Heart rate over 100. Should I lower or up my Levo??

[HappyBadger]

Hi I was wondering if someone had any advice on whether or not I should lower or up my Levo dose?

I had upped from 100mg to 112.5 mg beginning of June, but my heart-rate just keeps going over 100bpm when I’m not doing anything. I’m still tired and feel as if I just can’t be bothered. I’ve been sitting all day and so far my watch has notified me 8 times that my heart rate has gone over 100bpm while being inactive for more than 10 minutes.

The Doctor prescribed Adcal-D3 Lemon chewable tablets that I take twice a day.

I’m also taking Thorne basic B complex and also Holland and Barrett’s B12.

All the last tests were done at 9am with no Levo 24h before and stopped all supplements 5days before.

These were my last tests done end of May

Any help would be appreciated

Thanks in advance x

Serum sodium level 140 mmol/L [133.0 - 146.0]

Serum potassium level 4.5 mmol/L [3.5 - 5.3]

Serum creatinine level 63 umol/L [45.0 - 84.0]

eGFR using creatinine (CKD-EPI) per 1.73 square metres > 90 mL/min

Serum total protein level 72 g/L [60.0 - 80.0]

Serum calcium level 2.23 mmol/L [2.25 - 2.55]

Outside reference range

Serum albumin level 47 g/L [35.0 - 50.0]

Serum adjusted calcium concentration 2.13 mmol/L [2.2 - 2.6]

Outside reference range

Serum alkaline phosphatase level 54 iu/L [30.0 - 130.0]

Serum bilirubin level 9 umol/L [< 21.0]

Serum alanine aminotransferase level 12 iu/L [5.0 - 33.0]

Plasma glucose level 4.6 mmol/L

Serum magnesium level 0.91 mmol/L [0.7 - 1.0]

Blood haematinic levels

Serum vitamin B12 level 459 ng/L [197.0 - 771.0]

Serum folate level 3.3 ug/L [3.0 - 20.0]

Serum ferritin level 81 ug/L [13.0 - 150.0]

Serum TSH level < 0.05 mu/L [0.27 - 4.2]

Outside reference range

Serum free T4 level 21.5 pmol/L [12.0 - 22.0]

Serum C reactive protein level 3 mg/L [< 5.0]

[greygoose]

You don't really want any more levo. But, whether or not you need less is impossible to say without seeing an FT3 result. Could be that you are not converting very much of that T4 into T3, so you would be under-medicated. But, the solution to that would not be to increase the levo, because that could make conversion worse. But, it's not something we can guess at. It has to be tested to find out.

The Doctor prescribed Adcal-D3 Lemon chewable tablets that I take twice a day.

Silly doctor! Your calcium is only slightly low. Just taking vit D on its own would have raised it because it increases absorption of calcium from food. Taking calcium supplements is not a good thing to do because they are difficult to absorb and tend to build up in the soft tissues and arteries. Maybe your heart doesn't like all that calcium!

Did your doctor at least test your vit D before prescribing it? Because I can't see a result for it. And, if you are taking vit D, you should also be taking its cofactors: magnesium and vit K2-MK7.

[HappyBadger in reply to greygoose]

Hi greygoose and thank you so much for the speedy reply. No Dr didn’t test Vit D. The last time the it was tested was on the 2/04/22. I was taking BetterYou vitamin D spray but he said to stop as my results were too high

( 91 nmol/L) and I did do a Monitor my Health test for thyroid which was

( 4.3 pmol/L

FT3 levels normal (normal range 3.1 - 6.8 pmol/L)

And that was done on 31/05/22

I’ve noticed that my cholesterol is going up as well.

I think I will just stop the Adcal and just continue with the spray, and probably go back down to 100mg and see how I feel.

Thanks again x

[greygoose in reply to HappyBadger]

( 4.3 pmol/L FT3 levels normal (normal range 3.1 - 6.8 pmol/L)

Your cholesterol is going up because your FT3 is too low. It may be within the so-called 'normal' range, but that doen't make it 'normal'. The majority of hypos need it much higher than that.

[DippyDame]

You don't have the really important lab result... FT3.

T3 is the active thyroid hormone and if that is low then health suffers

It's possible that your T4 to T3 conversion is poor...so causing low T3

Without FT3 we have no idea what is going on!

