Levothyroxine and arrhythmia

[SolihullMan]

Diagnosed with hypothyroidism in infancy. Been on treatment my entire life. Currently 200mcg levo daily. Last few years been having ectopic heartbeats and arrhythmia. Anybody else had this and is it linked to thyroid hormone treatment?

[SlowDragon Administrator]

Could be …..under medicated, or poor conversion of Ft4 (levothyroxine) to Ft3 (active hormone) or low vitamin levels

Do you always get same brand levothyroxine at each prescription

Do you know if you have autoimmune thyroid disease or were you born with no thyroid

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

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

Also both TPO and TG thyroid antibodies tested at least once for autoimmune thyroid disease (hashimoto’s)

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG 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.

Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)

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

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 and last dose levothyroxine 24 hours before test

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

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

[DippyDame]

Welcome!

You need to have FT3 tested as part of a full thyroid evaluation....TSH, FT4, FT3, vit D, vitB12, folate, ferritin and thyroid antibodies TPO and Tg.

I suspect your FT3 is low or is not adequately reaching the nuclei of the cells.

Your T4 to T3 conversion is possibly poor

The level may have been very slowly falling over some time

Your essential nutrients which support thyroid function are very possibly also deficient.....this is a common problem

The heart needs a great deal of T3!

200mcg T4 is quite a large dose and if it is not being adequately converted to T3 in the tissues the high dose can cause cardiac issues and increase the risk of cancer.

Your GP may not be aware of this.

Suggest you request a full thyroid test on the basis of your historic thyroid disease, if GP refuses then request an appointment withan endo

It is essential that symptoms are considered during diagnosis....not just the lab numbers!

thyroiduk.org/signs-and-sym...

Or do as many of us do to quickly obtain labs, test privately...

thyroiduk.org/testing/our-v...

thyroiduk.org/testing/priva...

Post any lab results you can obtain. You are legally entitled to request previous results from your surgery... ask the Practice Manager

You very likely need some T3 added to a reduced levo dose but first you need adequate testing which will point the way forward

So, to answer your question...is it (ectopic heartbeats and arrhythmia) linked to thyroid hormone treatment?

It is highly possible...but you need to start investigating!

We're all here to help....just ask.

[SlowDragon Administrator]

Examples of other members private blood test results

Medichecks results

healthunlocked.com/search/p...

Blue horizon results

healthunlocked.com/search/p...

If you have low Ft3 improving low vitamin levels can improve conversion rate

If Ft3 remains low ….. getting small dose T3 prescribed alongside levothyroxine if necessary

[SolihullMan]

I was born with non functioning thyroid. No disease and no auto immune issue. It’s just caput!

Just spoke to Gp who confirmed they did full t3 and t4 test. T4 was slightly elevated in the high range of normal and tsh was low.

Pathology Investigations

Serum free T4 level 17.4 pmol/L [9.0 - 19.0]

Serum TSH level 0.20 mu/L [0.4 - 4.9];

Serum free triiodothyronine level 4.6 pmol/L [2.4 - 6.0]

Serum vitamin B12 level 277 ng/L [187.0 - 883.0]

Serum folate level 6.9 ug/L [3.1 - 20.5]

Serum cholesterol level 5.6 mmol/L [< 5.0]; Above high reference limit

Serum triglyceride levels 3.6 mmol/L [0.0 - 1.7]; Above high reference limit

Serum HDL cholesterol level 0.90 mmol/L [> 1.0]; Below low reference limit

Calculated LDL cholesterol level 3.06 mmol/L [< 3.3]

Serum cholesterol/HDL ratio 6.22 [< 5.0]; Above high reference limit

Serum non high density lipoprotein cholesterol level 4.70 mmol/L [< 7.5]

Total white blood count 7.58 10*9/L [3.26 - 11.2]

Red blood cell count 6.30 x10*12/L [3.9 - 5.77]; Above high reference limit

Haemoglobin concentration 181 g/L [130.0 - 171.0]; Above high reference limit

Haematocrit 0.576 L/L [0.37 - 0.52]; Above high reference limit

Mean cell volume 91.4 fL [83.0 - 103.0]

Mean cell haemoglobin level 28.7 pg [27.0 - 34.0]

Mean cell haemoglobin concentration 314 g/L [304.0 - 353.0]

Red blood cell distribution width 15.4 % [12.2 - 14.8]; Above high reference limit

Platelet count - observation 221 10*9/L [150.0 - 400.0]

Platelet distribution width 14.8 fL [9.0 - 16.0]

Neutrophil count 3.07 10*9/L [1.5 - 7.0]

Lymphocyte count 3.61 10*9/L [0.5 - 4.0]

Monocyte count - observation 0.59 10*9/L [0.3 - 0.9]

Eosinophil count - observation 0.26 10*9/L [0.03 - 0.61]

Basophil count 0.05 10*9/L [0.05 - 0.1]

Nucleated red blood cell count 0.00 10*9/L

[thyreoidea in reply to SolihullMan]

I developed ectopic heartbeats in 2020 which lasted all year without being able to see anyone, basically every time I moved. They kind of went away but came back with a vengeance while on high dose steroids in 2022 after being diagnosed with auto immune haemolytic anaemia. I was admitted to hospital with Afib in June 2020 and put on Bisoprolol 2.5mg. After taking the Bisoprolol my heart would leap about even more. When admitted I was on 112.5mcg Levothyroxine but a doctor at the hospital saw that my TSH was 0.1 so advise to reduce to 100mcg. Reduced Bisoprolol also eventually from 2.5mg to 1.25mg as it was lowering my blood pressure too much. I seems we have a couple of the same issues.

[thyreoidea]

There are quite a few of your bloods that are over range, is that normal for you or is it something new?

[SolihullMan in reply to thyreoidea]

Red cell and cholesterol are out of range yes, but they were more out of range previously. I’ve made dietary changes in last couple of months and cholesterol is coming back in range!

[thyreoidea in reply to SolihullMan]

Just out of interest I suffer from an illness that causes low haemoglobin, what dietary changes did yo make to reduce yours? It may be worth me adding in what you cut out.

[SolihullMan in reply to thyreoidea]

Vastly reduced my red meat intake. Only have steak or burgers 1-2 a month now. No sausages except on Christmas Day for pigs in blankets. Rarely have bacon except on a dirty burger once a month.

Now eating lots more chicken, fish and more vegetables. Chicken skin off! and when I crave sweet things, nice apples and oranges!

Cut out chocolate and haribo type sweets .

[thyreoidea in reply to SolihullMan]

Thanks, thats very interesting. I have beef at least twice a week to help with my B vitamins to aid blood production. Avoid chicken due to 2 different food poisoning episodes when out. Eat an apple, banana and prunes every day along with occasional blueberries and definitely raspberries and strawberries in the summer.

[Contra21]

I feel it did for me but drs say no way. Live in fear. Hate it no thyroid 10 years now I just want to be free of them, have no dizziness, no ectopics and no anxiety. But no your in range

[Miffie]

Your GP should have made some conclusions after you had these symptoms investigated. Mine certainly took note of the echocardiogram report. I was totally unaware of the symptoms. I understand a number of patients do not realise they heart rhythm is in any way altered. In my case they decided more thyroid testing was needed as I might be over treated. I wasn’t it was in fact undertreated. I self treat to make up for current medical incompetence re all things thyroid. When questioned I remind them I was diagnosed over sixty years ago and so know my own body and had so much time to learn about the topic. Hopefully your GP will have an open mind and look at all potential causes.