Hi everyone. I have not written for a while. I was diagnosed with hashi in June of 17' and this past 10 months has been pretty good starting Armour in January. I been having palpitations for the past three weeks maybe more. Very seldom at the beginning but the last week or so has been increased amounts of them happening. Some real big ones that I can feel in my throat and pounding on my chest. I sleep good at night and dont notice any. It seams some movements cause them and my stress and anxiety levels have been up last few weeks also.
My doctor could not get me in on Tuesday after I emailed him Monday night about the Palps but his nurse called and said to get to a Urgent care or ER to get evaluated. So i did go to both.
Urgent care could not help me. Er did Ekg, lots of blood work, chest Xray and kept me on the monitor by my bed for four hours as I sat there and watched TV. I had one Palp there that could be seen on screen in the first 20 minutes being there but no more the rest of time there. . Ekg they said was fine
I currently take 135MG armour and 4.5Mg LDn. Both of these were increased at my last apt. two months ago. Before that I was at 120mg and 3mg LDN.
My Blood work in ER. was all pretty good except for blood protein was just slightly over range. Total protein 8.6 range 6.4-8.2
Anion Gap blood test 18 range 7-15
The following blood test were taken mid day in ER when I usually take my blood test early in am before my Armour pill.
TSH - 0.311 range .358 - 3.74 so am below range.
T4- 8.2- Range 4.5-11
Total T3- 168 Range 60-180
Free T3- I just had done today with my hormone doc and wont get that until next week.
All other blood work was in range for the CMP tests.
My chest xray showed nothing wrong and heart look normal.
Two months ago my numbers where
TSh 1.83
Free T3- 2.9 r 2.3-4.2
Total T3- 153 r76-181
Free T4 0.7 Low r0.8-1.8
-Do you think these palps could be coming from going almost Hyper? Its very scary, I had about 25 on tuesday , 30 wednesday, About 12 today that were small it seamed like but when in shower yesterday and today I got a real big one both times. Felt like a fist pounding chest and abdomen. Any advice is welcome and I hope I can calm about this Soon.
I did cut the amount of armour and LDN last few days to see if it helps but not much yet.
-I am adding my updated bloods as a reply to this post. It It will be posted within the hour. Thank you.
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PittsburghKris
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In a word no, it seems unlikely you're properly hyper as your total t3 is still in range and the all important free t3 for this month which you haven't got yet is probably going to be far more conservative going by your previous result where it was really quite low... to the point where we may be thinking that low t3 (and high rt3) is the issue.
There is another possible factor that may contribute to these palpitations - too low cellular levels of electrolytes - magnesium is the one that always comes to my mind (especially since it is also heavily involved in vitamin d synthesis and adrenal health and t4-t3 conversion). Unless you've had a RBC check on Magnesium you won't know that your levels are good.
Were you feeling ok a couple of months back?
Maybe others on your hormone replacement combination could shed some light (as I am not on this myself. ) It also appears that your t4 results for this month are for total rather than free t4.
I believe too much T3 gives me heart palpitation.In Natural thyroid hormone the ratio of T3 to T4 the T3 is higher than normal human T3 to T4 is. We are all different but cutting back on T3 seems to help my palpitations . I also found that when my dose of T4 was too high that also caused palpitations. When I lowered my dose it took 24 hours before I felt better. Have you taken propranilol if your blood pressure is up too high? , that also helped me with palpitations and made me feel a lot better.
I had severe palpitations on T4 alone and even the cardiologist was puzzled and was going to put an implant in my heart to 'see what was going on'. I had had umpteen monitors before that. I even had severe palps on T4/T3 combination.
Just before implant was going to happen I switched to T3 alone and that resolved all palpitations.
We are all so different in how our body reacts to hypothyroidism and replacement hormones.
I feel this may be the case here as the OP has seemingly increased her t4 levels significantly (not actually possible to tell precisely as she had a free t4 below range last time and a bang on middle of the range total t4 this month - so it's not comparing the same thing). Not in the same boat myself with meds, but I suspect t4-t3 ratio (frees) has been impaired by the increase.
Yes, but..... In true NDT the ratio of T4 to T3 is indeed 3:1 ie you get 1 molecule of T3 out of 3 molecules of T4. In the human ratio you need 4 molecules of T4 to generate 1 molecule of T3 i.e. the ration is 4:1 - like you said. But... Armour (Forest Pharma) has got on to this and they stuff a bit of Levo (pure T4) into their tablets to raise the ratio to the human 4:1.
A little note, Amour is measured in grains and definitely not MGs. Makes me wonder if the OP is using the name Amour for NDT. But I get the point.
Looking at your thyroid panel results, two months ago you were pretty undermedicated. Your freeT4 was just under rage, but this isn't a concern when taking any T3 and Armour is NDT containing T3. But your freeT3 was also very low in range - this is the important thing to look at when on hormone replacement containing T3, and it will most closely reflect symptoms. I'd expect you to feel pretty rubbish with these low numbers, most people need it in the top third of the range to feel well.
Since then you've had a small increase of Armour, I think this translates to a quarter grain increase. Looking at your old results, I would expect you to need a few increases like this to get your freeT3 high in range and feel well. But that's all fine, everything with thyroid hormone takes time.
Your current result shows a much higher freeT4 than the older results. Although the Total T3 hasn't changed much. When first spotting this I though you might be having a Hashis flare and that could explain the palpitations. But then I realized you had already taken your tablets before the blood draw. That could explain the considerably higher freeT4 (it's gone from just below range to mid-range). But if you're able to it would be good to get a retest and confirm whether your thyroid hormone really is raised.
