Palpitations on T4/T3

[pandaheaney]

Am taking 25mcg. Levothyroxin and 20mcg. T3 (in a split dose) but experiencing palpitations and

missed beats.  Should I reduce the T4?  I cant increase the T3 at present as I dont have enough tablets 

left.

[shaws Administrator]

Your dose is quite small so it could be that you need an increase in your meds.

It is a bit complicated in that not sufficient hormones can cause our heart to beat incorrectly, also, if too much heart would race and palpitate too.

On looking at a couple of your previous posts I see you were treated with atrial fibrillation when on levo.

I had similar when on levo (not atrial fib but palps) but when I stopped levo so did the palps. I am not qualified to advise but just give my own experience and a suggestion. 

I take T3 only in one daily dose. T3 is required to saturate all of our receptor cells and then the action begins and lasts between 1 to 3 days. I take around 45mcg. Your combined dose at present is equivalent to 85mcg of levo.

If you stop T4 dose for a few days to see if T3 only would suit you better and calm your heart/body. You would need to increase your dose of T3 to be equal to your combined T4/T3 dose i.e. 1-and-a-half T3 which would be equal to approx 90mcg T4.

web.archive.org/web/2010103...

[pandaheaney in reply to shaws]

Thanks, will stop T4 and see how I feel.  Will try and get new prescription

for T3 so I can increase my dose.

[shaws Administrator in reply to pandaheaney]

Please remember that I'm not medically qualified just have my own experience.

[pandaheaney in reply to shaws]

I would add that I went gluten free a couple of weeks ago and wondered whether that could have affected my T4 absorption to give me the palpitations.  My anxiety levels have increased over the last few days also. Does T3 react to gf too?

[shaws Administrator in reply to pandaheaney]

I don't think gf would affect T4. It affects the antibodies by helping reduce them. That's all I know.

If' you've had your test results put them on another post.

[jimh111]

A month ago your posted "Was taking Levothyroxine 100 mcg for 10 years then started to get palpitations, missed beats and landed up in A&E with Atrial Fibrillation. Diagnosed with T4 toxicosis and taken off T4 for short period where I immediately felt better. IBS I had had for years cleared up and I was less anxious. However my TSH went up to 44!"

I would reduce the liothyronine (L-T3).  However, you should be getting advice from your GP and pehaps a beta blocker to protect your heart.  Did this endocrinologist measure your fT3, fT4 when your TSH was 44?  They should have this information before putting you on L-T3.  Levothyroxine (L-T4) is a safer option than L-T3 because the heart can adjust local deiodinase to reduce over-stimulation.  Apart from your TSH going up to 44, how did you feel?

[Marz]

Cannot see any test results for your thyroid - perhaps I have missed them !  Could you post them with ranges ?  I am T3 only like shaws.  When I first started taking them I knew when the next dose was due - as I had the flutters - once I had taken the split dose all was well.

How are your levels of Iron - Ferritin - Folate - B12 - VitD ??  All need to be optimal for their various ranges for you to feel well and for the thyroid hormones to work efficiently.....

There is a book on Amazon called - Thyroid and Heart Failure.  You can look inside at its contents - it's a coming together of research papers from Cardiologists and Endocrinologists - possibly for the first time - and T3 or Liothyronine seems to be the star of the show !  Heart issues are not confined to the heart - it is a systemic condition - and the endocrine system also plays its part.

Low iron can also cause the flutters.

I am not a medic - just a Hashimotos girl with Low B12 issues !  Which reminds me - have you had your thyroid anti-bodies tested ?

[Clutter]

Pandaheany,

I would have TSH, FT4 and FT3 tested before adjusting dose.  Palpitations can be due to under and over medication.

__________________________________________________________________________________________

I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

[pandaheaney]

Thanks for your replies.  Having new bloods done again next week and appointment

with endocrinologist a week later.