AF and Thyroid problems

[gerryatriq]

Been known for some time that thyroid issues can lead to AF, has anyone had their Thyroid TSH, checked or show symptoms of a high thyroid?

[BobD Volunteer]

Most people get thyroid check ,long before they are diagnosed with AF. It is not thyroid leading to AF as they come from different areas although the symptoms can be confused.

Bob

[gerryatriq in reply to BobD]

hi bob

is it OK to post direct links on here??

[BobD Volunteer in reply to gerryatriq]

so long as they aren't commercials I can;t see a problem.

[Hidden in reply to BobD]

Hi Bob, posting a link - I was reading this and started googling, found a few interesting snippets including this one:

medpagetoday.com/Cardiology...

Lis

[BobD Volunteer in reply to Hidden]

Hi Lis, That is quite interesting but ignores one important factor. You need a predisposition to AF for any trigger to work and produce it. Thyroid problems will perhaps lead to increased heart rate which it would be possible to control by controlling the thyroid. To actually cause AF there must be a predisposition.

Lets examine what AF is. It is a condition where rogue impulses from outside the normal internal pace maker system (AV Node) cause the left atria to pulsate out of control. It has been likened to writhing like a bag of worms. Those impulses often come from the pulmonary veins which is why these are isolated by lines of scar tissue during ablation. Raised heart rate per se will not cause AF unless this is over long periods (endurance athletes are prime candidates for AF). Over long periods of exercise the atria may expand and stretch the normal pathways allowing other incorrect ones to form.

Most patients presenting with raised or slightly irregular heart beat will be tested for thyroid function to rule this out. I had tests several times over my AF journey all of which proved normal.

So my conclusion is that if you are a likely candidate for AF then yes thyroid imbalance may trigger it but with no predisposition it won't. Alcohol is not the cause of AF but if you have a predisposition to it you may find it a trigger, likewise lots of food allergies for those with vagal AF . Wishful thinking could produce the magic bullet of AF but sadly it is far more complex a condition with no single cause which is why we all experience different levels and treatment is so hit and miss. I pray that one day we will find one universal common denominator (like helibacter pylori in stomach ulcers) which would allow medics to produced a one size fits all treatment but for now that is but a dream.

Usual proviso, not medically trained just been at this game for many years.

Bob

[jude99 in reply to BobD]

Hi Bob - I am slightly concerned that you are so forthright with your opinion that people seeking advice and peer support on this forum are unable to get past your posts. There is plenty of medical evidence that points to an association between thyroid disease (particularly hyperthyroidism) and AF. Your comment that a link could not be possible as 'they come from different areas' doesn't make sense as thyroid disease affects every single body system, including the cardiovascular system, resulting in a struggle for the body to maintain homeostasis.

A large population study of 586,460 patients in Denmark (BMJ 2012;345:e7895) recently published their findings that 'Patients with subclinical hyperthyroidism had a 30% increased risk of atrial fibrillation compared with euthyroid patients, and patients with high normal thyroid function had a 12% increased risk of atrial fibrillation.'

Whilst I believe you mean well with your advice, and I know that you have built up such a following that many people on this forum regard you as an expert, I think it would be helpful if you allowed posters to discuss their concerns rather than stonewalling them with your opinions.

[BobD Volunteer in reply to jude99]

Hi Jude.I'm, sorry if that was the impression but I hope my later post explained what I mean. I did read the paper and obviously thyroid can be a contributing factor but is not the cause of AF. If there was no connection then testing would not be done but what I am trying (badly obviously) to convey is that AF is much more complex than that. Many people who are found to have thyroid problems and successfully treated will not suffer AF symptoms if that is the trigger.. You can have AF without a thyroid problem and thyroid problem without AF. and if one rushes to blame one thing then one will be disappointed . I only wish it were possible to find one cause but many things blamed are merely triggers it appears.

As a wise man once said "there are Lies, damned lies and statistics" which is why I never use statistics and always make the point that it is only my opinion or quote the source so please make your own minds up.

And no I'm not going to sulk and hide. LOL

Bob

[jude99 in reply to BobD]

I didn't expect you to sulk and hide, lol! I don't know if anyone else has come this this conclusion but I have experienced a worsening of symptoms when I eat carbs, so maybe dietary sugar could be a contributing factor, as it is in many diseases?

