Irregular fast pulse rate, anxiety and dizziness - should I be concerned?

[owl87]

Hi everyone,

I increased from 10mcg to 15mcg last friday after becoming increasingly unwell staying on 10mcg and worse than when I previously tried to up dose. I have had strange ups and downs over this last week - periods of extreme buzzing (usually a hypo symptom for me and one I have previously got when increasing) and a higher heart rate in general that has seemed to be gradually getting better each day on the new dose. A few days ago it was 76-92 and in the 80s most of the day but I felt pretty good just a tad lightheaded. Yesterday and today the 80s periods have been less and it hasn't really reached 92.

However my pulse is very irregular and erratic though it has been somewhat irregular for a while it seems to almost constantly have extra beats and goes fast then slow all the time even at lower levels. The lightheadedness is also worse - yesterday and today I am laying most of the time as feel very lightheaded and also have a sensation I can only describe as like an anxious uncomfortable chest. Standing and sitting up to eat feel bad but even laying and slouching doesn't remove it. Today I have felt out of it and tight in my head. I am also having increasing periods over the last few weeks and 2 in the last 3 days where my heart rate becomes very fast and I feel awful like I am going to fall out of my own body, short of breath and I am shaking and its so frightening. It only lasts a few minutes but its awful. There is no rhyme of reason to these periods - they use to happen in the morning now they are happening later in the day, they have happened 2 hours after thyroid meds and todays period 5 hours after and today my pulse has been lower than the last few days. They use to happen more rarely but recently they have been more frequent - I've never had two in 3 days like I am now since upping.

I am just terrified of these periods and now of the constant lightheadedness and anxiety chest sensation today. Even writing this now I feel horrible and its scary enough to make me wonder if I need to go to hospital. Does anyone have any experience of anything like this and do you think I should be concerned? I feel at a total loss and very frightened as I felt bad staying where I was but now I feel awful too. Any help hugely appreciated.

[shaws Administrator]

Hi owl87, you stated:-

I increased from 10mcg to 15mcg

but you don't say what was increased, i.e. levothyroxine (T4) or liothyronine (T3) or NDT.

When I took levothyroxine (T4) I was always very unwell with heart taking off for no reason at all, especially during the night.

I think that some of the members might get similar (and very unpleasant) symptoms.

Mine improved when I was prescribed some T3 to T4, but I felt best of all when I took T3 alone. Unfortunately doctors have been told not to prescribed T3 as it became too expensive.

We used to have only one supplier of T3 then when another two joined in we, the patients, were shocked to find out that instead of some competition between three suppliers that T3's cost had been increased so much that it was withdrawn. A good excuse for doing so but left many patients very unwell indeed. They do not seem to care one iota that we're dependent on replacemen hormones and ones that make us well again.

I'm still hoping that these pharmaceutical companies can reduce their T3 to a more reasonable cost and that it can be prescribed again. I felt an enormouse difference when I stopped T4 and took T3 alone. Mind you they withdrew the prescriptions for T3 but I was fortunate to source my own.

[owl87 in reply to shaws]

Hi shaws thank you i increased liothyronine. Currently also on 75mcg Levothyroxine.

I have been horrendously lightheaded and dizzy the last two hours especially every time I get up or even sit up feel very unwell. I was on just Levothyroxine alone before I started t3 and never had any issues but no benefits either!

[shaws Administrator in reply to owl87]

I'm not medically qualified but did you reduce your levo before adding T3? What dose of T3 did you take?

[owl87 in reply to shaws]

Thank you shaws. When I started on liothyronine Levothyroxine was not reduced it was 18.8 (range 10-20) when I started back in January. I was instructed to take 10mcg but started on 5mcg as had some overstimulated symptoms from 10 in one go.

[SlowDragon Administrator in reply to owl87]

How are you taking the T3 as split doses or single dose

What are your most recent vitamin results like?

What vitamin supplements are you currently taking

Presumably you have Hashimoto’s?

Are you on strictly gluten free diet?

Do you always get same brand of levothyroxine and T3?

Bloods should be retested 6-8 weeks after any dose change

Have you had any testing since adding T3

Ideally after 6-8 weeks on constant unchanging dose

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Ask GP to test vitamin levels

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

If/when also on T3, make sure to take last third or half of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you do your tests?

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus ultra vitamin

medichecks.com/products/thy...

Medichecks often have special offers, if order on Thursdays

Thriva Thyroid plus vitamins

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes vitamins

bluehorizonbloodtests.co.uk...

