Palpitations at night

[Catalpa]

Hi. I'm hoping someone might be able to advise me before I contact my GP surgery. I've been on 75mcg Levo and was increased to 100mcg just before Christmas. For the last couple of weeks I've been getting palpitations in bed and especially if I lie on my left side. I take the meds in the morning. Does this mean my dose is too high? It was increased because TSH was 9.76 . My surgery has not tested any other bloods. As it is online consultation now, I am wondering what the best way is to approach the GP in terms of asking for blood tests, ECG etc. Thank you for any advice.

[SlowDragon Administrator]

Highly unlikely....more likely low vitamin levels and/or poor conversion of Ft4 to Ft3

Do you always get same brand of levothyroxine?

Many people find different brands are not interchangeable

You could try splitting your dose , taking 50mcg in morning and 50mcg at bedtime

Essential to regularly retest vitamin D, folate, ferritin and B12

What vitamin supplements are you currently taking?

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

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 NOW or test privately alongside thyroid tests

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)

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 antibodies and vitamins

medichecks.com/products/adv...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

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

monitormyhealth.org.uk/

Also vitamin D available as separate test via MMH

Or alternative Vitamin D NHS postal kit

vitamindtest.org.uk

[Catalpa in reply to SlowDragon]

Thank you for your helpful reply. I was taking Teva brand 50 mcg plus 25mcg I notice I am on Mercury Pharma Group 100mcg now so that may be something to do with it.

I currently take Vitamin D and a B Complex plus biotin. Sometimes I also take Spatone as I have been anaemic in the past but have not had iron tested for years.

I have followed the advice and always get an early thyroid test at about 9.45am and fasting so that results are consistent. I take biotin for my thinning hair and stop that about 5 days before blood tests as I believe it can affect the results.

My GP services only tests TSH and if it is above 5, then they also test T4 but never T3 or antibodies. My last T4 for 13.6 but I guess that is meaningless without the ranges? My GP is adamant that she can diagnose and treat thyroid from TSH alone.

I will request the Vitamin tests from the surgery. The answer will probably be no but no harm in trying and if they refuse, I will do them privately and give a copy to my GP.

I will also see about getting the online access or detailed blood results.

[SlowDragon Administrator in reply to Catalpa]

You need to stop vitamin B complex A WEEK BEFORE ALL BLOOD TESTS as well as biotin

Vitamin B also contains biotin

Recommend getting tested privately if GP refuses

So you MIGHT do better on 100mcg Teva

Obviously it’s impossible to manage a thyroid patient by just testing TSH

Recommend you get full thyroid testing 6-8 weeks after being on 100mcg at constant unchanging brand

Thinning hair frequently low ferritin/iron

[Catalpa in reply to SlowDragon]

Thank you. I notice Medichecks have a January sale with 25% off so may take advantage of that. My GP tests every 3 months following a dose change but once she is happy with TSH apparently it will be annually.

[SlowDragon Administrator in reply to Catalpa]

Come back with new post once you get results

[SlowDragon Administrator]

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

Link re access

healthunlocked.com/thyroidu...

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

[shaws Administrator]

When I was on levothyroxine alone I had frequent palpitations during the day and night. The cardiologist could not find the reason but gave me beta blockers and I still take one before I go to bed.

[serenfach]

I had very bad palps when I was taking an NDT that later proved useless. So palpitations can also happen when you are too low for your thyroid. I wore a heart monitor for 48 hours that picked up the palps, but nothing was done, and in fact I had to chase up the results as the heart nurse had not passed them to anyone.

[shaws Administrator in reply to serenfach]

The professionals don't seem to be aware of how the patient feels when their heart beat goes 'over the top' which is quite scary at first. Mine always seemed to be in the middle of the night but I found sipping ice-cold water (not good when half asleep) and breathing slowly resolved them. The one beta-blocker before bed also resolved them. I still take a beta-blocker and that's for quite a number of years now. I do feel well so am not that bothered now.

Hopefully you'll feel better soon.

[magsyh]

Palpations can be complicated. I suffered with it for two years I have it more or less under control now. I discovered my cortisol was too low and I cannot tolerate levothyroxine over 62mcg. I have just got off propranolol which helped a little bit. I also discovered that vitamin b complex made it worse so ditching that made a huge difference. The big question is do you have hashimotos? I don't, and discovered I actually am deficient in iodine. Problem is if you are like me and deficient in iodine you will not tolerate levothyroxine. Without sufficient iodine you will not tolerate B2. It all works together. Right now my palpitations are under control. You should test for low cortisol. I am still on my thyroid medication but I'm slowly introducing iodine and selenium and low dose b vitamins. So far it's working and I hope eventually to ditch the levo. Took me a few years to work it out. We are all individuals it's just a case of working out where your problems fit in.

[Catalpa in reply to magsyh]

Thank you. Did you get anyone helping you with your journey of finding out it was not Hashimotos and feeling better? I've never had antibodies tested but assumed it is Hashi's because of my age (54) and that there is autoimmune in the family

[magsyh in reply to Catalpa]

Get your antibodies tested. My sister has hashimotos but I don't. I'm 62 so don't assume you have it till you are tested. No I didn't get help once I had ECG and they said nothing wrong with my heart they said antidepressants or nothing. I said no thank you so they dropped me like a hot cake not interested. High dose vitamin c and b5 has also done wonders for me.

[Catalpa]

Thank you. I will get a comprehensive test and see what comes back.