Does a suppressed TSH cause heart problems - Thyroid UK

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Does a suppressed TSH cause heart problems

BURKEB3 profile image

Hi. consultant has said that a suppressed TSH may cause weakening of the valves around the heart so may cause heart problems. also said that TSH is not suppressed by WP Thyroid (ndt). reduced meds from 2.25grains to 90mcg 3 days and 75mcg 4 days. just looking for comments.

23 Replies

I think you might well find that he is using something other than his mouth to speak.

Anything which contains T3 will suppress the TSH, but unless you are overdosed, which involves checking the T3 and the T4, you will not be putting the heart in danger. As ever, they get confused with a suppressed TSH due to an overactive thyroid, which means extremely high T3, and a suppressed TSH due to being optimally medicated.

In fact, being underdosed with Hypothyroidim is FAR more likely to cause heart problems.

Steni profile image
Steni in reply to marram

Oddly enough I was told a similar thing today too ( see my post this evening) that I was creating heart problems by having such a low tsh

shaws profile image
shawsAdministrator

A 'Consultant' - what is his speciality as it is obvious from his comment that it isn't hypothyroid/hyperthyroid.

Has he switched you to levothyroxine, to 90mcg one day and 75mcg for 4 days?

because 2.25 grains of WP Thyroid is equal, in its effect to 225 of levo and when on NDT we should increase dose about 1/4 to 1/2 till we have no symptoms and feel well..

Why should they frighten the patient into submission?

BURKEB3 profile image
BURKEB3 in reply to shaws

Well, marram. I must say it was good to get a laugh re using something else and yes shaws, fright tactics were used re overdosing etc., very much the idea that because the TSH was suppressed that I was overdosing so heart and bone problems immediately. I did stop taking tabs for 2 days but back on meds now.

put me on Armour but was considering thyroxine and may be the end game.

very suck it up attitude when queried over the low dosage and possible side effects. not sure if I should reduce or even if I should go back to this consultant.

shaws profile image
shawsAdministrator in reply to BURKEB3

It would dent your confidence somewhat. People who've had thyroid cancer have to have a suppressed and they don't appearing to be dropping with heart attacks or osteo otherwise there would be a calamatous amount attending the A&E. :)

BURKEB3 profile image
BURKEB3 in reply to shaws

this was a second opinion so it has certainly left me confused and unsure how to proceed.

The book - The Thyroid and Heart Failure - sits on my shelf. It is full of research papers - most of which can be found by googling PubMed. The authors are Italian and it is where an Endocrinologist and a Cardiologist came together for the first time for the purposes of research. They found the best papers to illustrate the connections between hearts and the Endocrine system. You can Look inside the book on-line and read the contents - detailing each paper and you will see Liothyronine ( T3 ) mentioned time and again.

Both low and high levels of thyroid hormones are detrimental to the heart. T3 is needed in muscles and after all the heart is a muscle. The brain has the biggest demand for T3 followed by the immune system it seems - so we need GOOD levels of FT3 for there to be enough to go around and supply the heart :-)

amazon.co.uk/Thyroid-Heart-...

I am not a medic - just a Hashi's gal with a B12 issue :-)

BurkeB3,

My TSH is to be suppressed <0.1 post thyCa. I've not had any warnings about suppression causing heart damage. My endo has tried to raise TSH to 0.05 on two occasions until I refused further dose reductions. The Rotterdam Study finds no association between TSH and atrial fibrillation.

press.endocrine.org/doi/abs...

Someone who is truly hyperthyroid has a suppressed TSH, a high (over the range) Free T4 and a very high Free T3 (multiples of the top of the range).

Doctors, in their collective wisdom, have decided that the only one that counts is TSH. They don't really care about the Free T4 and the Free T3.

Someone who is hypothyroid and is over-medicated has a TSH which is suppressed, a Free T4 which might be high in range or may be a bit over range, and a Free T3 which is well over range, but it is not multiples of the top of the range.

In both cases the thing which causes the bulk of the symptoms is the high Free T3, and there may be a contribution to symptoms of high Free T4. But TSH (or lack of it) doesn't make you feel anything.

Some hypothyroid people have a suppressed TSH with Free T4 and Free T3 being well in range. They are not over-medicated. The Free T3 is the important one, not the TSH.

It is low Free T3 or excessively high Free T3 that causes damage to the heart, the muscles and other organs. TSH has nothing to do with it.

greygoose profile image
greygoose in reply to humanbean

Very well said. That just about sums it all up. :)

NO!

