Confused

[Wob58]

Please see attached copy of letter from my Cardiologist. Not sure what he is trying say in the second paragraph starting This current recording suggests that not all her symptoms are caused by abnormal fast heart rhythms .... I do not see myself as a hypochondriac. These episodes of high heart rate are real and hard to ignore at times. I have to sit down when it makes me feel light headed. I feel exactly the same symptom wise before I had the procedure and they know that. I am at a loss as to what is really causing them. Its not stress or anxiety. Due to Covid my next review is not until March 2022. What does the last sentence in the first paragraph mean in lay mans terms? Feeling frustrated because I cannot think what may be causing them. The Medication I take is Thyroxine for Hypothyroidism, Flutiform for very mild Asthma and Amitriptyline 10mg one a night. The only other thing to add is that I am a 61 year old Menopausal woman. I was hoping to start taking HRT again following the outcome of the Ablation procedure. I am hoping to still do that despite the episodes of increased heart rate. Any advice or help would be more than welcome.

[Hidden]

My take (and I could be wrong) is that they are suggesting that what you think is a racing heart rate is actually palpitations. I get palpitations from time to time that can last several minutes and it can feel like my heart is racing when it is actually still at resting rate.

[Wob58 in reply to Hidden]

Thank you for your response. If it is palpations its certainly not a resting heart rate. Can be up as high as 150. The trigger seems to be exertion but not much exertion.

[Hidden in reply to Wob58]

Sorry to hear that. I hope you are able to get to the bottom of it.

[Pete1]

I concur with Supafil. I had many a sleepless night worrying myself to sleep. I had all the tests and all came back fine - but I was still getting palpitations. Over time the symptoms got less and less until I stopped getting them. The doctor discharged me back to my GP but was never given a reason for my symptoms. I put it down to a virus. Have been fine ever since.

[Wob58 in reply to Pete1]

Thank you for your response much appreciated.

[soppysokes]

seems to be saying pretty much that you getting ectopic beats occasionally. could it be that because you are now very aware of heartbeat, as and when the ectopics kick in that alone then gives rise to increased heartrate something like palpatations? you mention you are taking thyroxine for hypothyroid problem- if your dosage and blood levels are not optimal the thyroid issue is very possibly the reason for your ectopic beats and feelings of palpatations.

[Wob58 in reply to soppysokes]

I have been on Thyroxine for so long without any problem before. My dosage is only 75mcg daily. Nobody in Cardiology has mentioned that this could be the cause.

[davina70 in reply to Wob58]

I have been having palpitations for several months ..after an echo and two ecg’s my heart apart from a noisy normal murmur has been declared excellent by cardiologist ..so my GP has now reduced my thyroxin by 25mg to 100 its only been a week apparently can take three to reduce levels watch this space I’m hoping !!

[Wob58 in reply to davina70]

Thanks for response much appreciated. Everybody has got me thinking about the Thyroxine. Only taking 75mcg daily. I need to raise this with the Cardiologist.

[bantam12 in reply to Wob58]

75mcg thyroxine is only just above the starter dose of 50 so you may well be undermedicated as many people are ! Ideally we need TSH below 1 with T4 and T3 in the top half of the ranges.

I'm also on thyroxine 125mcg but still have constant ectopics, unfortunately with hypothyroidism it's not an easy fix.

[soppysokes in reply to Wob58]

Hi there. without doubt the thyroid can affect heart performance and does if either under/over medicated give rise to palpitations, ectopic beats etc so if your heart,as such, has been cleared as ok it may be worth getting thyroid levels properly checked. Depending very much on the cardiologist, many will show little interest in the connection and would likely to suggest an endocrinologist/GP to delve further. If you are in the position to do it a good thing is to get a FULL thyroid blood panel done via a private test, giving far more detail than the usual TSH( and free T4 if you are lucky!) that is done on NHS.

[Wob58 in reply to soppysokes]

Thanks I will get in touch with GP. Easier said than done due to restructions

[soppysokes in reply to Wob58]

the problem you may encounter with any gp is that the nhs can only go by the book and will normally be allowed by labs to only check TSH and if it falls within the ‘normal’ range they will then usually tell you that its fine when without the Free T4/T3/antibody checks/certain mineral and vitamin levels that cant be safely assumed. If you havent already a good place for full info is on healthunlocked thyroid site.

[Wob58 in reply to soppysokes]

Thanks I will look at the Thyroid website. My results always say satisfactory. I just think we'll there happy so don't worry about it. Bit complacent if me perhaps. So what does that really mean. Do I need more or less Thyroxine.