[owl87 in reply to SlowDragon]

Thank you for the wealth of information slowdragon.

I am taking as a split dose of two 7.5mcgs. I am gluten free and always get the same brand. My endocrinologist hasn't tested vitamins so I am unsure how good they are. My bloods before this increase were

Free T3 4.7 (3.5-6.5)

Free T4 16.5 (10-20)

On 75mcg t4 and 10mcg t3

This was a couple of months ago now as I have been trying to up dose for a while but always seem to run into problems however recently the old dose was also giving me periods of high heart rate, anxiety dizziness etc when previously I felt well and had higher blood levels on it.

[SlowDragon Administrator in reply to owl87]

Well strongly suggest you get vitamins tested ASAP

We frequently can’t tolerate T3 unless vitamins are OPTIMAL

Absolutely essential to have all your ducks in a row first BEFORE even considering adding T3

As you are gluten intolerant low vitamins are highly likely

What vitamin supplements are you currently taking?

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Ask GP to test vitamin levels Or test privately ASAP

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

If/when also on T3, make sure to take last third or half of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you do your tests?

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus ultra vitamin

medichecks.com/products/thy...

Medichecks often have special offers, if order on Thursdays

Thriva Thyroid plus vitamins

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes vitamins

bluehorizonbloodtests.co.uk...

Come back with new post once you get vitamin results

[Purpledreamer in reply to shaws]

Hello, I know this is an old thread but I just wondered- what is the purpose of lowering your Levothyroxine dosage before adding t3?

[shaws Administrator in reply to Purpledreamer]

It's so that you will not feel over-stimulated as T3 is the Active Thyroid Hormone and goes straight into your blood stream. The heart and brain have the most T3 receptor cells, and we also have millions around our body.

Levo has to convert to T3.

It's always best to begin a new 'question' so that you get personal answers.

[Purpledreamer in reply to shaws]

I will do yes, Thankyou so much x

[SlowDragon Administrator]

Suggest you contact endo

You may need beta blocker to steady heart rate. Preferably not propranolol as it affects uptake and conversion of thyroid hormones. But propranolol is very effective if needed

Recommend wearing a Fitbit or equivalent to record resting heart rate

[owl87 in reply to SlowDragon]

Thanks slowdragon. I have heard of beta blockers but I saw they lower blood pressure and the last few days I have been taking my blood pressure and it seems quite low - it’s lower than it was when I had black out periods a few years ago and the doctor said it was likely the cause.

[SlowDragon Administrator in reply to owl87]

Low adrenal hormones can mean blood pressure is low

Have you had adrenal testing - short synacthen test. ACTH test .

Saliva cortisol and DHEA testing here

regeneruslabs.com/products/...

cdn.shopify.com/s/files/1/0...

I had very low blood pressure when first started on thyroid replacement hormones (over 25 years ago)

Going on beta blocker was tricky to start with, but actually my BP slowly improved.

[owl87 in reply to SlowDragon]

Thank you I haven’t had those tests. I did have a saliva test but it was before I increased to 15mcg that showed low but in range morning and noon cortisol.

That’s interesting about the blood pressure from medication and how beta blockers helped. Are you still on them?

[SlowDragon Administrator in reply to owl87]

No ...was on propranolol for almost 20 years..until strictly gluten free diet and significant levels of supplements to achieve optimal vitamin levels (That took roughly a year after going GF

Then, when vitamins were eventually optimal T3 was added

More on my profile

[PamLaa]

Have you discussed it with your GP, or had an ECG? I had atrial fibrillation - causes an irregular fast pulse (and is associated with thyroid problems)

[owl87 in reply to PamLaa]

I emailed my endocrinologist but he didn’t seem concerned. I am thinking of calling doctors Monday though as I feel very bad. The periods only last a couple of minutes and I feel anxious and lightheaded. When you say had goes that mean your atrial fibrillation went away? Thank you.

[PamLaa in reply to owl87]

I had a heart monitor and it showed paroxysmal atrial fibrillation, which comes and goes. I haven’t noticed it for a while. I did take a beta-blocker, but switched to just taking it when I feel the symptoms coming on, rather than regularly.

[PamLaa in reply to owl87]

The symptoms were a pulse that jumped around all over the place and lighthheadness. Not saying this is what it is for you....but worth discussing it with your doctor just in case!

[owl87 in reply to PamLaa]

Thank you!

[PamLaa in reply to owl87]

I should say I am a nurse and I am sure they would want to discuss this with you and try and get to the bottom of this. If you are feeling really poorly you could call 111 (if in England that is) for advice.

