Slow and irregular heart rate with T3

[Yostie]

I have taken NHS prescribed T3 only since 2012, three doses: 20 mcg 7am 10 mcg 3pm , 20 mcg 10 pm. 65 bpm is my normal resting rate. In the past I have had an occasional fall in bpm to mid 50's but found upping T3 dose for few days and changing to new packet (not short date) and my heart rate returned to normal. (This was some years ago - I thought it was a medication issue (i.e. deteriorated in quality close to use by date) and Yellow Carded the tablets).

Several weeks ago my heart rate fell below 60 and I increased my dose, which has increased my heart rate but my heart rate drops back below 60 when I go back to my usual dose of 50 mcg, but I now have irregular/missed beats, which vary from once or twice, to several times per minute.

I don't sleep well am awake for several hours 3-5 in the morning. I am otherwise slim, fit, gluten free, low dairy, have a vary varied diet, very low sugars.

Have an ECG this morning. Been putting it off as seriously concerned the new Doctor, (mine has retired) whom I have never met but has already incorrectly advised on blood tests - noted I was on T4 and delayed signing my T3 prescription, is going to cause problems about my T3 meds.

Any advice please. Thank you.

[Jaydee1507 Administrator]

It's probably best to check your thyroid levels. Do you get a full thyroid panel done by the NHS or do you monitor yourself with private tests?

Other than being on the wrong dose of hormones low vitamins, inparticular low ferritin/iron can cause heart rate issues.

Do you have a copy of your latest blood results that you can share with us? 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.

How are your key vitamin levels looking?

What are you supplementing with?

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. Have you recently or could you ask your GP to test levels of ferritin, folate, B12 & D3? 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.

[Yostie in reply to Jaydee1507]

Thank you.

I have all my blood results, last in April '23 a FBC showed:

Ferritin: 33ug/L (10-291). Too low. Has annually, since 2019, dropped steadily from 99ug/L. Don't have the serum iron etc.,

T3: 4.3pmol/L (3.1-6.8)

TSH: 0.024 (0.27-4.2)

Endo was content with the T3/TSH.

My last private test was last June 22.

Vitamin B12 - Active 85.6 pmol/L (Range: 37.5 - 150)

Vitamin D - 167 nmol/L (50- 200)

Folate - 10.91 ug/L (3.89 - 19.45)

Spent morning having 4 ECG's (irregular beat every 10 secs) and referred back to GP for referral to the local Cardiac Hub. They took a thyroid screen, which will be "irregular" as it was three hours after 20 mcg of T3. So, under the circumstances I am going to ask for a full screen from new Dr (my old Dr would have done a full screen for me). If not it will be private test.....

I take freeze dried beef liver and organs as capsules...I can't cope with fresh/cooked liver.

[Jaydee1507 Administrator in reply to Yostie]

Much will depend on when you took your last dose of T3 prior to this test. To see a stable blood level of T3 you need to take last dose 8-12 hours before the test. Any longer and the result will show a false low, any more and they will shpw a false high.

Free T3 (fT3) 4.3 pmol/L (3.1 - 6.8) 32.4%

Your FT3 looks on the low side but it really all hinges around how you took the test and timing of last dose.

Your folate is less than optimal. Aim for a level of 20. Recommend taking an active/methyl (should say on label) B complex which contains 400mcgs folate (also B12). Occasionally some people require a higher dose of folate, often due to having MTHFR genes in which case buy a separate 400mcgs methylfolate and slowly add to your dose over several weeks. This B complex has all the right vitamins at a not unreasonable cost for 90 days supply. amazon.co.uk/Liposomal-Soft...

Always stop the B complex 4 days before your blood test as it contains biotin and can interfere with thyroid blood results.

Your ferritin is only 3 points above deficiency so very low. Low ferritin often causes heart rate issues. Ferritin should be around 90 - 100 for best use of thyroid hormone. Suggest increasing iron rich foods in diet and eating them often. Chicken livers, pate, red meat etc

If you got a full iron panel done you would be able to see if you could use a supplement. Recommend doing that and posting the results here for comments.

[Yostie in reply to Jaydee1507]

I now have a new set of results

Ferritin 65 ug/L (30-150)

T3: 6.5pmo/L (3.1 -6.8)

TSH: 0.005 (0.27-0.4.2)

Serum Vit B12:585ng/L (197-771)

Folate: 12.8ug/L (>3.89)

Lymphocyte 0.96 x 10 (9)/L (1.34 - 4) (abnormal)

Total White Cell Count 3.1 x 10 (9)/L (4-11) (abnormal)

Agreed with Dr to check minerals Zn after 4 weeks of zinc supplements and will check Mg, which I supplement anyway.

Palpitations continue on a regular basis, there has been no change.