The Management of Thyroid Abnormalities in Chronic Heart Failure

[helvella]

Yet another paper which emphasises the importance of thyroid hormone for the heart. But still emphasises levothyroxine alone (in the abstract, at least).

Heart Fail Clin. 2019 Jul;15(3):393-398. doi: 10.1016/j.hfc.2019.02.008. Epub 2019 Apr 5.

The Management of Thyroid Abnormalities in Chronic Heart Failure.

Biondi B1.

Author information

Abstract

The cardiovascular system is one of the main targets of thyroid hormone action, and triiodothyronine deficiency has crucial consequences on cardiac structure and function. Patients with overt or subclinical hypothyroidism should be treated with levothyroxine to improve their cardiovascular function and the potential risk of heart failure. Even patients with thyroid hormone deficiency and heart failure should receive replacement doses of levothyroxine to improve their prognosis and worsening of the cardiovascular function. An innovative therapeutic multifactorial approach could improve the progression of heart failure. There is a potential beneficial effect of thyroid hormones and their analogs in patients with heart failure.

Copyright © 2019 Elsevier Inc. All rights reserved.

KEYWORDS:

Cardiac fetal phenotype; Heart failure; Hypothyroidism; Levothyroxine; Low T3 syndrome; liothyronine

PMID: 31079697

DOI: 10.1016/j.hfc.2019.02.008

ncbi.nlm.nih.gov/pubmed/310...

The first page is available to read - adds a little to the abstract:

sciencedirect.com/sdfe/pdf/...

[Gcart]

Recently lowered my T3 by 5mcg as a result of an incorrect test result . ( you may remember)

The first thing I noticed after about 3 days was a chest pain that stayed until I put my dose back to where it had been .

Prior to diagnosed chest pain and funny heart rhythms were so frequent I was having cardiac investigations.

Now having replacement T4 and T3 have had no further problems apart from above mentioned. !

I certainly need no convincing.

Thanks for article.

[Murphysmum]

I have no heart issues, and was thoroughly checked out after my “crash”.

However, it seems whenever my thyroid hormones are low I get palpitations, tight chest and pain.

If I hadn’t been previously checked I’d be really worried, as it is, I just freak out a little bit.

Although very different, I’m thoroughly convinced of the connection between thyroid and heart!

[NWA6]

My Nan had angina and died young at 65yrs. All I know is that she had an underactive thyriod. So far my mum is the oldest surviving member at 66yrs. This is one reason why I pursue adequate and proper treatment.

[Hidden in reply to NWA6]

My grandmother had thyroid trouble with a goitre and apparently heart problems. She died before I was born but my mother said she would perhaps be sitting eating her tea, suddenly stand up, clutching her throat and struggling to breathe, and have to rush outside for air. Maybe her swallowing was affected My mother also had thyroid trouble when young (the doctor said it must have been from an infection because she seemed to get over it), but her heart was OK. I have had a few episodes of palpitations and irregular heartbeat but not painful and didn't last long - it's very common.

[NWA6 in reply to Hidden]

Yes, my mum, Nan, sister and ofcourse myself all with thyriod issues and they say it’s not genetic? 😉

[Hidden]

"Patients with overt or subclinical hypothyroidism should be treated with levothyroxine to improve their cardiovascular function and the potential risk of heart failure. Even patients with thyroid hormone deficiency and heart failure should receive replacement doses of levothyroxine..."

I read the above three times but it still seems as if they are repeating themselves. Overt or subclinical hypothyroidism is the same as thyroid hormone deficiency isn't it??? Or is it me?

It seems a helpful article though. Thanks

[Marz in reply to Hidden]

... should it say - without rather than with ??

[Hidden in reply to Marz]

that's a thought - would make sense then. It makes no difference to what the article is about but it made me wonder if I was the one going a bit loopy, lol

[Hidden in reply to Marz]

But on second thoughts does that make sense either?

[Marz in reply to Hidden]

I think it is saying that people with heart failure and without a thyroid deficiency should still receive thyroid treatment

[Hidden in reply to Marz]

Right, that does make sense.

[kissemiss]

Interesting articles but in sciencedirect they seem to emphasize the importance of t3 rather than levothyroxine which some how makes sense. Helvella thank you so much for sharing this piece of resent research.

[Ossuryak in reply to kissemiss]

My understanding is that T3 effects the heart, when i lowered my T3 my heart palpitations went away, I also upped my T4 at the same time. What works for one may not work for everyone.

[helvella in reply to Ossuryak]

Agreed that T3 affects the heart.

But I look at it very much as a need to right-dose. For some, even a small under- or over-dose seems to be noticeable almost straight away. Others seem more tolerant.