Anxiety, palpitations and being believed

When the symptoms look "just" like anxiety

Hyperthyroidism, and particularly Graves' disease, can cause anxiety, panic, a fast or irregular heartbeat, tremor, insomnia, and irritability. These are direct physiological effects of excess thyroid hormone - not a psychological reaction, not stress, not weakness.

But because these symptoms overlap so closely with anxiety disorders, they can be misread. Some people are prescribed antidepressants or referred for talking therapy before anyone checks a thyroid blood test. Others are told their palpitations are "nothing to worry about" without investigation. Some are told they seem anxious - as if the observation explains the feeling rather than describing it.

If this has happened to you, you are not alone and you are not wrong to feel frustrated.

Palpitations: when to mention them and how

Palpitations - awareness of your heartbeat, whether fast, hard, or irregular - are common in thyroid disease. They can be frightening, especially when they appear without an obvious cause.

When to seek urgent help: If palpitations come with chest pain, breathlessness, feeling faint, or if your heart feels severely irregular and you feel unwell, seek help promptly. See when to seek urgent help.

For persistent or new palpitations: Mention them to your GP or thyroid team. They may want to check your thyroid levels, an ECG, or monitor your heart rhythm. Palpitations are a symptom - they deserve investigation, not dismissal.

After treatment: when anxiety lingers

Once hyperthyroidism is treated and levels normalise, many symptoms improve - but not always immediately, and not always completely. Some people continue to feel anxious even with good blood tests. This can be:

• a nervous system that has been on high alert for a long time and takes time to recalibrate
• genuine anxiety that the experience of illness has triggered or worsened
• something worth exploring further with your GP

Neither of these is a character flaw. Both are worth mentioning. You don't have to choose between "it's the thyroid" and "it's mental health" - for some people it's genuinely both, running in parallel.

The experience of being dismissed

Being told your symptoms are stress, anxiety, or "all in your head" before a thyroid problem is found is, for many people, one of the most lasting parts of the experience. It can leave people second-guessing themselves, reluctant to seek help, and distrustful of medical appointments.

If you are not being heard, some things that have helped others:

• Being specific and concrete: "My resting heart rate is consistently above 100" or "I've lost 8 kg without trying in the last three months" is harder to dismiss than "I feel anxious and my heart races."
• Asking directly: "Could we check my thyroid function?" is a reasonable and straightforward request.
• Tracking symptoms: A symptom log with dates and specifics gives a clinical picture that goes beyond one appointment. The symptom journal can help with this.
• A second opinion: If you feel your concerns are persistently not being addressed, you are entitled to ask for a second opinion. Your GP can facilitate this.

If you are struggling right now

Living with physical symptoms that feel like anxiety - or with both at once - is genuinely hard. If things feel overwhelming, please reach out to someone.

There are free support lines you can reach any time - you don't have to be in crisis to call; they talk to people who are struggling, not only those at immediate risk.

You can also speak to your GP about mental health support - the two things can be treated alongside each other, and asking for help with how you are feeling is not a concession that your physical symptoms are imaginary.

Questions to raise with your doctor

• "I've been feeling anxious and my heart has been racing - could we check my thyroid function?"
• "My thyroid levels are normal now but I'm still feeling anxious - what might help?"
• "Are palpitations I'm still having something we should investigate further?"

You can use the questions tool to build a list before your appointment.