Thyroid and AFib nightmares in chalk hill and river country

[Lotika]

The Husband has been struggling a lot recently; symptoms included swollen ankles, breathlessness on exertion, extreme fatigue, loss of appetite and insomnia, all of which gradually became worse as the days went by.

We couldn’t work out if these were symptoms of COVID in the double-vaccinated (endless tests came back negative) or if they were symptoms of over or under medication for thyroid. We waited until it was time to test and sent a sample off to Medichecks, which incidentally, took an age to be processed. I’ve found Thriva far quicker, for what it’s worth!

In the meantime, he became too ill to get out of bed much or move much further than from the bed to the sofa. I put his main symptom - breathlessness - into the 111 website on Wednesday and it advised calling 999 immediately, suspecting COVID. Given the negative tests, this seemed unlikely, so we called the doctor for a same day telephone appointment to try to avoid bed blocking in the middle of a pandemic and frankly, COVID, given that hospital is probably a good place to catch it! They arranged to see him in person the day after the consultation.

He had some kind of ECG the next day at the local surgery and got a diagnosis of AFib and some tablets. The medichecks results finally came back last night as follows:

TSH 1.77 (0.27-4.2)

FT3 4.5 (3.1-6.8)

FT4 14.3 (12-22)

So… that looks a touch under medicated. In normal circumstances I’d be saying “up the levo” but given I know nothing about AFib, I’m keeping quiet and we will await the views of the GP when they see the results of their test, which he took this morning.

I am writing for two reasons, really.

1) We can’t be alone in trying to deal with hashis and AFib together, so I am curious to read about other people’s experiences… he’s been given a beta blocker and a blood thinner.

2) Given that his AFib symptoms looked a lot like thyroid symptoms of one sort or another - and initially at least, I was convinced thyroid was to blame - I thought it may be useful to share.

Obviously it has all been terrifying: I was convinced that he’d end up going straight to hospital from the surgery yesterday with the blue lights flashing… I was also scared that I’d over medicated him and caused the problem as the GP thought he was on 100 mcg levo and he’s actually on 150. Being the patient and kind soul he is (my uncle calls him “Bear” as he is big, bearded, tattooed and gentle) and even though we were both convinced I was probably to blame for over medicating him before we got the test results, he wasn’t mad at me. I was mad at me. Because I always know better. But those are the results on 150, so… it’s not an over medicated know-it-all-wife thing… just a life thing, by the look of it.

When it rains, it pours, eh?

[SlowDragon Administrator]

When were vitamin D, folate, ferritin and B12 last tested

Latest Apple Watch 6 can record ECG to iPhone on demand. Helpful to see what’s going on

[Lotika in reply to SlowDragon]

Last tested about 8 weeks ago. All what we would call optimal, with only B12 good enough for medichecks (or whoever, I forget) but not quite good enough for us… And he still looks like a super-converter to me as well. I struggle to get my fT3 higher than that on T4 & T3! Good idea re the Apple Watch. He will prevaricate about spending that much money on himself, but I can use my money and get a sneaky little order in when he’s not looking, perhaps… ! He uses an old Apple Watch, so I can’t see that he’d hate the idea. I will have a google and see what I can learn about it…

[SlowDragon Administrator in reply to Lotika]

Recent ECG showing irregular heartbeat

I found reducing my T3 dose a small amount completely stopped this (both Ft4 and Ft3 were well within range)

Perhaps he should try slight dose reduction in levothyroxine….or see if splitting dose improves symptoms first

ECG

[Lotika in reply to SlowDragon]

Thank you for this… I’ll try to learn a bit more about it all and see what The Husband thinks… !

[SlowDragon Administrator]

Perhaps try splitting levothyroxine dose into 2 smaller doses

Does he always get same brand levothyroxine

[Lotika in reply to SlowDragon]

Good thought - he could always take one at night and one in the morning.

[Lotika in reply to SlowDragon]

Oops - yes, Accord. We’re both on that one…

[shaws Administrator]

You can read my journey to being diagnosed as hypo if you click on my name.

On levothyroxine I had constant, severe palpitations, particularly overnight. The cardiologist was puzzled as I had overnight phone calls that recorded them to the department and was considering putting an implant in my heart to record them.

When the Endo added T3 to a reduced T4, I immediately felt much better and palpitations reduced and I had no more contact with the Cardio Dept.

When I took T3 only, I had no more symptoms nor palpitations (usually these were very early a.m.) and the only way I could reduce palps was to sip ice-cold water and wrap an ice-cold towel from freezer around my neck at whatever time, 1 a.m. 3. a.m. etc etc.

I think that sometimes people may be affected by something in a tablet that causes the problem.

I've also read that if you take one anti-histamine tablet about an hour before levo and if symptoms don't resolve an option should be trialled.

[tattybogle]

if it helps with the 'self blame' look at my profile .. after diagnosis i basically 'upped' myself from 50 to 100 to 150 to 'a bit over 150 but can't remember exactly how much' over about a year and a half... then stayed on 150 for years ...and didn't get A Fib .

Back then the TSH range was [0.02 ! - 6] mine was 0.09 /0.05 and just in range. fT4 was over range at 28/30 [13 -26] ... (this was after i reduced back to 150, before that on 150 my TSH was stubbornly stuck at 2.5 ish on 50/100 and150 )

so if 'overmedicating' on just levo was going to cause A-Fib all by itself , then i should have been a candidate.

That was 18 yrs ago , and i've had similar dose and results ever since .. ie. low / below range (but not supressed) TSH, and fT4 all over the place from 50% to to 242% and a few fT3's all between 40/60% ... still no A-fib, and still no idea what a 'palpitation' is.

So if my experience is any comparison,, then 150 levo with blood results like he has . is unlikely to be ' to blame' for Afib .

[Lotika in reply to tattybogle]

Thanks for this - I agree it’s unlikely that it was the levo, but heck, in that gap between him going to the surgery and getting diagnosed with AFib and us sat around waiting for the medichecks thyroid test result, I honestly did think it was all my fault…! (I was contemplating a cottage by myself in the middle of nowhere with no internet access for the rest of my days so that I could spare the world any further damage from my habit of being a know-it-all…) But when I saw the numbers I changed my mind as overmedicated he ain’t… Just probably some god-awful coincidence…

[tattybogle in reply to Lotika]

........

some of us can still manage to be a nuisance all on our own

[Buddy195 Administrator]

I just wanted to pass on my best wishes to you both Lotika; I hope things improve soon! 👍

[Lotika in reply to Buddy195]

Thank you! I think we are going in the right direction…

[Yeswithasmile]

Aww…. Lotika, I feel for you. What a tough time you’re having. I hope your old fella picks up really soon. Upshot.. nope you haven’t over medicated him and you can join my club of being the ‘know it all’s’. 🤣

Sending lots of positive thoughts your way hoping everything improves asap.

[Lotika in reply to Yeswithasmile]

Thank you! Well I’m glad I’m in good company with the know-it-all thing!! We think it is improving - fingers crossed 🤞 He says he wants to see a specialist endo on the private, which makes sense… we are scared to up the meds but an endo might know… we shall see…!