Goodness knows why he thinks Adcal-D3 is the appropriate treatment.

I'd suggest you reduce levo back to 100mcg and stop adding the supplement

Then have a full thyroid test in 6 weeks to include ...

TSH, FT4, FT3, vit D, vit B12, folate ferritin andthyroid antibodies TPO and TG in 6 weeks Post the new results here...and go from there!

[HappyBadger in reply to DippyDame]

Hi DippyDame, thank you for replying. I did do a Monitor my Health thyroid test on 31/05/22

(4.3 pmol/LFT3 levels normal (normal range 3.1 - 6.8 pmol/L)

I think I will go back to 100mg and stop the Adcal and just go back to my BetterYou vitamin d spray.

Thank you so much again.x

[DippyDame in reply to HappyBadger]

OK, so that FT3 lab is only 43% through the reference range .

We aim to have it approaching 75%... though obviously we are all different so the ideal % age for the individual will vary

Your T4 to T3 conversion is poor ....note the high FT4 with low FT3

I'd suggest you need add some T3 and a visit to a knowledgeable endo would be a start

Low T3 will raise cholesterol.

My cholesterol level dropped when I became adequately medicated.

Just a few thoughts

[HappyBadger in reply to DippyDame]

Yes I think I must be a poor converter and I am going to ask my GP first if he can refer me if not I guess I have to go private which would be just wrong. I’m sick of the doctors 😫

[DippyDame in reply to HappyBadger]

Serum TSH level < 0.05 mu/L [0.27 - 4.2]

With TSH so low your GP should be doing a full thyroid test...which includes FT3!

Mine did that....although I already knew having had a positive ( homozygous) Dio2 genetic test

thyroiduk.org/deiodinase-2-...

This link shows adding T3 can help if the genetic variant is present....more so if inherited from both, rather than one parent.

pubmed.ncbi.nlm.nih.gov/191...

Common variation in the DIO2 gene predicts baseline psychological well-being and response to combination thyroxine plus triiodothyronine therapy in hypothyroid patients

But the following comparison should suffice!

You can then compare the Frees...

High FT4 with low FT3 = poor conversion

Poor conversion = low FT3 = poor health = attention required!

On that basis request an appointment with an endo ....and a trial of T3.

There is no guarantee that private is better than NHS...they have had the same training!

Try to ensure they are a thyroid rather than a diabetic specialist...but rare as hen's teeth!!

[Sparklingsunshine]

Hi

Some of your bloods look scarily similar to mine, my folate was 3. 4,my calcium is 2.1. I have raised ferritin, unlike you. I've got to have my bloods repeated in two weeks.

Your low folate won't be helping you feel well. That could certainly do with improving. As the others have said you need your FT3 result to see how well you are coverting your Levo. It's difficult to know if you're over or under medicated without it.

[HappyBadger in reply to Sparklingsunshine]

It’s just so annoying isn’t it that our GPs can’t really get it right. I think I’m going to have to see a private Endo to try to see if they can get to the bottom of it. X

[Sparklingsunshine in reply to HappyBadger]

Hi

For some inexplicable reason my GP is retesting all my bloods, even those that came back as normal. Yet I've asked for my vitamin D to be tested as I've got a history of deficiency and nada, nothing. I do wonder sometimes if I'm talking to a brick wall. As if my levels are going to move much in 3 weeks. What a waste of time and resources.

[SlowDragon Administrator]

I was taking BetterYou vitamin D spray but he said to stop as my results were too high

( 91 nmol/L)

Recommended that vitamin D is at least over 80nmol and around 100nmol maybe better

Were you taking Better You vitamin D spray with vitamin K2 added

Vitamin D and thyroid disease

grassrootshealth.net/blog/t...

Vitamin D may prevent Autoimmune disease

newscientist.com/article/23...

Any obvious reason for low calcium.

Are you on dairy free diet for example?

Considering you’re taking Thorne B complex and a separate B12 your folate and B12 are very low

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement and separate B12

Are you now on absolutely strictly gluten free diet.

Likely to need to get T3 prescribed alongside (slightly reduced) dose levothyroxine

Email Thyroid U.K. for list of recommended thyroid specialist endocrinologist and doctors who will prescribe T3

[e-mail]