I have not posted for awhile but have a quick question.
I attended A & E in March for heart palpatations and chest pain, my ecg was abnormal but not a heart attack thank godness.
In june i wore a heart holter monitor for 24 hours, which has picked on on Atrial Enlargement and now have to attend a heart screening but not until October
My question is that whilst in A & E they tested my thyroid and it was ( T4 10 range 11-22)
and TSH 23 Range 0.1-6)
I was currently on 50mg Levo at the time, but with the Atrial Enlargement they are pushing me to take blood pressure meditcation.
My GP had gradually lowered my 150mg Levo to 50mg due to tsh,
But my main question is can low thyroid effect your heart and cause the Atrial Enlargement and would upping my Levo help to correct this and can it help to lower my blood pressure also? Or do i start taking the blood pressure pill first?
Also if anyone out there as Atrial Enlargement and is doing well please let me know, as i am freaking out and this definately doesnt help with the palpatations and chest pain, as you can imagination
Thank you so much for reading this post
Regards
Annette
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Paulannttsmn
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My question is that whilst in A & E they tested my thyroid and it was ( T4 10 range 11-22) and TSH 23 Range 0.1-6)
My GP had gradually lowered my 150mg Levo to 50mg due to tsh,
When did your GP lower your dose of Levo and what TSH result prompted that?
With a TSH of 23 and FT4 below range you are now very hypothyroid and require an increase in your Levo.
I don't know anything about atrial enlargement but both hypOthyroidism and hypERthyroidsm can cause heart problems and hypothyroidism can cause high blood pressure (according to the list of signs/symptoms of hypothyroidism on ThyroidUK thyroiduk.org/if-you-are-un... )
Hi thank you for getting back to me and providing the link, my GP has been lowering my dose over the last year and said over the phone due to TSH below 1. I have just increased to 75mg but if effecting heart, really want to sort soon as possible.
my GP has been lowering my dose over the last year and said over the phone due to TSH below 1
A TSH below 1 is not a problem. Most doctors erroneously adjust dos by TSH result. They should be looking at the actual thyroid hormones - FT4 and FT3 - to confirm thyroid status, TSH is a pituitary hormone. It's the FT3 test that is most important and if FT3 is over range that indicates overmedication, not low TSH. Take relevant information and links from this post to show your GP why it's OK to have a TSH below 1:
I have just increased to 75mg but if effecting heart, really want to sort soon as possible.
Unfortunately we can't rush increases, they should be done in no more than 25mcg increases every 6-8 weeks. Make sure that you are retested 6-8 weeks after every dose change and also ensure that all tests are done under exact same circumstances to get accurate results:
* Book the first appointment of the morning, or with private tests at home no later than 9am. This is because TSH is highest early morning and lowers throughout the day.
In fact, 9am is the perfect time, see first graph here, it shows TSH is highest around midnight - 4am (when we can't get a blood draw), then lowers, next high is at 9am then lowers before it starts it's climb again about 9pm:
If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.
* Nothing to eat or drink except water before the test - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Certain foods may lower TSH, caffeine containing drinks affect TSH.
* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw. If taking NDT or T3 then last dose should be 8-12 hours before blood draw, split dose and adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.
* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 3-7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (most labs use biotin).
These are patient to patient tips which we don't discuss with phlebotomists or doctors.
I will have to have any tests done privately as GP isn't very helpful, i have read the links provided today and now understand the outcome of dosing by TSH only and hopefully can get my doctors to understand this too, but hard when I cant even get a face to face appointment.
Reducing levo dose from 150mcg to 50mcg is most likely the problem....a rediculous decision!!
The heart needs a huge amount of T3 and being hypothyroid and on only 50mcg T4 it's only a very remote chance that the body is able to produce adequate T3 from 50mcg levo ( by T4 to T3 conversion)
50mcg is just a starter dose
You are undermedicated!
Yes you need more levo/ T4!
How did you feel on 150mcg levo?
