Hello!I was wondering if anyone has experience of this. What can be done about it, is it reversible with optimal levo?
For context, I have Hashi's, I'm 51 and currently experiencing another bout of terrible anxiety ( last time was 5 years ago). Tests have discovered the enlarged LA. I don't have any other reasons for it to be like that other than thyroid, unless anxiety can temporarily enlarge it.
Thanks in advance!
I don't have experience with this in particular but looking it up it seems that high blood pressure can be a cause which under treated hypothyroidism can cause. ncbi.nlm.nih.gov/books/NBK5...
Do you have high blood pressure and is it treated well?
What were your latest blood results with ranges?
Have you recently had key vitamins tested - ferritin, folate, B12 & D3? We need OPTIMAL levels of these for our thyroid hormone to work properly. Hypo people get low vitamins due to low stomach acid and malabsorption.
Hi! My blood pressure has been fine but has been higher with the recent anxiety - something I've had since September/October. Bloods were fine and pretty normal for me. Haven't had vitamins and minerals tested for a long time, will remedy that soon. Thanks for your reply!
So what were the blood result numbers? The ones you posted some years ago looked on the low side. Anxiety is a hypo symptoms.
Nov '22TSH 1.22Free T4 12.32
TSH will be around 2.5 now as I've reduced a little because of the anxiety.
Going by TSH only is inadequate. You really need to know whats happening with your FT3, the active hormone.
You haven't given lab ranges but your TSH at 1.22 could have been improved by a 25mcg dose increase which would have helped your anxiety and BP rather than reducing dose.
Yes, agreed re: Free T3. Unfortunately it wasn't tested. I'll make sure it is next time. I was good for years at around 2 to 3 TSH but thought it would be good to increase Levo. That led me to 1.22. Then new anxiety and tachycardia started so I reduced the Levo to previous levels. Perhaps I should increase it again.
Hi MPG1972,
It's interesting, I'm on the site because I have lone paroxysmal atrial fibrillation and I'm trying to figure out whether subclinical hypothyroidism may have predisposed me to it.
And you have conclusive clinical hypothyroidism and an incidental finding of left atrial dilation, which could certainly predispose you to AFib and other supraventricular tachyarrhythmias.
An enlarged left atrium, whether arising from undiagnosed 'silent' AF, or e.g. endurance training, high blood pressure, pulse pressure or structural heart defects, is prone to create a 'substrate' in which, once started, the characteristically irregularly irregular rhythm of AFib is sustained and reinforced in a degenerative feedback loop... which enlarges the left atrium.
Whether or not you have had AFib to date, it would certainly be worth avoiding in future. And I presume that the tests which unearthed LA enlargement arose because of the tachycardia?
Some more background would be useful.
You do not want AFib to take hold. And, unless you are e.g. a regular 10K runner, have some haemodynamic issue, or structural heart anomaly that independently explains your LA enlargement, there must be a suspicion that AF is at least beginning to cause it on the quiet.
Famously 'AFib begets AFib', precisely through it promoting the LA enlargement that then supports it in the chicken-and-egg relationship I describe above. You must turn this around.
There is an entire sister site devoted to AF, and you really don't want to become a regular visitor there. But neither do you want to suffer any adverse consequences of undiagnosed AF.
It sounds to me as if someone medical has already been over this terrain with you. But it looks incomplete.
How frequent are these symptoms of arrhythmia? Has anyone suggested a Holter Monitor? Are you very symptomatic - do you notice palpitations easily when you get them? Have you any proper means to measure your ECG yourself, like a SnapECG or Kardia device (store.kardia.com/products/k..., or even some sort of sports watch? Get some means, if you don't have a device already. And keep a log.
You do need to get on top of this. No one dies of AF. But an enlarged LA in the presence of AF runs a much increased risk of throwing off a blood clot that can go somewhere it shouldn't, and ruin your whole day.
Get it properly checked out.
And, by the same token, there is no point in trying to regularise your thyroid in the presence of an Adrenal problem which is upstream of it. That needs to get sorted upfront too.
If you have been experiencing unusual stress, like thinking about all this(!), and experiencing anxiety, odds are your adrenals are out of whack.
It's a system. I see lone AF (i.e. AF of unknown cause) as a symptom of system breakdown.
As others have pointed out, it will be as well to audit your entire system, including vitamins D, B12, Folate, iron, cortisol, and FT3 (the business end of hypothyroidism), as well a allied gastric symptoms of possible malabsorption associated with it. A spoke could be put in the wheel anywhere along the line. B12 deficiency (and consequently increased homocysteine) alone could explain an awful lot.
And, were it not all exquisitely joined up already, the 10th cranial, or Vagus, nerve wraps it all up in a bow by, as the name suggests, wandering around and enervating the whole shebang. So, a dysfunction anywhere can trigger a problem anywhere else.
You will not get a conclave of cardio, endo, gastro and neuro specialists to look at the overlap until you get a really serious problem (if then!). So, I am afraid this is on you.
Or on us, on sites like this. It's why we are here. There are a lot of variables that straddle specialities and often fall below the medical radar, until they cause something you really don't want.
Clinical thyroid issues, like yours, are a known cause of AF, and LA dilation a known mechanism. That's a start.
There are those, and I don't disparage them, who have eventually to deal with AF (as I have had to) through ablation and other invasive techniques. But these are just like dealing with a house-fire by knocking off the alarm. Nothing else changes, not even the crucial need for chronic anticoagulation in many cases.
Far better to get it under control early because AFib is, as I say, degenerative.
Apologies for the mind-dump, and perhaps over-admonitory tone. But I hope this helps.
Carbimazole side effects: Salivary gland enlargement.
Enlarged tyroid
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THYROXINE AND ATRIAL FIBRILLATION
