Cardio and thyroidism

[gunnerred67]

5and a half years ago I suffered a heart attack. I had a stent implanted and went to cardio rehab. I have noticed over the last year I get tired quickly and have shortage of breath. I was shocked to be told by my new doctor that I have an underactive thyroid. My question is this! Is my heart contributing to the thyroid problem or could any of the drugs I take be the cause.

[SlowDragon Administrator]

What medications are you currently taking

Are you taking Amiodarone?

This can significantly affect thyroid

ncbi.nlm.nih.gov/pmc/articl....

[gunnerred67 in reply to SlowDragon]

I take 10mg lercanidipine, 75,mg aspiring, 80mg Atorvastatin, 3.75mg Bisoprolol, 10mg Ramipril 400micro.g Tamsulosin. I have just had a medic, review and they changed amlodipine for the lercanidipine.

[Jazzw]

Well. It could be a new problem. It could be, as SlowDragon has already said, a side effect from medication.

Or it could be that you’ve had “mild” hypothyroidism for a long time which could even theoretically have caused your heart attack.

Was your thyroid function tested fully 5 and a half years ago?

[gunnerred67 in reply to Jazzw]

Thank you for your input, I have just had a medic review.

[SlowDragon Administrator in reply to gunnerred67]

Please get actual thyroid and vitamin results

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

[arTistapple]

I had a heart attack twenty plus years ago but no coronary artery occlusion. A thyroid test was taken at the start of inquiries. It showed ‘slight’ abnormalities (that I am now aware of) but was ignored by medics. I ‘managed’ for the last twenty years or so after refusing their medication because, for me, it made no difference to the angina pain I was experiencing and the exhaustion (I thought was down to the medication) was debilitating. Two angiograms and twenty years later, I also find out that iodine used in the test upsets thyroid levels in individuals already prone to hypothyroidism. It’s different for you because you have had to have a stent (life saving) but there are definite medications which worsen issues, hence Jazzw remarks. So your hypothyroidism is likely to be contributing to your symptoms, even causing your original heart attack. Your heart maybe contributing to your symptoms but not to your hypothyroidism. Hypothyroidism and heart issues are closely linked.

My hypothyroid diagnosis only came in three years ago, after struggling all that time and more.

[Poniesrfun]

Do get a full thyroid and vitamin evaluation as Slow Dragon outlined above.

It is possibly that being hypothyroid may have contributed to your cardiac issues - optimizing thyroid levels has been shown t lower cholesterol, blood sugar and blood pressure levels.

But you are also taking three medications which have the effect of lowering blood pressure:

10mg lercanidipine, (Zanidip) Belongs to the dihydropyridine class of calcium channel blockers, which work by relaxing and opening the blood vessels allowing the blood to circulate more freely

3.75mg bisoprolol (Zabeta) Beta blocker. β1 selective.

10mg ramipril (Altace) Decrease in angiotensin II results in relaxation of arteriole smooth muscle leading to a decrease in total peripheral resistance, reducing blood pressure.

While opening up blood vessels so the heart receives more oxygen and lowering blood pressure to reduce resistance so the heart doesn't have to work as hard it can sometimes make it harder to get enough oxygen to all your muscles and brain. Also, the Flomax (tamsulosin - I presume you're male? your profile doesn't say) can cause severe hypotension.

You should be monitoring your blood pressure every morning at the same time before you take any medication and your medical team should provide instruction on what blood pressure level and heart rate should prompt a call or holding a med. (If they didn't do this then ask them.)

We do need to remember that all our body systems work in concert - what happens to one affects all the others and a bad note in one section will mess up the whole concert. While thyroid may be the conductor it needs help from all the others to keep us in tune - you need all the evaluations/tests suggested.

Patti in AZ