Everyone, I was so busy yesterday I didnt get a chance to check replies so i am not ignoring anyone. Thank you all very much and all very informative and does support my own research so I will be refusing to reduce medication. I am waiting for blood results but the t3 instead of ft3 was requested so results will not be conclusive. my last results were and as you can see the ft4 was low rather than above.

TSH *0.03 mIU/L 0.27-4.2

Free T4 *11.0 pmol/L 12.0-22.0

Total T3 *0.89 nmol/L 1.3-3.1

Thanks

humanbean profile image
humanbean in reply to BURKEB3

Any form of treatment for hypothyroidism that includes T3 may suppress TSH. NDTs like WP Thyroid do contain T3, so yes, NDT could suppress TSH. Different people react to different degrees to taking T3 - some will have a suppressed TSH with very low doses of T3, some people may need slighter higher levels of T3 to suppress their TSH.

If your consultant refuses to accept that then you really need to find another one. The one you are seeing will not help you get well, he will keep you ill.

Could you tell us which country you come from? It is unusual in the UK for anyone to do a test for Total T3, so I think you must come from elsewhere. The options you have depend on where you live as to what you might be able to do for yourself.

BURKEB3 profile image
BURKEB3 in reply to humanbean

I am living in Ireland and it seems that FT3 testing here is not the norm so very hard to get. I am going to get this done privately so that I can be confident that there are no problems. I am still a little astounded that the only result diagnosis was based on was the TSH and the ft4 and t3 were disregarded.

humanbean profile image
humanbean in reply to BURKEB3

Looking at the TSH and disregarding everything else is, sadly, standard practice with a lot of doctors.

Once you have a complete set of results including Free T3 write a new post and ask for feedback.

You could say to your consultant (if you see him again) that people who have had thyroid cancer have their TSH kept suppressed for years to reduce the risk of their thyroid re-growing and then getting a recurrence of their cancer.

Ask him to show you research evidence of people with a history of treated thyroid cancer having a greater risk of heart problems (or anything else he wants to claim is a side-effect of a low TSH).

BURKEB3 profile image
BURKEB3 in reply to humanbean

I will do as you suggest re opening new post when I have all results. Consultation was not quite the right word as attitude was 'you do not know more than me so why would you question me'. left me with very little scope for querying viewpoint so in hindsight i think it would be too stressful to continue with visits.

humanbean profile image
humanbean in reply to BURKEB3

Make sure you get nutrients tested as well as thyroid - vitamin B12, folate, vitamin D, iron/ferritin.

Rita-D profile image
Rita-D in reply to humanbean

I challenged a registrar to show me evidence of very low TSH causing AF and osteoporosis by saying that when on HRT I was give statistical evidence if the risks for breast cancer and on that basis I decided that I was prepared to accept the risk for the benefits that HRT gave me and that when my husband died of cancer I changed my mind I decided that I couldn't live with the risk, but that I had made an informed decision based on the statistical evidence. He admitted there is no evidence and said on could stay on the dose that I was happy on!

humanbean profile image
humanbean in reply to Rita-D

Well done, very few people ever challenge doctors about the BS that comes out of their mouths.

Rita-D profile image
Rita-D in reply to humanbean

I'm not prepared for the BS that they spout any more! The only people who have helped me are the lovely people on this forum, a functional health practitioner and the lovely Dr Peatfield. Apart from an eye check on March I'm done with the NHS. And their stupid ignorant endos.

will do and thanks everyone for all the support. its very hard when the professional you think is going to help is actually putting you on the road to reversing all progress with an attitude that you just have to suck it up

That is a very good idea and I will certainly ask for this evidence when or if I go back to the consultant. As you say you were provided with concrete evidence to help make a decision rather than accepting what someone says and especially when what I read or hear goes against this. Hopefully everything has worked out for you.

Rita-D profile image
Rita-D in reply to BURKEB3

Always ask for evidence.

I had a hysterectomy for fibroids and extremely heavy periods. The surgeon wanted to do a total hysterectomy. I had already researched it and said no. I want to keep ovaries and cervix. They said it was easier for them if they do a total hysterectomy!! So I said it may be but i have to live the the consequences of an early menopause at 48 and a possible prolapse in the future if you take ovaries and cervix too. I got my way but the surgeon was awful with me afterwards. You just have to do your own research always! Good luck xxx

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