Hi All,
I had a total thyroidectomy on July 21st. I started my levothyroxine the next day. Ever since the surgery, I have had a higher resting heart rate, between 80-110. It’s very frustrating and a really annoying symptom. Has anyone experienced, and if so how long did it last? I have to wait a few more weeks for blood work to see where my levels are at, I’m on 100mcg which is a pretty low dosage starting so my endo doesn’t think it’s due to my levels. Anyone else relate to this? Thanks!
Welcome to the group. If you could complete your profile it helps members understand your thyroid journey so far and be able to advise you better. Click on your image icon to start.
What was the reason for your thyroidectomy?
Approximately how much do you weigh? Its possible to do a very rough guestimate of your final dose by this calculation.
weight in kilos x 1.6 = very approx final dose
Do you have a copy of your blood results from before your thyroidectomy? You are legally entitled to a printed copy of your results, ask at GP reception. In England you can get the NHS app and ask for permission to see your blood results on that by asking at GP’s reception.
Low ferritin is a frequent offender for causing heart rate issues.
It would be a good idea to get GP/Endo to test all your key vitamins - ferritin, folate, B12 & D3. When hypo we get low stomach acid which means we cannot absorb vitamins well from our food, regardless of a great diet. For thyroid hormone to work well we need OPTIMAL levels of vitamins.
Private tests are available, see link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/help-and-supp...
There is also a new company offering walk in & mail order blood tests in London, Kent, Sussex & Surrey areas. Check to see if there is a blood test company near you. onedaytests.com/products/ul...
Only do private tests on a Monday or Tuesday to avoid postal delays.
It's ideal if you can always get the same brand of levo at every prescription. You can do this by getting GP to write the brand you prefer in the first line of the prescription. Many people find that different brands are not interchangeable.
Always take Levo on an empty stomach an hour away from food or caffeine containing drinks & other meds. Many people find taking it at bedtime works well for them.
hello Rfranzoni
I had a total thyroidectomy almost 2 years ago and it was the worst decision of my life.
I'm now on 2 heart medications from it. You're not alone. Thyroidectomies and Levothyroxine increase incidence of cardiovascular problems.
I agree having a higher heart rate makes everything difficult. I hope it settles for u
I'm sorry to hear that! Unfortunately because of my nodule and the chance of malignancy, I had to remove the whole thing. Luckily it was benign. I don't regret my decision but it definitely is rough for your body to adjust afterwards
Thyroidectomies and Levothyroxine increase incidence of cardiovascular problems.
Could you please explain this in more detail? Are you saying that first the thyroidectomy increases the risk of cardiovascular problems and then levothyroxine adds to that problem? If so, how and why?
Hello Hidden
My cardiologist told me that living without a thyroid gland puts pressure on your heart to work harder.
Cardiac arrhythmias are the most frequently documented side-effects of LT4 therapy (levothyroxine). It also lowers the threshold for the onset or aggravation of cardiac arrhythmias for patients with pre-existing heart diseases
Here are some links that may shed more light, definitely worth a read
mdedge.com/cardiology/artic...
pubmed.ncbi.nlm.nih.gov/343...
healio.com/news/endocrinolo...
ahajournals.org/doi/full/10...
frontiersin.org/articles/10...
Thank you so much!
Thank you. I do have some problems with these articles. First of all, they say that LT4 (synthetic T4) increases the risk of CVD. But since all healthy thyroids also produce T4, does that mean that euthyroid people are also at risk?
One of the articles states: In patients treated with LT4 alone, thyroid function becomes normalized. I don´t know if they just express themselves badly or if they really mean that. Which of course is incorrect as levothyroxine does not restore normal thyroid function.
These articles seem to suggest that although hypothyroid patients need LT4, they cannot take it without risk. So, my question is: does this only apply to synthetic LT4 taken by hypothyroid patients, or to every single human being with a working thyroid? Is LT4 somehow more dangerous than endogenous T4? Or is it TSH suppression on LT4 more specifically that is considered problematic?
Hypothyroidism (especially low FT3 levels) is also known to increase the risk of CVD, so the information gets somewhat contradictory at times.
