"Normal" TSH and T4 but resting heart rate too slow (52 BPM) !

Does any one else have any experience of this? Was diagnosed with Hashi's last year and am on 75 mcg levothyroxine. Over the last couple of months I have noticed my pulse rate becoming slower - at rest it ranges from 52-56 bpm. I asked my GP for a retest of TSH and T4 and today they tell me these values are "normal" i.e. within the reference range (receptionist did not know exact values). Have made appt to speak to GP about this as I suspect values are close to being outside of the range. Has anyone else been through this?

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19 Replies

  • I read that some people become more hypo on a low dose of levo. Your thyroid stops squeezing out whatever hormones it can make but you're not on a high enough dose to correct your levels, so you're actually getting less than you started with (or if my interpretation is incorrect I'm sure someone will explain it correctly for me).

    When you get your results for both sets of tests you should be able to see whatever progression there has been since your first test. I'm surprised that they didn't do the second test earlier considering you were on your 'trial' of the meds and it can take some tweaking to get the dose right.

    How are you feeling? Were you symptomatic before and are you now?

  • Thanks for your reply. I should explain further: Last year, when I was diagnosed in May 2012 I had a TSH of 8.1 and T4 of 10.7 and was put on 25 mcg (can you believe it!) which of course was not nearly enough. It was then upped to 75 mcg Sept 2012 and TSH dropped to 7.1, then 1.4 (Oct 2012), then 0.83 (Nov 2012) and finally to 0.68 (T4 not measured) by Feb 2013. Felt OK until a few months ago and very recently symptoms have started to reappear i.e. slow resting heart rate, dry skin, fatigue, muscle aches, etc. Makes me think TSH has crept up again, but obviously not beyond the reference range.

  • Yes, this can happen (I fear it is happening to me too). But it seems like you're quite sensitive to t4, so maybe it's time for a cautious adjustment. After all, you're not on very much; there's room for maneuver.

  • My TSh was said to be normal range but its moving around who knows what my normal actually is. It went to 2.7 then 3.87 then 2.9 but the only other test I think is something to do with hormones I think he said it was 22 and within range top could be up to I think he said 33 but I have all above syptoms plus my resting pulse is usually around 42 and has been for years palpitations and a steady temp when I get out of bed of 34.9 asked for a trial but no chance. Does anyone know if I can go see someone private not much money but very desperate to get help struggled especially with all above plus weight gain for all my life but always ignored. Or any trial or research for us who can't get treatment but have all syptoms. Getting desperate even thought of getting medicine on line that fed up. Any help would be great :(

  • Hi Shirley, Probably the best thing for you to do is get a blood test done privately to see if you have autoimmune hypothyroidism (Hashimoto's). Blue horizon medicals do one for TSH, T4, free T3, free T4 and Thyroid antibodies (Google it). It is worth finding out - then you will have some evidence for treatment, if reqquired.

  • Thanks for that will do that. :)

  • Have you got Hashimotos ie have you had your antibodies tested

    And the Free T3 and Reverse T3 tested?

    If you are still sick then you may well need more T4 or even T3.

    SHirley - the TSH does not measure your thyroid levels - the TSH is produced by the pituitary...

    Then the Thyroid is meant to be stimulated buy the TSH to produce T4, and T3 (and T2, T1 and something else as well)

    Without T4 as a minimum and probably Thyroid Antibody and even T3 testing you cannot be deemed to be "well" with a high TSH (>1) and so many symptoms.

  • I think I'm going to get these bloods done private see what happens. Thanks

  • I have been Hypo for 27yrs and my heart rate has always been between 47-54, I am ok but walking up slight inclines makes me ridiculously breathless. Am on 125 Levo,, cannot lose weight. Have started going to the Gym, this is my second week and always eat a healthy diet as also type 1 diabetes (with insulin pump) and have only lost a 1lb. Disheartening to say the least.

  • Thanks Kathy21 - I am glad to hear that someone else has a low resting heart rate. Was it like that even when your TSH was considered 'normal'?

  • Hi Khepri, Well my TSH is considered normal by my GP. But I need to retest. I have join a Gym 20 mins. fast walking it only goes up to 110-120 and I'm definitely not an athlete lol. I have followed the links to stop the thyroid madness and think some of the supplement might help converting T4 to T3 which should help to get my metabolic rate better. Best wishes Kathy. x

  • My conversion was meant to be fine but the only thing that helped me was adding in a little t3. I lost weight, no longer struggled with oedema and had much more stamina. Not feeling so great now and I'm looking to tweak a little so it's not a magic bullet, but a little taste of normality was just great...

  • "walking up slight inclines makes me ridiculously breathless"

    I believe someone once wrote that that was a sign of adrenal insufficiency.

    Its certainly a mitochondrial energy source failure

  • I think when pulse drops to 35 you're dead :)

    Mine went down to low 40's on beta blockers [now stopped]. Recently ,on Levo 25mcg, it was 44 at one point. Steady at 60 normally.

    My view- if something like adrenal depletion is causing your body to slow down then the heart rate will follow the same course and lower to suit.

    Getting it back higher for activity must put further demands on the body and why, if too much is done, a crash must surely follow.

    We've all been there ;) I do keep fairly fit with walking and yoga, though.

    The only Drs who 'get it' about energy levels are those with low T function themselves, it seems.

  • Hi Khepri, Did you take your Meds on day of test. I did that's why I need a retest. Also ask for a printout. I did so I can start to compare future tests. Good luck, kathy21. x

  • My resting pulse went down to 42 in the end. Basal temperature about 35. something low. I was a tortoise hibernating. Hot bath in the morning to get moving. Hot bath at night to warm up enough to get some sleep. Half dead all day.

  • Hi Issy, have read about Sellenium and B12 and am going to try them. With what I have they are pretty much essential for Hyperthyroid people. Good luck, hope you soon get moving. Kathy21

  • Hi Tegz, thanks for reply, nice to know were not alone. I have been to some recommended web sites and am going to take Sellenium and B12 which apparently should up my energy levels, I'm forever hopeful.

    Thanks Kathy21

  • You need to have your free t3 checked. This is just as important as t4 (synthroid), and could be a result of your low heart rate if your body is not coverting any t4 to t3.

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