High heart rate post thyroidectomy

[ajw38]

Hi, I have just joined!!! Thanks in advance for any advice you can offer.

I am 4 days post total thyroidectomy. I had the op due to being hyperthyroid and being told I couldn’t stay on my medication (PTU) longterm. I also found out 2 days prior to op that I had a 2cm ‘borderline suspicious’ nodule.

I have suffered with a high heart rate and palpatations for about 10 years. I had several cardiac investigations done and nothing was found. It wasn’t until my first pregnancy 4 years ago that I was found to be hyperthyroid ( something I had long suspected but results had always been borderline.) My heart rate has been generally under control since. Bothers me occasionally but I’ve alwags thought that was because I was undermedicated since being pregnant or breastfeeding for the past 4 years.

On the morning of the op I had a very fast heart rate which I assumed was anxiety. However, whilst under GA my heart rate was 90/100 and when I woke I was 140. It has been high ever since, between 80 and 120 .

I can’t stop panicking that I have done completely the wrong thing having the op, and that there has always been some other cause of my problems ie pituitary gland problem.

Is there anyone else that had high heart rate during and after surgery and then it all settled down?

Thank you so much

[Nanaedake]

I have had high heart rate on and off, mainly when undermedicated or overmedicated, both seem to set it off. I was reassured that although 100 was high, it was not anythiing too much to worry about, even up to 150/60 as the heart is designed to cope with rapid heart rate such as when running or with exertion. HOwever, it's obvious you don't want this to continue at rest as it's hard to relax and disruptive for normal life.

Do you think the surgery has released some thyroid hormone into the blood that will clear and everything will settle down? You could contact your doctor for reassurance and ask if there is something temporary you can do to help you rest while your heart rate settles down.

When you have a high heart rate, it tends to trigger anxiety and things you would not normally worry about seem very frightening so do you think you are more frightened than you need to be and your worries about making the wrong decision about the op and speculating about an underlying pituitary problem might all be part of a reaction?

Rapid heart rate might be releasing more adrenaline than usual and causing a fight or flight reflex. If you can get a relaxation tape and listen to it every morning and night it could help. If you've done yoga in the past, some of the breathing techniques. Anything that helps to slow the heart and help you regain control of your fearful feelings might help while your body calms down.

Also, get your vitamin D levels tested as good vitamin D helps aid recovery post thyroidectomy. Rapid heart rate could be caused by low vitamin levels too so check Vit D, B12, folate and ferritin. Also, ensure calcium levels are fine and make sure you include calcium rich food in every meal. I understand that thyroid hormone should be taken 4 hours apart from calcium rich food, which seems to be new advice but I'm not clear whether you have been started on levothyroxine or don't need it?

[ajw38 in reply to Nanaedake]

Hi, thanks so much for your reply and apologies for the delay in mine!

Really interesting that you have rapid heart rate when both undermediacted and over. I know anxiety is playing a part, but it’s def not the whole problem.

My pulse has settled down a little now, though still unbearable at times so getting some bloods done today and will see my endo in a couple of days. I know it’s too early to know if my dose if levo is correct but I need to know if it’s my levels causing my palpatations or I need to see a cardiologist! I will also push to get those other bloods done.

Thanks again!

[Nanaedake in reply to ajw38]

Definitely push for the other bloods, particularly vitamin D. My post thyroid care was terrible. doctors don't seem to be aware that really good vitamin D levels are so important before and after thyroidectomy. Being somewhere in the NHS range is not good enough, you need to be at least mid-NHS-laboratory range. You cannot absorb calcium efficiently if your vitamin D is low and both the heart and brain need a good supply of calcium so if it's low your heart may be unhappy. I saw a cardiologist and my heart was absolutely fine physiologically but it wasn't until I started taking vitamin D and later was prescribed calcium that it settle down entirely.

This is a website thyroid surgeons subscribe to... British-thyroid-association...

british-thyroid-association...

Page 9 refers to nutritional deficiencies as a possible cause of continued symptoms and advises investigation. It gives this list.

"Nutritional

Vitamin B12 deficiency

Folate deficiency

Vitamin D deficiency

Iron deficiency"

This article explains how some nutrient deficiencies can cause a number of symptoms and links calcium deficiency to thyroid disease. news-medical.net/health/Cal...

This article suggests a link between low calcium and anxiety.

tranquilitylabs.com/calcium...

[ajw38 in reply to Nanaedake]

Thanks so much again. I had my vitamin d tested and it’s fine. I’m also taking Vit D and calcium tablets as prescribed by the surgeon as a precaution although my calcium was doing fine after surgery. Saw my endo today who said my levels were good so I’m mighty confused. TSH 0.66, FT4 24.5, FT3 4.5. I know these are towards the hyper end and I’m just wondering if it’s possible they are causing me symptoms (despite the endo saying it couldn’t be !)

I will get B12 and folate tested too! Think I’m going to have to pay for some private tests

[Nanaedake in reply to ajw38]

What was your vitamin D result? Did you check it was good? NHS lab range low end might not make you feel well. Good plan to check B12 and Folate. Also may benefit from taking magnesium and K2-MK7 which is what is generally advised on the forum.

I also take vit C and codliver oil for the omega 3 fats and vitamin A. Just seems to work for me, it's not advice, I've no medical background.

[Nanaedake in reply to ajw38]

I think TSH suppression does mess other hormones up if your body isn't used to it. Never mind what Endo says, everyone is different. What levo are you on? Some brands don't suit as people vary in response. I think thyroidectomy is very traumatic for the body.

[Sam3tu]

wow this happened exactly to me!!!

The palpitations got so bad I now take heart medication for it

It sucks doctors don't warn you about the long terms affects of levo and the strain it puts on the heart living without a thyroid