New member with heart palpitations.

Hi. Everyone.I am new here.I have been taking levothyroxine 75mg for about 14 years now. Originally diagnosed under active thyroid after investigations for heart palpitations. Been taking Levo ok but last few years have not felt right. Had op for endometriosis 4 years ago as had stomach pains for several years. Op did not cure the low stomach pain at all, then Dr Diagnosed IBS. The palpitations have always been there but not regular. Now they are more frequent and Dr has referred me to a cardiologist. I noticed a while back that my skin looked slightly yellowish I was feeling tired and brain fog, (which I think I've had a while and not really realised) So had bloods done. Asked for t3 etc to be done, but although DR had put on form lab didn't do. Here is result I have so far.

TSH level is 0.14 (range 0.27-2.2).

free T4 is 18.5 range(12.0-22.0)

B12 is 490ng (180.0-900.0)

folate is 10.4 ug (4.6 - 9999.0

ferritin is 39ng/ml (15.0 - 300.0)

25-hydroxy bit D 89nmol/l (50.00 - 900.00) stating between 79 and 150 as sufficient.

Dr has said that these results are satisfactory. Satisfactory to her maybe.

Any advice anyone can give would be appreciated as I've just really started to try to take control of this. A bit late I know, but I had always accepted that the GP new best. I have just obtained a few books that I've seen recommended on here too, which suggest lots of different supplements. Any notions on why I'm getting palpitations? I don't feel particularly stressed.

I did couple of the test indicated in one of the books for adrenal failure. (The eye pupil and blood pressure) and that seemed to point to an issue wth my adrenals. My blood pressure is always low ranging 115/57 119/42 and pulse ranging 45 to 50, taken first thing in the morning. I am considering having private blood test done and the swab for adrenaline.

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Hi - you mention PoTS in your post. PoTS can be a condition of itself but is often secondary to other diseases - not only thyroid disease. If you have Hashimoto's hypothyroidism you can also get other autoimmune diseases. These can be of the rheumatic family - and there are broadly five of these diseases or syndromes that could be affecting you now. These are RA, Lupus, Sjogren's, Vasculitis and Scleroderma. Plus there are overlap diseases known as UCTD and MCTD. As well as these there are neuro autoimmune diseases such as MS that can cause PoTS and immune mediated spondyloarthritis such as Psoriatic Arthritis and Ankylosing Spondyloarthritis. There are sub diseases within most of these umbrella diseases too.

I say this not to worry you further, but just because, to me your thyroid results look okay, although others here know far more than me about this and may disagree.

You may want to go back to your GP, say that you feel rubbish and could they please run a full blood count, inflammatory markers ESR/ PV and CRP and autoantibodies for rheumatoid factor and ANA. If possible also vitamin D again.

For an example of why these tests are a good idea, most people with Sjogren's are also hypothyroid, although obviously this doesn't work the other way around as only about half a million people in the UK have Sjogren's. Many with Lupus and RA also have Hashimoto's.

PoTS can be tested for by your GP and may be your problem by itself. I think the main test is whether your heart rate rises by around 30bpm from sitting to standing - and this should be tested immediately and then again after standing still for 10 minutes. I think that, if it rises by 30 beats per minute this is autonomic and you have PoTS. Not sure if there are treatments but it's important to know the underlying cause, if there is one, as treating this should also help your PoTS.

Sorry if you know or have tested for all this already. I'm learning as I go along so just sharing what I've learned so far in case it's useful to others.

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Ps I should have added Addison's, Graves and type 1 Diabetes to my list of the endocrine autoimmune diseases that can cause PoTS

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Hi Twitchtoes- Thank you for replying. All this a bit daunting, but will look into these a bit further. I did have a full blood count done but looking at the inflammatory ones you advise, I don't think they were included. So will go back and ask for them.

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I didn't mean to make you feel daunted at all but I wanted to give you something to work with as you requested. I have found it impossible to account for everything by focussing only on my thyroid - the whole systemic process has to be investigated and understood if PoTS is your main concern.

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Ps but apparently testing for PoTS is very simple and any GP can do it!

[jacrjacr]

this is just my personal opinion but if you are on t4 only, it is best for your tsh to be around one and less than that can cause heart paps...it happened to me....my dr shoots for 1 and no higher than 2, your b12 could be higher yetyour free t3 was not tested, many things can cause heart paps, how is your ferritin iron hence i was told higher around 70-80 is better or cause fatigue and even hair loss,your stomach problems can cause poor digestion therefore deficiencies in poor absorption ... probiotics before bed help....and or enzymes with meals... i think you may do well with a more nature path dr that will look deeper....also do you have high coritsol....i was shocked to find i do......stress can cause it and with it i had low dhea and low testosterone so adrenals need to be checked.....just personal thoughts from my own battles