[CDreamer in reply to jude99]

My AF was definitely triggered by vagal, postural but also adrenaline - I discovered this when I went to dentist who gave me local anaesthetic with adrenaline which sent me into AF immediately. Caffeine & alcohol also trigger my AF as does chocolate (sadly) some carbs give me really bad indigestion which was often followed by AF within 24 hour period. As to a predisposition toward a disease I really don't know, I really like the new biology theories which are finally being recognised that we are not controlled by our genes and can change our genetic codes. Perception is everything! Tell a person they are going to die in 3 months and they mostly do.

It would be a shame if one person's views dominated everyone else's perception, but my view is that we are intelligent people and therefore can make up our own minds and make our own choices. I do take your point, and have some sympathy with it, that we do need to discuss and ask these questions because the medics certainly don't join up all the dots and unless you can produce 'scientific' data they are rarely interested in working holistically.

I think sugar is definitely a contributing factor, difficulty is that you need to be very strong minded to eliminate it from diet. I also think the mindset has an enormous affect. Pesticides are also another issue as are being saturated in radio waves from our gadgets - electromagnetic fields - our heart electromagnetic field can be measured 4 ft from the body so surely that will also influence things.......

[jude99 in reply to CDreamer]

Interesting about electromagnetic fields, I'd never considered this!

[rosyG in reply to jude99]

I think everyone on this site learns from and makes contributions from their own experience and reading. and we don't all agree with everything that is posted . We are grateful for posts from people like Bob and Ian who have had long experience of AF. People often post different points of view and join in discussions of differences and I think this is why we all benefit from this site.

[Hidden in reply to BobD]

Thank you Bob, very grateful for your thoughts... I'm interested because nobody even suggested testing for thyroid function when or since I presented with my 'writhing bag of worms', but I am sure you are right, you need a predisposition - I certainly have a family history and thinking back, I'm sure I had an attack when I was 20, pregnant, and under extreme stress, I just didn't recognise it as such.

Perhaps the thing that's being recognised increasingly is that more people have a predisposition than had been thought, I read somewhere that one in four have or will have AF, which sounds like a lot. That being the case, perhaps it will become a more mainstream area for research, which would be good.

[BobD Volunteer in reply to Hidden]

Yes Lis, a lot of the increase in numbers is down to more frequent diagnosis. Up until quite recently many people. particularly ladies of a certain age were dismissed by GPs as having hysteria (coming from the Greek for womb I think) or panic attacks. (similar). Add in an ageing population (AF becomes more likely as one ages) and you have an AF time bomb. We keep discovering types of people who may be likely (or more likely ) to get AF and in some cases the reason is obvious. Endurance athletes tend to cause their atria to expand and similarly many fighter jet pilots who are subjected to high G loads with attendant extra work for the heart have the same problem but for most of us it appears to be a genetic pre-disposition*. (I'm sadly neither of the above. lol)

Proving that I can use statistics, there are apparently something like 800.000 diagnosed cases of AF in UK but it is estimated that the real number is more like 1.2 million.

It is also,worth considering that since the link with AF and stroke was noted in about 2007 there appears to have been more research into the problem and for sure more attention paid to it although sadly whilst this may be the case at senior level it has yet to filter down to many primary care centres where some GPs still do not take it seriously as we are constantly reminded by posts on here.

We must also remember that AFA and before that Arrhythmia Alliance , both brain children of our CEO Trudie Lobhan have been the main reason why any of this has had any credence at government level and this has already led to many new initiatives. Long may it continue.

Bob

* It could be argued that you need a genetic pre-disposition for a lot of conditions/illnesses, cancer being a prime candidate..Not everyone who is exposed to a carcinogenic compound will get cancer for example.

[Hidden in reply to BobD]

Hear, hear, I'm so grateful for the AFA and Trudie, without whom I'm sure we would not be as far down the line as we are. And I always knew my days as an ace fighter pilot would come back to bite me sometime

Lis

[Hidden in reply to BobD]

Hi Bob -- I thought that an overactive thyroid did contribute to AF as it speeded up the heart rate. I have an underactive thyroid treated with thyroxine & had my dose increased by a GP without a test first. I subsequently ended up in A & E with persistent fast AF which was put down to overactivity.

