Heart palpitations with levothyroxine

[Em121412]

Hi, I have had annunderacrive thyroid for 13 years now. The past 3 years I've really struggled with heart palpitations (all heart checks done and no condition found) I've now come to realise it coincides with taking my thyroxine tablets, because I stopped fully dor 8 weeks and the heart palpitations stopped - but my bloods went crazy and so had to start my tablets again.. palpitations now back and I don't really want to be taking beta blockers forever alongside the thyroxine.. has anyone ever experienced similar and what did you do?

[humanbean]

I had palpitations, tachycardia, and chest pain which turned out to be caused by extremely low iron and very low ferritin (iron stores). Doctors never found and treated that for me, I had to test and treat my own iron/ferritin problems.

When I went to A&E for the chest pain, the doctors looked for signs of a heart attack - i.e. blockages, but they found none and assumed I was perfectly well except for anxiety. Absolutely typical of doctors of all stripes and specialities. If they can't find a cause of the patient's problems they just blame the patient's mental health.

[Jazzw in reply to humanbean]

Absolutely agree with this. That was my experience too (oh, and blaming the fact that my TSH was suppressed, even with in range FT4 and FT3).

Must check my iron levels with my next set of bloods!

[Obsdian in reply to humanbean]

I sure can relate. My mental health gets a lot of blame... Even though my mental health is suffering from my physical health struggles and experiences not causing them.

[SlowDragon Administrator]

How much levothyroxine were you taking before you stopped

What were results on that dose

Retest 6-8 weeks after getting back on levothyroxine

Which brand levothyroxine are you taking

Exactly what vitamin supplements are you taking

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

Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune

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

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)

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

Post all about what time of day to test

healthunlocked.com/thyroidu...

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

[bikebabe]

I’ve had hypothyroidism for 60 yrs and started getting palpitations after menopause when on t4 only. Docs reduced t4 slowly which didn’t help and started getting mild hypo symptoms as well bcas palps so went on t3 10mcg in addition to 100mcg t4 which sorted it. I take beta blockers now for other post surgery cardiac issues but it was the t3/t4 and getting vitamin levels adjusted wot did it for me.

[McPammy]

I would check your T3 level as well as T4 and TSH. You might have to do that privately though monitor my health in line quite cheaply as the NHS are reluctant to check t3. They may not check as to the NHS T3 medication is costly. But it’s not expensive if you get it privately. Anyways first thing is to check T3 to see if you’re converting T4 to T3 adequately. If it’s low you may need to add t3 medication to your daily routine.

Regarding your palpitations you could try splitting your t4 dose half on waking and half going to bed. It doesn’t matter when you take it as long as you do to ensure your T4 level is adequate. T4 converts to the magic T3 hormone. I split my levothyroxine T4 I. Two doses I find that helps with spiking. I also take T3 twice a day 8hrs apart. For myself it’s splitting my doses and the addition of T3 which helps me. I’m now symptom free and enjoy life as I have loads of energy and feel great.

[WhyAmISoTired]

IBS can also cause palpitations, so that's something else to keep in mind.

[LostinHeadSpace]

I developed problems with palpitations and chest pain, and like Humanbean, it turned out to be an iron issue for me! I did all the checks with the cardiologist to be safe.

I was dead sure I was going to turn up with low iron because I had such terrible fatigue, but it turned out to be high ferritin (iron stores) which is genetic, and fixed by donating blood (like it’s the 1600s!) This only shows up after menopause for many women.

Gluten also seems to give me palpitations, and the cardiologist agreed this is a thing. I was off gluten completely for months, then went back on to test for celiac, so I’d have it near bedtime cause it bothered my stomach, then get palpitations within a half hour. So weird.

Good luck to you as you figure it out!

[Dlm3557]

hi there. Yes I had the same problem last year. I was taking 75ug levothyroxine a day. Had all the heart checks and everything was fine but I got palpitations every time I lay down in bed.

Like you I stopped taking my Levo for two weeks. The palpitations stopped but it was a big mistake as I felt so unwell.

So I started the tablets again but I decided to reduce my dose slightly. Instead of 75ug daily I reduced it to 50ug for 3 days a week and stayed on 75ug for the other 4 days.

It worked. I’ve been on this same dose for nearly a year now and I feel fine. Never mentioned it to the GP just self medicated. My blood test results are OK, TSH is a bit higher than it was but still around 1 so I’m happy with that.

Worth a try!

[KathFrances]

I used to get palpitations when taking my thyroid meds. Through much experimentation I've found the daily combo of T4 and T3 that works for me (50mg Levo plus half grain NDT). I've also discovered that splitting my dose and taking a bigger dose before bed (25mg Levo plus half grain NDT) and a smaller dose (25mg Levo) in the morning means that I no longer have any palpitations. This dosing regime keeps me stable without any side effects.

[Regenallotment]

for me it’s dark chocolate 🥹🙈 or ferritin being to high or FT3 being too high. It’s great when you have the power to control it through small additives 🌱

[levelslass]

I find my heart slows down when I need my meds and that appears as heart palpitations. But yours is when. you take t4. Why does full blood test reveal?

[josephinius1]

This was me, too. Had them for 16 years and they got bad enough (PVCs,) that every other beat was "ectopic" for almost every waking hour of every day. Totally benign, though, I was assured.

It was actually in another forum here that someone suggested I Google "PVCs and taurine," so, I did. Apparently, at least one study showed that pretty high doses of taurine stopped PVCs entirely, and with an added smaller dose of L-arginine, all PACs and pauses stopped too. Mine were starting to be annoying so I tried it.

It took about three weeks, and I got up to about 9 grams of taurine split over three doses, 3-4 g of L-arginine, but they DID stop. If you Google taurine and hypothyroidism, you may find as I did that though the body makes taurine, so it's not considered an "essential" amino acid (guess it isn't even really an amino acid,) people with thyroid issues can actually be deficient. And why wouldn't we be? This is also something I didn't know until recently, but apparently if you have thyroid issues, (despite medication?) you almost surely have "gut issues" and you're not absorbing lots of things, though how that affects taurine, I don't know. Just know I wasn't surprised. There are a lot of downstream effects no one ever warned ME about, anyway.

All to say, I'm still taking taurine, (am tapering off the L-arginine, apparently you don't want to take that for too long,) down to 4 g per day, 2g in the morning, 2 in the evening. And so far the PVCs are still gone. BUT, I did miss two doses last week, and the next day, I started to feel that familiar "whomp" in my chest. Did an egg with my kardiamobile monitor and though there were just a few, it did suggest it's not a permanent cure. When I got back up to full dosing again, my heart calmed down again.

I can't swear (it's only been about 2-3 months now,) that my body will start to outwit the taurine effect. But, it still is probably worth taking. I also have pretty bad osteoporosis--that's what got me digging into all of this: I could bear being tired, having my heart be in fight or flight mode, extra weight--but chronic pain lit a fire under me. And taurine is supposed to be good for bones, too. And it's inexpensive. So, it's going to stay on my shelf fir the duration.

Good luck!

[josephinius1 in reply to josephinius1]

*ekg not egg...geez, autocorrect