Thyroid UK
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Can hashis and overmedication mimic POTs?

Can Hashimotos mimic POTs? The hallmark of POTS seems to be to feel dizzy and lightheaded with a pulse increase of over 30bpm upon standing.

I was overmedicated a little while back now and had some horrid symptoms sweating, high pulse, panic attacks, insomnia, severe heat intolerance and terrible palpitations. I didn’t have these symptoms before the overmedication.

I pulled back and my labs look ok. Wondering if perhaps my T3 is still a little high for me personally as I’m still having some insomnia, one or two minor palpitations a day and some heat intolerance. Nowhere near as bad don’t get me wrong just lingering. I’m also experiencing the pulse jump of 30bpm or over which is seen in POTS patients but with none of the dizziness/lightheadedness or exercise intolerance.

I’m just wondering if this could still be an overmedicated or Hashimotos thing or whether I could actually have POTs and that could explain the lingering symptoms I’ve been left with.

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Sounds like low vitamin levels, which are extremely common when hypo, especially if you have Hashimoto's (high thyroid antibodies)

When you say over medicated do you just mean low TSH. What about FT4 and FT3? If these are in range you probably weren't over medicated

Low B12 can make feel dizzy and lightheaded

b12deficiency.info/signs-an...

Low vitamin D linked to insomnia

drgominak.com/sleep/vitamin...

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

thyroiduk.org.uk/tuk/testin...

Vitamindtest.org.uk - £28 postal kit

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

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My FT3 went over range and FT4 jwas sitting at top but now isn’t. My FT3 is sitting at 6.11 currently with top end of 6.8 but I know some people can feel a bit off with it that high even though it’s in range as I’ve seen them mention insomnia and palpitations.

My vitamin D was 90 with top range of 175 so I know this isn’t ideal.

My iron, B12 and folate are all fine.

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Sounds like you were genuinely over medicated. Also a good converter

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Yes it seemed to sneak up on me unfortunately. Pulling back has helped as I say and I’m now within range again with FT4 midway and FT3 top end but I still don’t feel like I did before. Wonder if I’m still just a bit high “for me”.

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I would wait 6 weeks on reduced dose.

How much did you reduce by?

Some of us need very fine adjustment

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When I went over I came down by half a grain (NDT) and waited around 7 weeks and now I’m back in range but my FT3 is a little higher than it was when I last felt good. I’m tempted to drop by a quarter again. I have zero of my usual hypo symptoms just the lingering over ones.

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I had something like that recently myself. I’ve been taking thyroid-s last 5 years and this summer was feeling hypo so I bumped up by 1/2 a grain for 10 days. All the sudden out of the blue when I got outside in heat my blood pressure rose to 185/110 and pulse to 140! I had never had that before. Even when stepping in tepid shower it happened. I stopped all hormone and 2 weeks later had thyroid labs that show profound hypothyroidism I wish I had felt well enough to get labs when it happened. Anyway I’m a bit puzzled if I was over medicated. It has slowly gotten better I can shower now but I haven’t gone outside I’ve been nervous.

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Also a quick note, I took L carnitine for heat intolerance and it helped very much. I don’t know if hypothyroid people can take so I stopped when I found how hypo I was

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