Sandra

[gerryatriq in reply to Hidden]

this was the link I was gonna post earlier in the thread. A rather indepth look at the topic, but some interesting results. It might seem that ensuring a correctly functioning Thyroid could be a useful tool in treating all heart issues, hence my question regarding blood testing.

circ.ahajournals.org/conten...

[Beancounter Volunteer]

Gosh this is a complex area, and one that we are all stumbling around in to some extent, what causes A Fib?

And I think the most honest answer is no-one really knows, there seem to be multiple factors which influence it and hyperthyroidism certainly seems to be linked, which is why as Bob says we are often tested for thyroid with a blood test (I was at least). Is it a cause?

The problem as I see it, in my opinion, is how do you isolate potential causes with so many other potential causes also taking effect?

For an extreme example, we are all subject to microwave radiation in our normal day to day lives, so maybe try giving up chocolate and saying Oh Yes I feel so much better?, but did the radio station down the road actually change their frequency and the radiation no longer effect your heart?.

Unless we were in a lead lined room being fed highly controlled food and drink and on a permanent ECG scanning for the reactions to each input, I personally think that sometimes we can be led astray by our imperfect results of self diagnosis of symptoms.

That's NOT to say that I don't think people should experiment, and see if they can find triggers, and then obviously cut them out of their lives, I just think that we are not all skilled research scientists and therefore need to be a little cautious about drawing too many conclusions, but heck if it works for you then go for it.

But just the potential causes that I have heard from this and other forums, Hyperthyroidism, Sugar, Sacarrine, Aspartame, MSG, Caffeine, Chocolate, Alcohol, Weight, Age of course, Anxiety, Depression, Viral infections, Drugs such as Cocaine and Heroin, Smoking. And as someone has said in this thread, Pesticides, Air Pollution, other food additives, Radiation of all forms, not to mention a dozen other medical conditions that would appear to make us more likely or more potentially liable to A Fib.

So what I am saying is I don't think anyone knows the causes of A Fib, and for most of us, yes we can potentially control or cut out one of the items in the list above, but can you REALLY be certain that all of the others have not changed when you do this?

Just some food for thought and my tuppence worth.

[Gilli54]

Very interesting post thread. My AF started with hyperthyroid. During a stressful period I was not very compliant with my meds and became unwell at work. My heart was racing. I felt very strange. I was referred to the hospital and admitted with AF and tachycardia. I was in for two weeks and blamed myself for not keeping the thyroid under control. I was told that conditions do often go hand in hand. Once my rate was controlled and my INR was within range I left hospital with a cardioversion scheduled a few weeks down the line. That was successful. I was simply taking warfarin, digoxin and my thyroid medication. Stopped those after successful cardioversion. I decided to have a complete thyroidectomy thinking that would cure the problem permanently as my over active thyroid showed no sign of calming down and I didn’t fancy the radioactive option.

However, five years later the same condition of AF with tachycardia re-emerged after a stressful work period in school. This time I only stayed overnight and had a flecainide drip cardioversion, leaving hospital again with no extra meds, apart from my Levothyroxine. The gap then became three years. This time I left with bisoprolol added to the mix. The next episode was a year later. Again flecainide and eventually reverted. Anticoagulants discussed but I decided against these. But my bisoprolol was ramped up to 7.5mg. I felt like I had been stopped in my tracks. A year later I was back. Sent home without a cardioversion of any kind. But digoxin used to control the rate and bisoprolol now 10mg. The hospital was on the highest alert for being busy and I didn’t realise nobody was going to follow this up.somewhere in the midst of these visits my thyroid levels were spotted as being a little low and my Levothyroxine was increased.

I felt so dreadful on all that medication that I went privately to see a cardiologist and to cut a long story short I was cardioverted and given flecainide.

Eventually after several weeks of being in and out of AF and NSR, I settled and stopped digoxin and lowered bisoprolol to 5mg. Still on warfarin but feel much better having reduced the other meds. So not sure how the links work. I know my sister has similar problems to me with thyroid and also had AF.

Could be genetic predisposition. Could be stress and anxiety within our lives. As has already been said, it is not a simple condition and people seem to experience a range of situations. It would be nice if they could find a definite cause. Meanwhile we all have to get on with finding what works for us and adding information into the network. Great that everybody shares their experiences so willingly. Thank you 😃