The short explanation
Both are worth taking seriously and they are not alternatives. An overactive thyroid, anaemia, low blood sugar, some medicines and caffeine can all produce a racing heart, trembling, poor sleep and a sense of dread that is indistinguishable from anxiety — and anxiety itself produces genuinely physical symptoms that are not imagined. A reasonable first step is simple: a thyroid test, a full blood count, and a conversation about what has been happening. Finding a physical cause does not mean the distress was not real; finding none does not mean it was invented.
What depends on your situation
The parts of this that change from woman to woman. Uncertainty is stated, not hidden.
- What gets checked depends on your age, your symptoms and your history. Palpitations with weight loss and heat intolerance point one way; breathlessness and exhaustion with heavy periods point another.
- Anxiety that started suddenly in someone who has never had it, or that began after a new medicine, is worth a closer look at the physical side.
What this answer cannot determine
The boundary of online education. These need a clinician who can see you.
- This cannot tell you which it is. It cannot interpret a symptom, rule out a cause, or tell you whether your results are normal — and a normal test does not settle the question either way on its own.
Questions for your clinician
Take these with you. You can add any of them to an appointment card.
- Should we check my thyroid and my haemoglobin?
- Could any of my current medicines be doing this?
- If the tests are normal, what would you suggest next?
- What support is available here that is not medication?
When to seek help
Clinician-approved guidance for this topic. When in doubt, being seen is never the wrong choice.
- Seek urgent care for chest pain, fainting, or a racing heart that will not settle. Seek help today if you are having thoughts of harming yourself — that is an emergency and it is treatable.
Sources
The evidence this explanation is built on.
No sources recorded yet.
Who wrote and reviewed this
Every AskHer answer names its author. A clinically reviewed answer also names the clinician who signed it off — if no clinician is named below, it has not been clinically reviewed.
- Author
- AskHer Editorial AskHer's editorial team — not an individual clinician Works in English, தமிழ், हिन्दी
- Clinical reviewer
- Nobody yet No clinician has signed this answer off. That is what the “Editorially reviewed” badge means, and why it does not say “Clinically reviewed”. It was written and checked by AskHer’s editorial team, and it is queued for a clinician who works in this area. No sources are recorded against it yet.
- Review status
- Editorially reviewed
- Last reviewed
- Last reviewed 26 September 2026
- Version
- 1
Correction history
Substantive changes are listed, not quietly edited away.
No corrections have been made since this answer was first published.
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