Heart palpitations

[Rainyweather]

I was diagnosed 2 months ago with an under active thyroid (had to ask the pharmacist what medication was for) just told to pick up a prescription 20mg Levothyroxine and then told to get blood test in 2 months time, that was it! Had the 2 month blood test done today and should get results tomorrow, told nurse I sometimes feel as if my heart is beating so hard and I also have dizzy spells. I have been circuit training once a week (started 8 weeks ago)and been cold water swimming about 3 years, I really love the swimming in the sea and don’t want to stop, but reading the comments here now has me worried. I am so new to this.

[Jaydee1507 Administrator]

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. Fill out the free text box at the top.

I'm sorry that you haven't been given much information about your condition. Do feel free to ask any questions you may have and members will have answers for you.

There are a few websites I can recommend you to look at with lots of information.

thyroiduk.org/

thyroidpharmacist.com/

While you are early on in your treatment it might be a good idea to reduce how much stress you're putting on oyur body with fitness training. Your body just doesnt have the capacity for using a lot of energy and recovering well.

It will take many months for you to regain the health level that you once had.

Initially you start on a low dose of Levo and slowly over manymonths increase the dose. Blood tests are usually run every 6-8 weeks and your dose increased depending on results, repeat until TSH is at or just below 1 where most people feel well.

Its a good idea if you're in England to download the NHS app, then ask GP reception to authorise you to see your blood results on the app.

Otherwise you are legally entitled to a printed copy of your results, ask at GP reception.

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.

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/testing/priva...

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.

Do you do tests as per the protocol recommended here?

Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process).

Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsely elevated result and your GP/Endo might change your dose incorrectly as a result.

[Rainyweather in reply to Jaydee1507]

Jaydee, thank you for all the information, I have learned more from your post than I have in the last 2 months since my diagnosis, I had my Levothyroxine 12 hours before my blood test, but I will ask for a print of the results (live in Northern Ireland) I am also taking 20mg Omoprazole for IBS since 2017

[Jaydee1507 Administrator in reply to Rainyweather]

Omeprazole isn't a good medicine to take when hypo. It further reduces your vitamin absorption (and Levo). It might be that once you're more optimally replaced you could try and cut it out which would help you. IBS is a common hypo symptom and likely you've been having symptoms for years.

Start a new post when you have your results. Always remember to quote the reference range as they arent standard.

Always book an early blood test - 9am or earlier but likely at this stage it wont be critical.

See if GP will do the vitamin testing.

Palpitations are a very common hypo symptom and when you change dose they can increase for a while. Usually they are nothing to be concerned about.

[SlowDragon Administrator in reply to Rainyweather]

I am also taking 20mg Omoprazole for IBS since 2017

So gut issues quite likely due to being hypothyroid

Taking any PPI like Omeprazole will tend to lower vitamin levels

Low stomach acid can be a common hypothyroid issue

Thousands of posts on here about low stomach acid

healthunlocked.com/search/p...

Web links re low stomach acid and reflux and hypothyroidism

nutritionjersey.com/high-or...

stopthethyroidmadness.com/s...

thyroidpharmacist.com/artic...

How to test your stomach acid levels

healthygut.com/articles/3-t...

meraki-nutrition.co.uk/indi...

huffingtonpost.co.uk/laura-...

lispine.com/blog/10-telling...

Useful post and recipe book

healthunlocked.com/thyroidu...

Ppi

Omeprazole will frequently lower vitamin levels further

gov.uk/drug-safety-update/p...

webmd.com/heartburn-gerd/ne...

pharmacytimes.com/publicati...

PPI and increased risk T2 diabetes

gut.bmj.com/content/early/2...

Iron Deficiency and PPI

medpagetoday.com/resource-c...

futurity.org/anemia-proton-...

onlinelibrary.wiley.com/doi...

sciencedirect.com/science/a...

Levothyroxine

You presumably mean you started on 25mcg levothyroxine

Highly likely ready for next increase in dose to 50mcg daily

Retest again in another 6-8 weeks

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

which brand of levothyroxine are you currently taking

[Rainyweather in reply to SlowDragon]

Sorry I also meant to say I was also diagnosed with a hiatus hernia at the same time as the IBS and supposed to take 2 20mg capsules a day but don’t just take the 1 capsule.

[SlowDragon Administrator in reply to Rainyweather]

You may well find gut issues improve significantly as dose levothyroxine increases

And, essentially….test and improve low vitamin levels

Plus, many, many thyroid patients find strictly gluten free and/or dairy free diet helps or is essential….especially if cause of your hypothyroidism is autoimmune - Hashimoto’s

if your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.

A trial of strictly gluten free diet is always worth doing

Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential

A strictly gluten free diet helps or is essential due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and may slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test first as per NICE Guidelines

nice.org.uk/guidance/ng20/c...

Or buy a test online, about £20

Assuming test is negative you can immediately go on strictly gluten free diet 

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially) 

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

pubmed.ncbi.nlm.nih.gov/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

restartmed.com/hashimotos-g...

Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.

Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial

With loads of vegan dairy alternatives these days it’s not as difficult as in the past

Post discussing gluten

healthunlocked.com/thyroidu...

[Rainyweather in reply to SlowDragon]

Thank you so much, I will read over everything that has been suggested and didn’t realise gut issues may be connected to thyroid.

[SlowDragon Administrator in reply to Rainyweather]

Read posts on here daily…you will see many posts discussing poor gut function/low vitamin levels and/or gluten free diet and dairy free diets

[sugarplumferry in reply to Rainyweather]

Have a look at Slippery Elm for your gut issues instead of Omeprazole, it affects the whole digestive system. I take it with loperamide to control bile acid malabsorption after having my gall bladder out. I’m waiting for a hemi thyroidectomy for a retrosternal goitre and have some swallowing issues. The SE helps with the awful feeling of something stuck half way down.

[Rainyweather in reply to sugarplumferry]

Thank you sugarplumferry, I will have a look at that.