Hallucinations in hypothyroidism
Ack. I have a headache today and it looks like I’m having one of those months when my hormones are back to front. I was dropping to sleep on the couch, so went to bed early, but I’m unable to sleep so here I am writing this. I’m sweating like a porker again, but my temperature is only 36°C (96.8°F). I feel like I’m writing from the front-line of hell, sending back dispatches of complaints that probably no one wants to read. I’m so impatient to get better. I’ve just realised I’ve only been taking thyroxine for nine days now but it feels like a century. Progress is so slooow and subtle. I just realised today that I haven’t had dyslexia since I started the thyroxine. My memory is a little less flaky too. Apart from that, I think the lump in my throat has gone down quite a bit and my breathing is somewhat improved.
I finished reading Dr Gordon Skinner’s book today. Here is a very interesting quote.
Hallucinations – of a certain sort particularly in the peripheral vision – are virtually pathognomonic of hypothyroidism and represent perhaps the most poorly-recognised feature of the disease occurring in my experience in approximately 75% of patients and rarely in non-hypothyroidal patients if their history is taken in detail. [...]
There can be ‘black floaters’ or ‘silvery wiggly things’ in front or at the side of the eyes but in more severe cases the patient is convinced that something is moving at the side of their vision or that somebody has passed by their side. Sometimes it’s all a bit sinister, the patient believes it might be Granny who has moved on [...]
It is common for patients to imagine insects or other creatures most usually cats, spiders, beetles, flies or even snakes running around the floor which presumably relates to ocular mucopolysaccharide opacities which move across the floor if the eye fixes on that focal plane but these can be very real to the patient and can be quite frightening. One of my patients was a gardener who believed robins were flying around and eating his newly-planted seeds; interestingly visual hallucinations are one of the first feature to disappear on thyroid replacement. [...]
Auditory disturbance is less common. Some patients are notably deaf and yet deplore loud or even moderate noise for example the television at normal volume. Tinnitus is often troublesome and a few patients report auditory hallucination of voices or (quite commonly) the telephone ringing or mishear what was actually said to them. Other patients lose their sense of smell and/or taste and like other senses describe hallucinatory phenomena where water tastes sweet or food tastes metallic; these features disappear following thyroid replacement.
Going back a few weeks (though it feels like decades), towards the end of April when I began to realise that something was going horribly and insidiously wrong, I started to notice occasional black spots in my vision. I didn’t really think of these as hallucinations at the time, but sometimes I would think I saw a bird flying in the corner of my eye, or a fly crossing the living room, and once a shadow I thought was a person.
I get silver wriggles when I stare into the sky, but I thought everyone did? I’ve occasionally been mistaking dots for insects for some time. I am indeed prone to mishearing what is said to me, I find loud noise painful, and I have constant tinnitus at the moment.
For some time I’ve been getting a sweet taste in my mouth, usually just before tea when I return from walking the dog. I thought this must be ketones, but I couldn’t explain why they tasted sweet to me. Water tastes very bitter and strange at the moment. I have a constant metallic taste in my mouth. No, not a feature of lead poisoning, mercury poisoning, or any other metal poisoning. A feature of hypothyroidism I never knew about.
Perhaps the most frightening thing I experienced recently, was during my very bad patch towards the end of April. I was awoken very abruptly early one Saturday morning by an infuriating auto-dial to my mobile phone; a debt collections agency harrassing me for a debt I didn’t actually owe and for which I have since received an apology. After hanging up, I tried to get back to sleep, but I couldn’t. I could hear the faint ringing of the phone for several hours afterward. Presumably a small group of sensory neurons decided to fire in synchronicity. I had to put on my iPod and listen to music to drown it out. Usually I daren’t listen to music because that takes over my brain and gets stuck in my head!
I haven’t had any visual or auditory hallucinations since I began thyroxine, but my sense of taste is still very weird.
This all relates, presumably, to a disturbance in dopamine levels in different parts of the brain.
Going back ten years to university days, my schizophrenic friend who also had goiter, used to hallucinate insects and snakes crawling all over the floor. She had goiter for heaven’s sakes! She wrote a book about having schizophrenia. When I read it, I was horrified because she complained of having a goiterous lump in her throat, repeatedly asking to see a doctor, and for months her psychiatrists did nothing about it (she had been sectioned), but they kept treating and treating her mental symptoms with higher and higher doses of antipsychotics, and she was completely unresponsive to the antipsychotics. I don’t know whether anything was ever done about it. She probably has never made the connection. The last I heard about her through a friend, she was stuck in permanent residence at the psychiatric hospital, and had “developed an ME-like condition and had neuropathy, which she blamed on the antipsychotics.” Or, her doctor isn’t doing his job properly.
But for the grace of God, there go I.
Addendum: What on earth just possessed me? I just “came out” on my onymous blog and posted a link to it on facebook, declaring, in a rather martyred post, that I was misdiagnosed with fibromylagia twenty years ago and actually I’m hypothyroid. Hmm. A sign of impaired judgement. I am rather emo again tonight. Ah well, some of my real life friends did need a slap around the face regarding how they have treated me in the past (or are still treating me) over this whole thing. I just hope thyroxine treatment makes me less passive-aggressive… If one didn’t LOL one would cry!