A full thyroid test to include TSH, FT4, FT3, vit D, vit B12, folate, ferritin and antibodies TPO and Tg will provide a clear picture of what is going on
The above nutrients are very likely deficient.
NHS testing is limited so many of us test privately
I don't know enough about AE to offer advice other than to say that thyroid disorders can lead to heart problems including an enlarged heart ....and that correct thyroid hormone replacement is necessary
You know your body better than anyone else, listen to it! The symptoms you are experiencing indicate it needs help.....and you already correctly sense you need more levo!
Thank you so much for your reply, i felt ok on the 150mg levo but got called in for medication review and then she started to reduce down until left on the 50mg, i hardly get to see a GP now anyway, but all the information i am receiving here is giving me confidence to argue about dosing by TSH at any upcoming appointments, so thank you.
Do you think i can delay the blood pressure tablets until on much higher Levo dose, i know no-one is medically trained but any advise is greatly appreciated
In your shoes I'd want to sort out my thyroid medication before looking at BP ....
And to sort out that GP!!
Heart problems
If you have an untreated underactive thyroid, your risk of developing cardiovascular disease is increased.
This is because having low levels of the hormone thyroxine can lead to increased levels of cholesterol in your blood. High cholesterol can cause fatty deposits to build up in your arteries, restricting the flow of blood.
Contact your doctor if you're being treated for an underactive thyroid and you develop chest pain, so that any problems can be detected and treated, if necessary.
Thank you so much DippyDame for your reply, which was very helpful, I think I will wait and not start the blood pressure tablets and concentrate on upping the Levo first and see if my bp comes down.
The link you sent definately shows the connection between hypothyroidism and heart problems, thank you, I have saved this and even took a photo on my phone for future GP appointments, much appreciated.
I attended A & E in March for heart palpatations and chest pain
...
In june i wore a heart holter monitor for 24 hours, which has picked on on Atrial Enlargement and now have to attend a heart screening but not until October
Is it possible you are losing blood from somewhere? Usually when this happens it would be via the gut e.g. bleeding stomach ulcers or bleeding polyps, and might be spotted in your poo, although I suppose it could be caused by really heavy periods. Check your poo for signs of blood which could be bright red, maroon, black, or could look like coffee grounds. You could also ask your doctor for a stool test to check your poo for microscopic amounts of blood because GI bleeds can't always be seen with the naked eye.
People who have a chronic bleed can end up with chest pain which is mistaken (by the patient) for a heart attack. I don't know anything about specifically "Atrial Enlargement" but I have read some stuff on "enlargement of the heart" otherwise known as "cardiomegaly" which may be related to atrial enlargement and could be caused by (amongst other things) a chronic bleed or by thyroid disease. Note that doctors associate overactive thyroid (hyperthyroidism) with heart problems but having underactive thyroid (hypothyroidism) can cause heart problems too.
You should also ask for tests to see if you are anaemic because severe anaemia can cause chest pain. You should ask for an iron panel and a Full Blood Count. It is possible to be iron deficient with or without anaemia, and it needs to be treated in either case.
Severe anaemia can cause several unpleasant cardiac symptoms - palpitations, tachycardia (fast heart rate), shortness of breath, as well as chest pain, and even heart failure.
Thank you for your reply humanbean and the very useful links, I have not noticed any blood loss and to be honest, poo's are very few and far between at the moment I had a private blood test done 2 yrs ago and my ferritin was high at (235 in a range of 13-150), no advise given, i will definately test again as this was quite a while ago, and things can change. I will read the links now.
To make you smile - I have a mental poo monitor to keep an eye on my thyroid levels. Vesuvius, too high a dose, regular and easy, just right, bunged up like a duck with a cork, up my dose.
May not work for all, but it does for me. Hope you feel better soon.
have you been tested for low cortisol? If not please get this tested via a 4 point saliva test.
Being hypothyroid can cause chest pains and palps but so can being on thyroid meds with no adrenal support in place with low cortisol. It can also mean you never feel fully better and struggle to get the thyroid meds right.
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