Well, my doctor says that potentially I could have a heart attack....

[sip1]

Saw my doctor on Monday - they do like to frighten people don't they! He said that, because my FT3 was above range from taking NDT, it could potentially cause a heart attack. Despite the fact that I have low blood pressure and low BP. I also feel well - but that doesn't seem to matter, just the numbers!! He also said that my TSH should be around 1, not suppressed like mine currently is. I did have palpitations from chewing the NDT, but this has ceased since swallowing them.

Anyway - he's going to retest me again now I have cut down by a quarter since the previous test.

My results before and after for reference!

Before:

TSH 2.83 mIU/L 0.27 - 4.2

FT4 14.7 pmol/l 12.0 - 22.0

FT3 4.0 pmol/L 3.1 - 6.8

7 weeks on 2 grains NDT:

TSH 0.01 (0.35 - 4.5)

FT4 18.7 (11.0 - 24.0)

FT3 7.6 (3.9 - 6.8)

Also wanted to add that he said he wouldn't prescribe NDT, but if I wanted I could take T4. He said this would convert to T3 anyway..........

Not going that route.

[Clutter]

Sip, Elevated FT3 can cause atrial fibrilliation so he's right to advise you to cut your dose to bring FT3 into range but there is a member who feels unwell unless her FT3 is over range. See how you feel on the decreased dose. If you don't feel well you can increase it but will have to manage the increased risk of AF.

Don't worry about the TSH, it's suppressed because of the T3 in NDT. TSH may rise a tad on the decreased dose but it's unlikely to rise to 1.0 by decreasing 1/4 grain.

[sip1 in reply to Clutter]

I'll find out in another couple of weeks if it's made much of a difference - I'm intrigued to see if swallowing it has made any difference too. I still feel sick on more than 1 3/4 though - which seems to be the start of being over medicated for me I think. Funny how just a 1/4 can make such a difference! Have also sent off my adrenal test today - I have everything crossed that this is now ok as it's one less thing to deal with. Hate the waiting game.....!

[sip1 in reply to Clutter]

Clutter - should my FT4 be higher than it currently is? And, by cutting down by a 1/4 - won't this decrease as well?? I can't help but think it should be higher than that.

[Clutter in reply to sip1]

Sip, the T3 in the NDT can lower FT4 as the oral T3 bypasses the need for a lot of T4 storage for conversion. Despite that, your FT4 is good.

[sip1 in reply to Clutter]

Ok - I had to read that 3 times, but it makes sense Thank you

[helvella Administrator]

This is not meant to say there is absolutely no danger from long term high FT3. There can be danger and it is well known as an issue in untreated hyperthyroid patients - though very often they have very high FT3 levels. But I would like to know how much care and attention your doctor paid to your heart when un-treated or under-treated for hypothyroidism? There most certainly is evidence that long term low thyroid hormone levels can be associated with heart problems.

It is also interesting how many papers in the past few years have mentioned use of T3 to help with heart problems.

Rod

[sip1]

Well, I had palpitations every now and then before I started the NDT - particularly before menstruation. My doctor checked my heart once, and that was when I kept going back about the tiredness. That was also the same time he ever asked me my symptoms! They have almost completely stopped now - just the odd one during any given day, compared to every 3rd or 4th beat when I upped to 2 - 2.5!

[Parbrook]

This is standard anti-T3 scare-mongering, along with the threat of osteoporosis.

You need to have been on a too-high dose for a long-time for such side-effects.

What they don't tell you is that an inadequate level of T3 over a long period has a far greater negative and potentially permanent impact on the body's organs.

[sip1 in reply to Parbrook]

He did say that it could potentially cause a heart attack - perhaps not now - but sometime in the future.

Perhaps I am being thick - but wouldn't somebody experience a racing heart, chest pains, high blood pressure in the run up to having a heart attack due to having a too high FT3?

[helvella Administrator in reply to sip1]

If you suffer those symptoms, then yes, it seems likely you'd do something about it. But for all sorts of reasons not everyone behaves in the same way.

I have sometimes been shocked at the way in which some patients have continued taking whatever they take despite symptoms. Sometimes with doctors not even recognising an issue and continuing to prescribe and ignoring what the patient reports. Sometimes despite advice to do something different.

Rod

[leroi01 in reply to Parbrook]

What are the long term effects of inadequate T3 on the body organs as generally understood? Heart, anything else?

[Parbrook in reply to leroi01]

I am no expert, but from what i have read most parts of the body can be damaged by long-term T3 insufficiency.

Apart from the heart, the most obvious one is the brain.

There seems to be a view that Dementia can be one of the consequences and there is a clue to this with Hypothyroid symptoms (lethargy, forgetfulness, fatigue).

[Gookygal]

you mentioned that your gp was aware of palpitations prior to you taking NDT , and you indicated he tested, did this take the form of an ECG? If not then it really should be advisable in order to get a better picture of what is going on.

[sip1 in reply to Gookygal]

Ah no, I meant he listened to my heart - that was it. They are ectopic beats - rarely get them now days, other than when I take too much NDT or before a period.

[Muffy]

What time of day did you have your blood test? Next time, make sure it's as early in the day as possible and also don't take your meds before your blood test.

[sip1]

I think it was 8 or 8.30, can't quite remember. I didn't take any meds since the previous morning, so that shouldn't have been a problem.

[TSH110]

I had heart palpitations on and off for 25 years. I did get tests 10 years ago and ECG was abnormal (much to my horror) then an exercise test with scans. I was told one chamber was not working properly but not to worry it was just a hormonal thing some women got esp during menopause. They got worse and I was eventually diagnosed with hypothyroidism (overt by this time c. 3 years ago). Treatment on Levo progressed glacially cos the heart pains were bad and I had had a serious episode of hyperthyroidism just before the final hypo state, so dose increases were small and very gradual. It took 9 mths to get me optimised and I was best on 125mcg Levo daily but this was reduced and I got many hypo symptoms persisting including the heart pains. After 2.5 years I switched to NDT (self medicating) and feel loads better. At last the heart pains have resolved but my heart beats a lot faster (c20 bpm - that started straight away on taking the Levo but NDT has not reduced it). I take 1.25 grains a day so about equivalent to the Levo dose. If anyone told me I was asking for a heart attack on NDT I would laugh in their face - common sense tells me this medicine works better for me than Levothryoxine, and my heart prefers it too, just a shame it still beats faster - no idea why. I have never had blood tests since self medicating and would expect my TSH to be suppressed from the helpful info given on TUK - but as I feel pretty much like the person I used to be (rather than a shadowy version of my former self on Levo which really did my head in) I think I can't be that far wrong with the dosage. I just go on how I feel. Thought you might find my experience an interesting comparison. If I do die of a heart attack at least I feel alive now not like some sort of malfunctioning zombie! I'd have no regrets either - quality not quantity is my mantra.