Is pulse rate an 'accurate' indicator of over / under medication?

[BreifneKing]

For the 20+ years before I was diagnosed with Hashi's my pulse rate had always been in the low to mid 40's. It is currently 49 and I am taking 187.5 mcg of levothyroxine (reduced from 212.5 at the beginning of August on Endo's advice). BP is 124/76.

Is it a given that pulse rate will be higher when taking the 'correct' dose of levothyroxine, or is it more of a general presumption that it 'should' be higher but it might not be?

[PurpleNails Administrator]

I find resting heart rate good indicator of levels.  

But it may not be for everyone.  like many things it’s not going be 100% accurate.

If your issue is autoimmune then fluctuations / changes can cause unexpected variations.  

if your levels aren’t balanced with either FT4 / FT3 being disproportionately high / low, how will this impact you.

Heart rate will also be affected by other factors.

It’s part of symptoms which vary greatly in everyone.  

Tracking heart rate good idea as you’ll get an indication & you’ll know what best for you. 

I’m my case I have a hyper nodule causing gradual rise in levels.  I was hyper for a prolonged time but not dangerously so.  

I hadn’t noticed my heart rate rise but I had tachycardia when diagnosed.

Soon after I started tracking heart rate.  It was high 70s by a few weeks into treatment and slowly came down with treatment.  

For a few months I was borderline low - 55 dipping to 40.  GP asked if I was dizzy, as I wasn’t he said no need to investigate. 

My conversion is also pretty stable - so as someone without autoimmune & never have very high or very low thyroid levels for a long time I can say my heart rate correlate quite accurately.