When you get your bloods done next insist on TSH, T4 and T3. It’s very important to get all three tested. You might be experiencing low conversion from T4 levothyroxine to the most important hormone T3. If the NHS won’t do this for you, but they should, you can do it privately through Monitor My Health. Or don’t wait and do it privately soon. Just google Monitor My Health as they do all sorts of blood tests. They’re not expensive and deliver results fast too.
My first thought would be to call the doctor and tell him you’re concerned at your high heart rate. He may decide to lower the dose until you are accustomed to it.
I did after my total thyroidectomy last May and did until my levothyroxine dose was reduced in Feb this year. It does though take a while to adjust, 21st July is very recent.
Yes, it is very recent! I was just wondering to see if anyone else experienced it after the surgery. It is very frustrating but hoping that it adjusts as my body adjusts to the medication. I am only on 100mcg of levo so I didn't think it was that high but I am getting my bloods checked soon. Thanks!
I had my Thyroid removed more than ten years ago but remember that was one of my first symptoms. The hospital did an ECG etc. to check I was ok and it did settle down. I agree with Didntexpectthis, your removal is so very recent, are you back to the hospital soon or can seek advice?
I did see my endo yesterday who said the dosage is low right now and he doesn't think it is from the dosage, but I will be getting my blood checked soon
I had. aTT over twelve years ago and remember it takes a while for things to settle. I had a problem with my heart rate before surgery, and it was still there for a good few weeks or more afterwards. It did settle down though.
Its very early days for you, its frustrating and slow but your body needs time to recover and give the levothyroixine time to see its going to be the right dose. Levothyroxine needs to be converted to active hormone T3 and to fully do that it takes at least 6 weeks.
McPammy has given you great advice you’d be wise to follow, its advice I wish Id had then.
I am currently almost 12 weeks post total thyroidectomy that didn't go well. A 1-2 hr expected operation time blew out to just under 8 hours. My heart rate was quite low with Hashimotos before the op but I was very hyperthyroid for around 3 weeks after due to the hormone dump that I was warned would happen straight after surgery. The surgeons need to do a lot of agitation to the thyroid before it's fully released from your body, and while doing so, the thyroid excretes a lot of hormone in response. I couldn't sleep for 4 days after I woke from surgery, it was so bad, then only slept every few days after that. It did get better, though.
Thank you for reminding me that I read and was not told by the surgeon that it takes time for your own thyroid hormones to leave the body. And when adding T4 it puts one into hyper state for a little while till it settles.
I had never been on any medication until after my Thyroidectomy when I was put on 100mcg of Levo. After six months on that dosage I couldn't even get up off the floor unaided. I then joined this site. I now know that it was much to low a dose. I never had a high heart rate though it could be that it's just the operation and it will gradually go back down.
I forgot to say I am now fine and well again after joining this site. My operation went well and it didn't take me long to recover either I was 68 at the time.
My sympathy for you. I too had TT. And experienced heart palpitations. I can tell you it was not a walk in the park.I was dosed on very high doses of T4. What I later found out was that Synthroid has fillers that caused my palpitations. In addition I don't convert my T4 to T3 well enough and the heart has a big T3 receptor sights. Switching to another brand of T4 was a great game changer for me. And adding T3 to my T4 made huge difference. Also have your Iron and ferritin and B-12 and vitamin D checked. Meanwhile take some Magnesium and fish oil to calm the fast heart rate. I hope you get sorted out very soon.
Best wishes for fast resolutions.
Thanks so much for the advice! I am switching to Unithroid soon from Levo. I am hoping this will make a difference - but it could very well be the dosage I am on is just not the right one for me. I am hopeful that in the next couple of weeks as my body adjusts that everything will sort itself out.
Was you thyroid removed due to cancer? If so your TSH will need to be suppressed always. My sister had hers removed due to cancer over a decade ago now. She has to keep her TSH suppressed by keeping her T4 level too high. The NHS won’t check her T3 level.
Hi Rfranzoni,
Another fellow thyroidectomy patient here 
Mine was ten years ago due to cancer.