[soppysokes in reply to Wob58]

Hi there, Thing is without the full thyroid panel bloods its not possible to see the full picture enough, which is where the nhs blood test for it is so limited, “if the tsh is in range, your fine”. That is so often not the case. But, and a big but, is because thyroxine is such a dose sensitive medication it can be, and often is dangerous to try to mess with dosage without the full tests, so please dont try to guess it and do it yourself.As others have said here its important to take at correct time and within the food intake before and after, not adhering to that can render the thyroxine pretty ineffective. Thyroid uk will give good solid advice.A private blood test, which they can direct you to is a great way to start if it is possible for you to do that, then if full results come back and flag up an issue you have solid evidence to take to your gp and get further help.

[Wob58 in reply to soppysokes]

Thank you again for your advice. I really don't know why the NHS don't do a full panel for Thyroid unless it comes down to cost again.

[richard_jw]

Could it be medicine related?For instance I believe Amitriptyline is associated with Long QT syndrome which may be related to arrhythmia. But I'm not a doctor or dispensing chemist.

[Wob58 in reply to richard_jw]

Thank you for your response much appreciated. I will look into the Amitriptyline angle.

[pasigal]

I can tell you only that I have had many episodes of stress-induced heart actions/palpitations, for lack of a better word, including some panic attacks that felt like I was having a heart attack that sent me to the hospital. It's tough -- but if all the tests check out, then you just have to trust the data. It's not hypochondriasis at all if you have physical symptoms, just the line between the mind and the heart...

To repeat: I think the hardest thing for me as a heart patient is separating "real" problems from those tied to my own anxiety.

[Wob58 in reply to pasigal]

Thank you for your response. Much appreciated.

[Thismorning]

I have just read on my Takotsubo support site that thyroid medication affects your heart rate ?

[Wob58 in reply to Thismorning]

Thanks for reply. Only on 75mcg daily is that enough to affect my heart. Why now been taking it for years.

[Thismorning in reply to Wob58]

No idea ,just telling you what I read ,best of luck

[Lilypocket]

Hello,It might get be worth looking at your dose of Thyroxine. Perhaps it needs " tweaking". I take Thyroxine and have PAfib and have slightly reduced my dose of Thyroxine ( following cardiologist's advice) due to increased episodes and a very low TSH. The difficulty is finding a Dr who can look at the whole picture ( thyroid and heart relationship).

Take care

[Wob58 in reply to Lilypocket]

Thank you for your response much appreciated. Didn't think that Thyroxine could be an issue. Cardiology have not even mentioned it. How safe is it to lower dose when your body needs it. I have Hypothyroidism.

[Lilypocket in reply to Wob58]

Hi I wouldn't be able to advise you on safe dosage. I was following my cardiologist's instructions and am seeing an endocrinologist in December but my heart seems less jumpy since reducing my dose. I feel certain there is a connection. But next time you can get an appointment with your Dr you could mention this.Take care x

[MyJinksy]

Prior to my heart attack I had several unexplained bouts of racing heart beats that were eventually put down to issues with my thyroxine dose being too high. The doctor reduced the levels and the episodes stopped. I also found that the way I was taking thyroxine affected its viability. I had become complacent with taking the medication and had fallen into bad habits. It should be taken First thing in the morning with a full glass of water and do not eat for 30 mins as it has an impact on its effectiveness. I hope all goes well with you in the future.

[Wob58 in reply to MyJinksy]

Thanks for your response much appreciated. Didn't think it could be the Thyroxine. Have been on it years with no problem. Only take 75mcg daily. I must admit I take it in the morning then have breakfast straight away. I am have Hypothyroidism. Perhaps I need to take it on waking then shower etc giving it time to take effect.

[Ansteynomad]

Agree with PP that your first step should be to take your Thyroxine strictly as per the instructions. Alternatively, you could move to taking it at bedtime if you haven’t eaten for two hours before.

The rules about starting Thyroxine have now changed and the starting dose is now based on your body weight in kilos x 1.6. If you do that calculation and get a result that is more than 75, it could well be that actually you are undermedicated and need an increase.

[Wob58 in reply to Ansteynomad]

Thanks going to get in touch with GP.

[nellie237 in reply to Wob58]

Hi Wob58,

I am also going to suggest that before getting in touch with your GP that you read through some posts on the thyroid forum.

The best advice I received was to obtain copies of my blood test results, preferably via online access, but if this is not available at your surgery ask the receptionist to print copies of all results for the past couple of years. Getting online access is usually filling in a very simple paper form and providing ID.

I discovered that I had been low on Iron, Folate, B12 for years, and the surgery hadn't told me.

[Wob58 in reply to nellie237]

Hi had blood test done via GP. Useless if course because they don't do a full test. So will now go private route. I moved house over a year ago so getting hold of past test results will be difficult.

[LMor]

Hi. Just letting you know that “Monitor my Health” website do Thyroid finger prick test for £29. That includes Tsh, T4 & T3. If you type in THYROIDUK10 at checkout you will get another 10% off. I use them all the time and they are very good & the cheapest around. Good luck.

[Wob58 in reply to LMor]

That's very kind of you.. Thanks.