These flares are caused by the thyroid being nibbled away during auto immune attacks. This dumps extra hormone into the blood and can cause short term overmedication symptoms.
Unfortunately these things can also come up while undermedicated. Don't let a doctor strong arm you into suspecting you are actually over medicated. With that low result two months ago it's very unlikely.
You are not "almost hyper". Your free t4 is still only just over half way up the range - you'll know more when you get your free T3 result. Palpitations can be related to low T3 or problems with cortisol or low iron (as well as other things).
Please do get the Vits tested Slowdragon mentions.
Also have you had your cortisol/ dhea measured.
Given you are reasonably new to Med taking i think it would be a good idea to measure body temps with a basal thermometer.( see drmyhill.co.uk and in the top right hand corner type in orchestra. Good article on achieving great health. By measuring your temps you can tell if your meds are optimal at 36.50 and if adrenals are not working properly.)
The magnesium you had tested is serum magnesium so counts for nothing. If it was low you’d be dead.
( maybe they were ruling out heart attacks!!!)
As mentioned above by HLAB35 you need a red cell magnesium test to determine if you are deficient. Perhaps your hormone Doc could arrange that for you as it’s private. Plus GPs don’t understand the difference between red call and serum.
When one is on any T3/NDT the TSH will be low . The most important markers are FT3 FT4 . Having a FT3 of 2.9-3 is usually fine some need a higher range up to 3.8 . FT4 ranges are good from 1.1-1.4 . You need your vitamin "D" levels and Iron/ferritin , B12/folate up to par is very important for us too.
Magnesium , fish oil (EPA/DHA) COQ10, minerals work well for us as well as for palpitations. Vitamin "C" is important for adrenals as is B-Complex Celtic Sea Salt is important for adrenals/electrolytes .
Gut/liver/gallbladder /digestive issues are very important to address too so that our thyroid meds can work *Optimally* for us .
Your potassium is only 21% of the way through the range. Mid-range would be 4.2. Low potassium can cause palpitations and an abnormal heart rhythm.
Personal anecdote : I once had a potassium level that matched the bottom of the range, and I ended up in hospital with a possible heart attack. (False alarm.) Personally I feel at my best with a potassium level that is mid-range. I also prefer my sodium level to be mid-range too.
You can improve your potassium by eating more food with good levels of potassium and there are dozens of lists of such foods online e.g.
It is also possible to supplement potassium but caution should be exercised with potassium supplements - get it wrong in either direction (too low or too high a level) can cause palpitations and arrhythmia.
Other things that affect the heart rhythm are low iron (it can cause tachycardia - very fast heart rate).
Also magnesium, which others have already mentioned, is important in maintaining a healthy heart.
First bring your Magnesium and Potassium electrolytes up to par. If that doesn't fix the problem then remember that you were well on 120 units of "armour" but have palpitations on 135 units. Either drop back to 120 units or take a mid point 127.5 units and take that. If 127.5 doesn't work drop back to 120 units.
T3 has a short half life (~8 hours). Do you have palms in the morning but not in the evening? If that is the case then your T3 is too high, reduce your dose a bit as described above.
Hi Kris, Even though your magnesium level seems all right, those serum tests do not adequately show a deficiency because your body tries to maintain a certain blood level at any cost. I urge you to supplement with an absorbable type of magnesium as it's known our adrenal glands need more when you are thyroid deficient. Magnesium is important to all muscles and so is co Q 10 especially for the heart muscle.
I have my updated bloods from last week that you all have been waiting for. Please review and let me know your thoughts. Thank you.
Bloods taken 10/17/2019
I took these at my normal time before my pill early in the am.
TSH 0.65 R 0.40-4.50
Free T3- 2.9 R 2.3-4.2
Free T4- 0.8 R0.8-1.8
T3 Total- 112 R76-181
T3 Reverse 10 R8-25
Zinc- 80 R 60-130
Magnesium- 5.1 R4.0-6.4
Iodine, Serum/plasma 38Low R 52-109- My fucntional doctor has me taking a little iodine every week to try to increase this. Is this necessary since my level of 38 is below level?
Vit B12- 663 R200-1100
Selenium 175 high, R63-160. I dont suppliment so why could this be high?
My labs from almost three months ago-->
TSH-1.63 R 0.40-4.50
Free T3 2.9 R 2.3-4.2
Free T4 0.7 LOW R 0.8-1.8
Total T3 153 R 76-181
Reverse T3 - 7 LOW R8-25
Thyroglobulin Antibodies 267 HIgh R <=1
TP antibodies - 193high R <9
Iodine 35 LOW Range 52-109
Folate, RBC 806 R>280
Ferritin- 85 R 38-380
Estradiol 25 R < =39. My functional doctor says that 25 is high for men ??? So she has me taking Estrobalance plus to help metabolise estrogen better. Any thoughts?
Testosterone Total - 564 R250-1100
Testosterone Free- 90.8 R35.0-155.0
- My palps have calmed a little and I think it has a lot to do with anxiety and maybe being hypo?
-My functional doctor says to drop from 135mg amour to 120 mg after my last bloods a week ago to see if palps decrease.
-They also said to increase iodine to three times a week because its so low.
--They said B12 is Low at 663 and said to start taking Methylcobalamin 1 tab daily. Not sure what this is, Havent had time to look into it yet.
--The last thing they recommend is to take my estrobalance plus everyday because high estrogen can cause anxiety and palpitations. ???
Thanks for all your time reviewing and sending me your thoughts.
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Can anyone help me interpret my blood test results please?
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