The most straightforward answer to your question is that low thyroid hormone can cause both low pulse or high pulse. Even though the most common/ characteristic symptom is that high thyroid hormone causes high pulses (and a general speeding up of the body) and low thyroid hormone causes low pulses (and a general slowing of the body).
I am a person who tends towards low hormone causing higher pulses. I've got no thyroid now, like you, and even though I've had periods of no thyroid hormone at all or super low hormone, I've never ever had a super low pusle. The lowest mine has ever gone is the low 60s, even when I've been stuck in bed hardly moving or breathing. And when I've been on low doses but still able to walk around and do things at my worst times had resting pulses in the 90s.
I suspect it has something to do with my blood pressure getting very low at these times, so as my blood pressure gets low, my pulse speeds up to compensate. But I haven't gone any more deeply than that.
This kind of thing is common with thyroid symptoms. Often a certain symptom is very associated with low thyroid hormone, for example weight gain, but a sizeable minority will experience it the other way round and have a low weight while their thyroid hormone is low.
The other more general point is that you are less than two weeks out from your operation. This is a very short time, and also a bit of a strange time, because hormones made by your own thyroid will still be in your body, and the synthetic hormones you are taking have not really settled down. Everything in thyroid hormones is slow. In general, you can't really know how you will feel on a given dose until at least six weeks have passed. For you this time round it will be longer, because having the operation is a much bigger change than just adjusting a hormone dose, it is your body completely transitioning from self made hormone through to being dependent on synthetic hormone replacement.
This can be a very difficult period, and almost any kind of symptom or strange event with your body wouldn't be surprising. Every single cell, tissue and organ in our body needs thyroid hormone. It is the chemical instruction telling them to make and use energy, so it functions a bit like fuel for the body, or like a battery in an electronic toy. This means if we don't have the hormone we need then it can show up in almost any of those places. Heart issues are one of the most common, though my sense is that they are more likely to come to a head years later if you had a completely healthy heart going into the operation.
Changing over from your own, home made thyroid hormone to taking hormone replacement is in some ways a reset for your body. You're kind of starting from scratch again and you may find your body is a bit different from how it was before. As you can see from some of the replies you've had, many people have a very rough ride after a thyroidectomy. I am one of the very unlucky ones as I am still very disabled a decade later and I doubt there is much room for improvement. Many people can keep up with most of their old life and will just need to rest a bit more, or cut down on the amount of work and exercise they do. Others are at the very lucky end and can return to life completely as normal.
If the only change you've noticed is a difference in pulse that you need to measure to be aware of, then it sounds like you are in very good shape and will hopefully go on to feel very very well. Possibly you are having a lot more symptoms than you mention and feeling very tired, but that is still not hugely bad news because you've just had a very serious operation and a huge shock to the body. My general advice at this point is just to hang in there, be kind and gentle with yourself and allow yourself whatever you need to do to feel comfortable and keep your head above water. You may find you need a lot of rest, and make the space for it if you do.
Even with things going perfectly, it will still take six months to a year to get completely settled on thyroid medication, you will need to get retested and adjust the dose every six weeks or so to find the perfect dose for you, but may end up having to wait a little longer, which adds time to the clock. So don't worry too much if you feel a bit off balance while your dose is still not right for you, a lot of symptoms can get ironed out by tailoring things for your unique hormone needs. If the adjustment goes less smoothly it can take a lot longer, and I think it always takes a bit of time to fully find yourself again and accept any changes.
Good luck! With this forum you have found the right place, and I suggest reading the forum regularly to learn more about thyroid. If you do start to run into trouble, you can read a lot about other people who have gone through similar things and the solutions knowledgeable members suggest or have tried.
Thank you so so much! This was so incredibly helpful you have no idea! I really appreciate it. As of right now, the elevated heart rate is really the only symptom I am feeling. Luckily, I am not tired and feeling good and hoping it continues this way! Thank you again so much, and I am so happy I found this forum
You're very welcome! Great to hear it was useful to read, thank you for letting me know
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