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Thyroid UK
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Thyroid or heart Disorder?

I had thyrodoctomy in 2014.Am on Thyroxine 25mg and have been checking my thyroid levels which show "normal range".Am also on Bisoprolol 5mg to control my heart palpitations which got off the truck because of thyroid disorders and failed to stablise even after surgery. I have been having wringing in my left ear and noise in my head which is so nagging that makes me very miserable. Recently, when I was having my eyes checked, they found that I have optic nerve atrophy but after a CT scan, they did not find anything leading to the optic nerve problem. Am tired of taking the medicine to reduce my heart's palpitation! because, I feel weak, cannot do any exercise and worse still the noise in my head.... Whatever causes it? I would like to know if there is someone who had similar condition to help me. Thanks. Marie

13 Replies

You are on only a very tiny starter dose of Levo, and both tinnitus/ear noises and palpitations can be due to being undermedicated. If you post all your latest blood results, with ranges, members can advise you more accurately - having your results just anywhere within the reference ranges doesn't mean they are optimal for you and good health.


Thank you so much for this observation.

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For full evaluation you ideally need TSH, FT4, FT3, TT4, TPO and TG antibodies, plus vitamin D, folate, ferritin and B12 tested

See if you can get full thyroid and vitamin testing from GP. Unlikely to get FT3

Private tests are available


Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results

Your TSH should be low, not higher than one, FT4 towards top of range and FT3 at least half way in range

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the articles from Thyroid UK email dionne.fulcher@thyroidUK.org. print it and highlight question 6 to show your doctor.

Prof Toft - article just published now saying T3 is likely essential for many and he is now unwilling to do thyroidectomy due to totally inadequate thyroid treatment afterwards



Thank you so much for this information am going to have the tests done and follow the advice.


My recent tests are as follows: TSH 2.59 uIU/mL. Reference (0.27-4.20), Free-Tri-Iodothyronine 4.8 pm1/1,Reference range(2.8-7.1), T4 : 16.3 pmo1/1,Reference range (10.16-22.0). This was done 3 days ago but I had taken thyroxine 25 mg in the morning.I never knew that we need to fast from the medicine before taking the test. I hope to get advise from members with better experience.Thank you.

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Ask GP to test vitamin D, folate, ferritin and B12

If these are too low you can not use thyroid hormones. Bloods appear normal, but your are actually hypo

See Box 1. Towards end of article

Some possible causes of persistent symptoms in euthyroid patients on L-T4

You will see low vitamin D, folate, ferritin and B12 listed


Perhaps print this list of symptoms off, tick all that apply and take to GP


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This is a typical case

Blood test suggests over medicated, until vitamins are tested




If your thyroid gland has been removed, why on earth are you only on 25mcg of levothyroxine?

50mcg is a starting dose with 25mcg incremental doses every six weeks or so after a blood test until the TSH is 1 or lower and Free T4 and Free T3 should be in the upper part of the range. Neither of the latter two are tested regularly and they are imperative especially if you have no thyroid gland at all.

Your heart is struggling because you have insufficient thyroid hormones in your body (and I am not medically qualified) and your whole body is undermedicated. We also get palpitations because our body is bereft of thyroid hormones and it is struggling do to insufficient dose. (we can also get palps if we are on too much but you are definitely not on too much but too little). We can develop other illnesses if we are neglected and given too little thyroid hormone replacements.

You are not able to exercise because you have so little T3 in your body, and it is T3 alone which is the Active Thyroid Hormone. Exercising before we are on a optimum dose of levothyroxine (converts to T3) we reduce T3 even more.

If you can afford a private blood test, I would certainly advise you to do so as the NHS only, usually, does a basic test. We have two recommended private labs.

All tests for thyroid hormones have to be at the very earliest possible, fasting (you can drink water) and allow a gap of 24 hours between last dose and the test and take afterwards.

Ask GP for TSH, T4, T3, Free T4, Free T3 and thyroid antibodies. B12, Vit D, iron, ferritin and folate. The Ones he or lab wont do you can have privately and they are pin-prick home tests.


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Thank you so much. I find this information very helpful.Am going to follow the advice and also display the results of my tests for members to advise.

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25mcg of lebo is a miniscule starter dose that would not treat a fly

Get hold ofvyour so called normal blood tests because you need a doctor who actually understands hypothyroid and its heart presentations issues

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Thank you.


It's very unlikely that 25mcg is a high enough dose for someone without a thyroid. Being undermedicated causes palpitations as do low levels of certain vitamins and minerals. What are your current levels of free T4, free t3 and TSH? Do you have results for B12. folate, ferritin and vitamin D?


Tick off your symptoms and if you were on an optimum dose you should have none and feel well. Unfortunately doctors, nowadays, appear not to know any at all which is a pity.



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