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Thyroid UK
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Hypo with arrhithmias

Hi, im hipo for 5 years after taking iodine for Graves. I am feeling bad for about 3 years with a lot of symptoms like cold, massive hair loss in the last 3 months , dry skin, tired all the time, heavy periods, anxiety, not in the mood for nothing, chest pain, headaches, slow pulse (60 when im in bad), tachycardia, a lot of extrasystoles every day and sometimes irregular pulse (wich i hope is not atrial fibrillation).

I have minor mitral insufficiency and h pylori for which i need 2 antibiotics...

For a month im on 75 mcg Euthyrox, increased from 62. My endo is afraid to increased the dose too much one time for my arrhythmias...

My last results on 62 mcg are:

Tsh 2.94 (0.4-4)

Ft3 1.96 (1.8-4.2)

Ft4 0.95 (0.8-1.9)

Anti tpo 331 (<35)

Hgb 13 (11-16)

Mcv 96 (80-104)

Mch 31.6 (25-34)

Mchc 33.1 (31-36)

B12 415 (211-911) in the last 3 yrs was around 200

Folat 3.22 (3-17)

Iron 112 (50-170)

Feritin 36 (5-148)

25 hidroxi vit d 20.7 ng/ml (acceptable) (30-100 optimal)

My questions are:

1. could this levels of vitamins be the cause of my symptoms? Because in the past i had better results of my thyroid ( tsh 1, ft3 3.7, ft4 0.9) but with the same symptoms.

I start supplement b12, folat, magnesium, b complex and 3000 ui vit d. Is this enough? Also take selenium for about 6 months

How much ferrous fumarate can i take?

2. a little dose of t3 may worsen my heart symptoms?

3 Replies


You were undermedicated on 62mcg and that can cause slow pulse, palpitations, tachycardia and ectopic beats (feels like miss beats). Your endo's caution is understandable and 75mcg should improve symptoms as it raises FT4 and FT3 which are low in range.

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.4 - 1.0 with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_...

Anti TPO (thyroid peroxidase) antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.



Hgb, MCV, MCH, MCHC are red cell evaluations and are all within normal range.

B12 415 is unlikely to be deficient.

Folate is very low in range. Ideally it will be halfway through range. You can supplement folic acid or methylfolate for 2-3 months to raise folate.

Iron is fine but ferritin is low and low ferritin can cause hairloss. You can supplement 1 x 210mg Ferrous Fumarate tablet with 1,000mg vitamin C to raise ferritin.

VitD 20.7 is deficient. 40-50ng/ml is optimal. I would supplement 10,000iu D3 daily x 6 weeks and then reduce to 5,000iu daily and retest in 4-6 months.

Iron and vitamin D should be taken 4 hours away from Levothyroxine and T3.

I'm not familiar with mitral insufficiency and how it is affected by thyroid medication. A little T3 will might improve your heart symptoms or it might make them worse. I recommend you discuss with your endo and a cardiologist before making a decision.

1 like

Thank you Clutter

I talked to two cardiologists. Both have said to quit Euthyrox (Merck KGaA) because can cause arrhythmias but in my country this is the only drug for hypothyroidism



What did they say about using Liothyronine (T3) instead?


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