I read here often, but haven't posted on the thyroid board. I am based in the US and was diagnosed with Hashi's in 2014. Been on compounded T4/T3 since. I apologize for the length of this, but I have a long history.
I actually thought Hashi's had been confirmed by antibody testing previously, but looking at old results, the thyroid peroxidase and thyroglobulin antibodies were normal, but plain thyroglobulin was elevated at 120. Don't have the units or ref ranges on that as it doesn't show on my online med recs.
This past January, I began having nighttime runs of tachycardia - approximately 150-160 beat per minute - that woke me up and landed me in the ER since I had no idea what was going on. The rhythm is always normal sinus rhythm, just fast. I've probably had these occur about 10 times now and have been to the ER a handful of times when I couldn't get them to slow down through vagal maneuvers.
No tachy during the day, but do have palps, presyncope, lightheadedness, etc.
Due to my history of Hashi's, the ER usually runs a thyroid panel because they think I may be going hyperthyroid. Of course, they only test TSH and Free T4 during these instances. For the most part, FT4 has been normal during the ER visit, but TSH is always elevated (I'll list labs below).
Family doc sent me to a cardiologist/electrophysiologist (EP) who diagnosed me with autonomic dysfunction/blood pressure dysregulation. He has been rather vague so far and just says that my body is relying on adrenaline to maintain my BP during the day and then is all kind of dumps out at night, causing these episodes. The EP has me on increased fluids/salt and wearing compression stockings and taking midodrine.
I just had another bad episode the other night that I couldn't get to abort on my own and ended up in the ER. TSH was the highest it's ever been, even before I was diagnosed. Recently treated for low vit D and B12, both of which are improving. Family doc thinks we should raise my thyroid meds, but I'm hesitant just because my FT4 and FT3 generally look okay.
Anyone else have nighttime tachycardia and elevated TSH? I feel like something is going on with my thyroid that may be causing/influencing all this? Advice?
TSH (range .30 - 3.80 uIU/mL)
Jan 2018 4.61 - first ER visit
Jul 2018 6.76 - most recent ER visit
TSH during follow-up visit with family doctor have been:
1.38 (Mar 2018)
2.42 (Apr 2018)
2.51 (Jun 2018 - about 10 days before most recent ER visit)
Free T3 (range 2.30 - 3.80 pg/mL)
Jan 2018 3.33
Mar 2018 3.22
Apr 2018 3.20
Jun 2018 3.24 (again 10 days before most recent ER visit)
Free T4 (range .80 - 1.80 ng/dL)
Jan 2018 1.32
Mar 2018 1.40
Apr 2018 1.25
Jun 2018 1.22
Jul 2018 1.22 (at ER)