogram
2 Electrolytes
3 Calcum
4 Creatinine
5 Glucose
6 SGOT/SGPT
7 Albumin
8 TSH
9 Plasma fractionated metanephrines
The last two tests are in connection with the thyroid and adrenal respectively.
Medications may interfere with the adrenal test so first do the test and if it abnormal then confirmatory testing can be done after considering if the medications need to be stopped in consultation with your prescribing physician
Anxiety
Detailed Answer:
I am sorry to learn about your panic attacks.
I agree with you that it is important to rule out a potentially treatable medical condition before ascribing your symptoms to depression.
I noted the thyroid history you shared above but it would be worthwhile knowing the current thyroid function status by running a simple blood test. I will mention it at the end along with other tests.
There is condition called pheochromocytoma that mimics panic attacks. It is very important to rule out.
So when I see someone with anxiety/panic attacks, I order the following tests
1 Complete hemogram
2 Electrolytes
3 Calcum
4 Creatinine
5 Glucose
6 SGOT/SGPT
7 Albumin
8 TSH
9 Plasma fractionated metanephrines
The last two tests are in connection with the thyroid and adrenal respectively.
Medications may interfere with the adrenal test so first do the test and if it abnormal then confirmatory testing can be done after considering if the medications need to be stopped in consultation with your prescribing physician
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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