I created the Hub following below, from a response I wrote to a fellow thyroid patient diagnosed with Hashimoto’s thyroiditis (disease I have), which usually progresses to hypothyroidism (under-active thyroid). In this patient’s case, their thyroid levels did not indicate a need to treat by their doctor. In addition to this, they related also experiencing severe anxiety symptoms with their Hashimoto’s. I commented on these aspects of their thyroid disease case in the reply that follows.

My Reply:

Sometimes doctors are cautious about starting treatment due to the fact that if they treat when your thyroid hormones are fluctuating upward, which can happen earlier into the onset of Hashimoto's, they could cause you thyrotoxicity (hyperthyroidism). This would make anxiety symptoms even worse. This fluctuation back & forth between hyper (overactive) and hypo (under-active) thyroid levels, is common with autoimmune thyroiditis. When hyperthyroid phases are severe, it's called "Hashitoxicosis", so in my opinion, the doctor is wise in monitoring your case a while longer before starting you on thyroid hormone replacement. He likely will be blood retesting your levels at about 3-month intervals or so.

As far as treatment for anxiety symptoms, mine too were severe early into the onset of Hashimoto's thyroiditis and I personally used as-needed anti-anxiety drugs (like Xanax) but I did not use them for longer than a couple of months at a time and usually took half-doses rather than full ones. These type drugs (benzodizepines) can be addictive and is why they should be taken with some caution. This is just an added option I would mention.

Also, you are absolutely right in that research studies state that Hashimoto's thyroiditis causes anxiety symptoms but strangely there are doctors who do not have knowledge of that fact and will tell patients that the anxiety is not thyroid-related. In addition to medical studies, thousands of patients on forums, message boards and blogs attesting to having anxiety symptoms with Hashimoto's can't all be wrong!

This is just lay-opinion but I would try low dose, as-needed anti-anxiety meds before accepting a prescription for the daily-dosing type, such as SSRI antidepressants. There's nothing wrong with these and they can be greatly helpful when needed but your thyroiditis flares causing anxiety may diminish over a few months or even within a few weeks time, so starting a permanent regimen drug might be an over-kill so-to-speak at this point of observing your case. Certainly if emotional symptoms are severe or overwhelming and an as-needed drug is not helping enough, therapy can be very beneficial, as can permanent type drugs. I would never discourage any of these things when they are necessary.

I wish you the best with your Hashimoto’s case and keep me updated if you can!