Please help Re: palpitations!

Hi everyone,

I am 40 & was DX last year with autoimmune thyroiditis.

I am now up to 100 mg of levo which seem's to be my optimal dose. My TSH at DX was 14 & now It's 1.6, the lowest it has been since DX.

Since my 20s I have suffered from palpitations due to anxiety on & off but did at that time have an ECG & scan which showed no structural abnormalities of my heart, so I just learned to ignore them & they didn't worry me until now . I tend to get them more at night or when I am tired or anxious but for the past few days I have been suffering from the palpitations in the day & at night & they are more frequent then I am used to. I wasn't feeling particularly anxious when they started but maybe a little tired, having not slept well the night before. It has been a few days now & they are not completely going away, despite having slept well & laying of all caffeine except green tea!

The thing is, I am fine until they do start, then I start worrying about them again, probably making them worse, so it's a vicious cycle!!

My question is, could these increased palpitations be down to my lower TSH (1.6, bloods taken beginning of Aug?) I have been on 100 mg of levo since last Christmas so thinking it's not the levo as surely I would have noticed these increased palpitations before now?

If any one can shed some light on this I would be very grateful as I am starting to worry about them a lot now. Thanks.

27 Replies

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  • Palpitations can be scary . Just wondering if your Levo is converting into the Active Thyroid hormone T3. Do you have any recent blood test results with ranges that you could post.

    Also how are your levels of Ferritin - Folate - B12 - VitD ? They need to be optimal and not just in range. Low iron can cause palpitations as oxygen sticks to the iron in the red blood cell for transportation around the body. Low Iron = Low Oxygen - and so your heart beats faster to try an push more oxygen around the body.... You also need good levels of Ferritin - stored iron - for a good conversion of T4 into T3.

    Please read my Profile to see that I am not a medical person - just a fellow sufferer :-)

  • Thank you for your reply! When you say fellow sufferer do you mean with the palpitations, the thyroid or both? With either, you have my sympathy!

    I had the full whack last year re: testing for everything along with iron, b12 etc & all came back 'normal' Stupidly, & being newly DX, I did not think to ask for a printout, although I wish I had done!

    As it has been over a year since those bloods were taken I think it wouldn't make much difference really for me to get a printout now. Probably best for me to go see the doctor really & ask for more bloods but a little scared (i'm such a woose!)

    Iron. potassium, calcium & magnesium deficiencies have crossed my mind. Trying to increase all with diet as much as possible. I know I am always on the lower side with iron but never enough to require the supplements! Although I do take a multi-vitamin (Holland & Barratt) that is supposed to give 129% NRV (nutrient reference value.) Does this mean with it being 129% that it is more than the recommended daily requirement? It's a special one for women 'Ultra Woman.' To be frank I feel more like coma woman!

  • It is best if you request a new blood test. Ask for TSH, T4, T3, Free T4 and Free T3 plus vitamin B,vitamin D iron, ferrin and folate. We are usually deficient if we are hypo.

    Make the blood test as early as possible, fast too. Leave about 24 hours between your last dose of levo and the blood test and take levo afterwards.

    Levo should be taken first thing with one glass of water and wait for about an hour before eating as food can interfere with the uptake.

  • Yes I have Hashimotos and HAD palpitations ! It was those that took me to the GP here in Crete in 2005 - after which I was diagnosed. I am now T3 only and am now free of the palps !

    You need to take supplements individually - apart from a good B complex. You could obtain your results from a year ago and post in a new post for people to comment. Also good for you to have them so you can monitor your own progress.

    Click onto peoples name so you can read their profile....

    Always be prepared to pay a good price for vitamins - the cheaper ones usually have lots of fillers....

    So for testing I would suggest Ferritin - Folate - VitD - B12.....

  • Hi Marz. I suffer Realy bad with palps also inner bidy trembling. should I stay on iron I thought to stop all vits for sep because I've been reading Isabella wentz an she states about methol b12 to reduce an ive been taking them everyday from June . That's why I thought il just stop everything for a month . Just wondered what your advice would be

  • When did you have your last blood test for the thyroid and ferritin - folate - B12 - VitD etc.... ??

    Inner trembling can sometimes be caused by low adrenals....

  • I got them done in June past an got the cottsol blood done but it was to late in day when I checked the range time I was way past it . Thank you for ur help 😁

  • Palpitations can be a sign of too much levo or too litte or being undiagnosed hypthyroid. It can also be caused (in my own case) due to something in the fillers/binders which were giving me palpitations.

    I've been given the all clear on my heart too but as soon as some T3 was added to a reduced T4 my palpitations calmed down. Ask your GP if you can have a trial of some T3 to a reduced levo for a few months and you will be lucky if he agrees.

    If you've had a recent blood test get a copy from the surgery with the ranges and post on a new question if you don't have them at present.