[owl87 in reply to PamLaa]

Thank you for all your help!

[PamLaa in reply to owl87]

Hope you are feeling better now.

[Gilli54]

This sounds like atrial fibrillation. It is a horrid feeling just like you described. Your irregular heartbeat beats and raised pulse rate can indicate this. As others have recommended, you need to get this checked out. It goes with the thyroid problems territory. If you could get a record of it when it is happening it would be useful. Or go to A and E for them to record it on an EKG. They can then identify the particular arrhythmia you are experiencing. All of us who have this type of condition can sympathise with the way you feel. Please get yourself checked out as soon as possible. They can give you a 24 hour monitor too, if necessary, so they can capture the episodes as they are happening. I hope you get reassurance and help with this distressing situation soon.

[owl87 in reply to Gilli54]

Thank you Gilli. Is this something I should be booking a doctors appointment for or is it more urgent? I am very lightheaded today - standing is uncomfortable and I have noted that my pulse is increasing by roughly 30 beats when I stand and doesn’t come down in accordance with feeling lightheaded. It also goes up when I eat.

[Gilli54 in reply to owl87]

Hi

I’m not sure where you are in the world. Medical provision is different I am aware. I would definitely book a doctor’s appointment anyway. In the UK you can ring a helpline to get advice based on your symptoms and they will tell you whether to go to Aand E. I believe you have to do what feels safe and right for you. If you have access to emergency care then use it. In my experience, they are pretty much fine with checking out irregular heart rhythms. They will not consider you to be attending frivolously. It might provide some answers and the reassurance and action you need. On this forum we can’t give any medical advice as we don’t know enough about you as an individual. But suggesting it is a good idea to get checked out seems to me to be ok general advice. But you need to make those decisions yourself. I hope you get some answers soon. How you are feeling right now must be very miserable for you. And it could be easily remedied once it has been diagnosed. So don’t put off doing something. 🙂

[owl87 in reply to Gilli54]

Thank you for your kindness and help. I had another period about 15 minutes ago where I got significantly worse so I’ve gone to a&e.

Thank you again for all your help.

[owl87 in reply to Gilli54]

Just to update you I have had an ecg and was all fine! I feel much happier having gone to check it out though so very grateful for your help!

[Hidden]

Owl87 I was quite severely over-medicated in 2018 and although my blood tests didn't show it for many months I became sicker and sicker ... and experienced very similar symptoms as to what you have listed here. For me symptoms started when I added T3 but we're so subtle I didn't realize the symptoms were connected to the new T3 until it was too late and I have suffered severely from it. Like you the worst always hit me about 3 hours after taking a a dose. Over the course of the year before I realized what was going on, I ended up in the ER three times from the horrible feeling of light-headed, head pressure / Head Rush, weakness, high heart rate , and the heavy feeling in my chest I couldn't really explain. Just horrible in a way I can't describe. It's very hard to describe how I felt. Good luck to you I hope it all works out and sounds to me like it could be dosage related for sure.

[owl87 in reply to Hidden]

Huge thanks sroth! That’s exactly how I describe it! I am thinking it’s dose related too. Just had a slew of blood tests but I’m hooked up to the heart monitor and heart rate is now 81 nearly 5 hours after dose and was 104 earlier just sitting for the ecg. Think my blood tests will show a high free t3 as the blood was drawn four and a half hours after a dose!

[Hidden]

You are welcome! I was extremely over-medicated in summer of 2018 and now over 18 months later I am just now finally starting to have days where I will feel normal. My head still feels weird at times with pressure and lightheadedness some and I have not regained all my strength I have fatigue with exertion but I'm definitely going in the right direction. Pay attention to your symptoms! Watch your pulse and blood pressure! My blood test just did not show the over medication for many months and that is what got me in trouble. A very old internist told me this trick and it rang very true for me... take your blood pressure with an accurate cuff, subtract the bottom number from the top number and then multiply that umber by your pulse rate. For example if your blood pressure is 130 over 80 subtract 80 from 130 and you get 50. Let's say your pulse is 70 multiply 70 * 50 to get 3500. If the resulting number is over 3,200 you might need a reduction in medicine. This old internist told me that was the method used to determine if anyone was over-medicated during World War II when they didn't have blood tests. That has been 100% true for me when I was over-medicated my number was anywhere from 4000 to 6500 and now over 18 months later it is routinely around 2,600. I absolutely hate thinking anyone has to suffer through overmedication like I have! Good luck to you!