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What Causes Shaky Hands,palpitations And Anxiety When Suffering From Hypothyroidism?

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Posted on Tue, 1 Apr 2014
Question: I am 38yrs old.I was diagnosed with hypothyroidism and taking medication regularly for last eleven years. Present medication eltroxin 50mcg.Rrecently I have symptoms of shaky hands, palpitations, anxiety, stomach upset etc. which were not there earlier. These symptoms occur twice in the last two years followed by menstrual irregularities. I have tested for blood and urine sugar, t3, t4 tsh lipid profile, BP, and all are within range. Can't understand why this happens or what is required to be done. Please advice.
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Answered by Dr. Vaddadi Suresh (12 minutes later)
Brief Answer: signs of excess thyroid hormone (Thyrotoxicosis). Detailed Answer: hi XXXX I understand your problem. You are clearly showing signs of excess thyroid hormone (Thyrotoxicosis). Even though the test results seem to be in range, the wide limit of normality is the reason for difficult to set target for TSH in patients. I would suggest you to further reduce the dose of thyroxine to 37.5 and then to 25 mcg over next 2 months to keep the TSH in the upper side of normal (eg 4.5-5). Hope you will improve with this. All the best.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Vaddadi Suresh (9 hours later)
If test results do not show any anomalies , in the future, should I titrate my dose according to my symptoms or is there any other parameter to do that?
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Answered by Dr. Vaddadi Suresh (37 hours later)
Brief Answer: Yes, you need to titrate based on symptoms. Detailed Answer: Hi, Yes, you need to titrate based on symptoms. let me explain. The normal TSH range is 2 to 5.5 mU/L ( may vary with the lab standards). some patients may remain comfortable with the levels at 2.5 while some develop signs of toxicity at the same level. Mind you, 2.5 is still in normal range. The best option here, is to titrate (gradulally reduce the dose in small amounts) and see at what dose of thyroxine and TSH levels, your symptoms abate. Hope this helped.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Vaddadi Suresh

Internal Medicine Specialist

Practicing since :2003

Answered : 963 Questions

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What Causes Shaky Hands,palpitations And Anxiety When Suffering From Hypothyroidism?

Brief Answer: signs of excess thyroid hormone (Thyrotoxicosis). Detailed Answer: hi XXXX I understand your problem. You are clearly showing signs of excess thyroid hormone (Thyrotoxicosis). Even though the test results seem to be in range, the wide limit of normality is the reason for difficult to set target for TSH in patients. I would suggest you to further reduce the dose of thyroxine to 37.5 and then to 25 mcg over next 2 months to keep the TSH in the upper side of normal (eg 4.5-5). Hope you will improve with this. All the best.