    AlsoIf you take a note of the make of levothyroxine you are on and make sure you get the same one each time you collect your prescription. If you then begin to have problems ask chemist to give you another make and see if you feel better. Sometimes the fillers/binders in hormones can cause us problems.

  • Thanks for your reply. Could you tell me which make of levothyroxine caused your palpitations? That would be very helpful. Yes my brands change all the time & didn't think it could possibly be that!

  • I couldn't say for sure now as I've now chopped and changed so much. I do know for sure that Eltroxin didn't cause any problems and that was the only Brand in the UK. Now there are only generic ones available. Eltroxin was stopped for some reason but I think it's because the makers might get bigger profits from the generic which replaced it.

    I had palpitations with whichever levothyroxine I took. It might just be my body but doctors don't realise it is the medication. I am on T3 only now and am fine with no problems and feel well. Sometimes the addition of T3 can be helpful.

    There is a big learning curve when we have hypothyroidism which isn't helped and we don't realise why we are still unwell despite taking prescribed meds.

  • Minniemuffinmoo, Palpitations improved slightly when I switched from Mercury Pharma to Actavis (also known as Almus). They were always worse at night and I found adding a pillow and sleeping slightly raised made me less conscious of them and able to sleep.

    TSH 1.6 is a little high for most people on Levothyroxine and most are comfortable with TSH just above or below 1.0. Palpitations can increase when undermedicated, a small dose increase 100/125mcg alternate days might ease palpitations.

    thyroiduk.org.uk/tuk/about_...

    Low ferritin can also cause palpitations so ask your GP to check. It's also worth asking for vitamin D, B12 and folate to checked too as they're often low/deficient in hypothyroid patients. Post the results and ranges in a new question for comment and advice.

    Finally, it's widely thought that autoimmune disease starts in the gut and is triggered by gluten. My palpitations were very bad when I was diagnosed with Hashimoto's eleven months before I was prescribed thyroid medication. 100% gluten-free diet can be helpful in reducing Hashimoto's symptoms and antibodies.

    thyroiduk.org.uk/tuk/about_...

  • Because 1.6 (tsh) is the lowest I have ever been since dx & my palpitations have been more of a problem the last few days than in a long time, I am starting to lean towards iron def as a possible cause. As I mentioned in initial post, I am prone to being low but not enough to be prescribed iron supplements. Also, I have been given actavis the last 2 times I have had to renew prescription. I have had no problems with them in the past. Only getting more frequent palps in the last 3 days or so. Before, I only got palpitations now & again or when anxious, not on a daily basis. But I have had them for many years.

    I will get my iron levels checked asap..

    Many thanks!

  • Minniemuffinmoo, NHS rarely prescribe when ferritin is within range but iron can be bought over the counter to optimise levels. Ferritin is optimal half way through range.

  • Thanks, yes I know NHS won't prescribe if ferritin within range. As stated earlier I have bought iron supplements myself, with an NRV (nutrient reference value) of 129%. I have no idea what this means really. I think it means 129% of recommended daily intake?

  • Minnie, I think it's the same as recommended daily allowance. Does it say how much iron is in mg?

  • Hi, yes it say's 18 mg. Do you know if that's enough daily? :)

  • Minnie, it's quite low, try 2 or 3 a day separate doses. Ferrous Fumarate 210mg contains 65-70mg elemental iron. Retest ferritin 4-6 months after supplementing. Too much iron is as bad as too little.

    Take each tablet with 500mg-1,000mg vitamin C to aid absorption and minimise constipation. Levothyroxine should be taken 4 hours away from iron.

  • Ok thank you. Think I'm going to ask doctor to do bloods anyway before I try supplementing with iron alone. The one I take now is a multi-vitamin.

  • Minnie, multi-vits rarely have enough of anything to be useful.

  • Really? What about diet? Is that better than supplementing?

  • So 129% of iron a day is not enough? That's what my multi-vit contains.

  • Minnie, a ferritin test will tell you whether it's enough.

    A person can take 10,000% of RDA but if they aren't absorbing or retaining iron it's not enough.

  • Ok thank you Clutter! I will leave you in peace for now..many many thanks for your help!

  • Just looked it up & it say's that woman should be consuming around 10 mg of iron a day if not menstruating/nursing. Therefore, with the supplement, I am getting more than enough by the looks of it. Could be magnesium deficiency causing the palpitations or potassium def. Is there any reason that my thyroid condition could prevent uptake of iron? Thanks.

  • ..yes but as Clutter said are you absorbing the iron into the system. Only a test will reveal your Ferritin level.... I cannot see any reason why the thyroid medication prevents uptake - but being Hypo slows most things down :-( Regarding magnesium - I have read that most people are low in levels.

  • I've had this! My mess were increased and it stopped good luck

  • I mean meds. ..sorry but interestingly I also took magnesium as i read they help migraines

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