I was diagnosed as overactive thyroid April this year and admitted into hospital with AF caused by my thyroid. Started Carbimazole 20 mg on May 10 which was lowered to 5mg on 21 August following blood tests.
Initially my heat intolerance improved after three weeks of Carbimazole but started again in later July. The endo doctor dismissed this as due to the heat which I knew it wasn’t.
I have for the past month been getting palpitations again which for the past week have become more constant and on Wednesday I struggled with breathlessness to the point of having to stop walking three times on a ten minute walk.
I am posting my most current blood results taken this Wednesday, 16/10.
I am going to email the endocrinologist today, has anyone any idea of why I might still be experiencing hyperthyroidism symptoms?
I had mentioned palpitations in August but the doctor dismissed that as anxiety. I do have anxiety for years but it never involved palpitations in a regular basis especially on and off all day!
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Catlover2145
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Catlover2145, There is no FT3 result showing on your image. Without this detail, the picture of your current thyroid status is incomplete.
This is important because, whilst TSH is at a reasonable level, and FT4 is rather too low, it is not impossible that your thyroid is pumping out the wrong amount of T3. That could account for your symptoms.
On the other hand, your symptoms could be from now having too little FT4. Symptoms of hypERthyroidism and hypOthyroidism can cross over.
Symptoms of hypERthyroidism and hypOthyroidism are NOT mutually exclusive. i.e. you can have palpitations with hypER as well as with hypO, and heat intolerance can occur with both hypO and hypER.
Here are my most recent Free T3 results however the Free T3 was meant to be added to my most recent bloods this week but she didn’t so I phoned this morning and was told they will be added on. I hope by Monday so I can do my new test.
Thank you for explaining about the symptoms. I thought those two were associated with being Hyperthyroid only.
Dr will say all good because results in range, but that FT4 is low & you’d expect a higher TSH. TSH is very unreliable & you have not had a FT3 result? FT3 might but out of balance.
I found symptoms worse when FT4 low & FT3 high than I did when level were abnormal high or low but balanced. Just to add to the Confusion.
Doctors won’t admit you can have symptoms when results in range, anxiety is a symptom too & palpitations common with abnormal thyroid & also with issues such as low ferritin.
Thank you. And for saying about the confusion as I’m finding it all very confusing especially when reading others posts and people seem to understand everything. Xx
I’m finding it all very confusing especially when reading others posts and people seem to understand everything.
Don't worry. Everyone who is a newbie to thyroid stuff feels confused. I know I did. And don't forget that some of us have been using the forum for many years. I've been a member for 11 years, and I'm by no means the longest serving member!
'Request GP retest TSH, Ft4 and essentially include Ft3'
Catlover2145 has done this. Possibly best not to confuse her with all this private testing info at this point, as she is already under the care of an endo and feeling anxious and overwhelmed.
I have a GP appointment next week and will ask for them to do the blood tests but will test privately otherwise. I have been making sure I fast and do the blood tests before 9am since I learned it’s best in a thyroid FB group back in May.
I currently take Vitamin D supplement only as it was low in March however everything else was fine when tested in the summer. I’m trying to eat very healthy and have cut out alcohol.
I felt listened to at my last appointment but everything I said or asked was disregarded in the letter afterwards and they just said I was fine with no symptoms which isn’t what I said at all.
It’s left me feeling like I can’t see the point in bringing up symptoms if they are disregarded. And angry with their response if ilm honest.
My GP is good so I’m going to explain all this to her next week and take it fr there.
“It’s left me feeling like I can’t see the point in bringing up symptoms if they are disregarded.” Eloquent explanation of your all too real understanding of ‘our’ situation. I think that’s what maybe we should be questioning of our ‘medical helpers’ on. Put the ball back in their court. I know I try to stick with one area of symptoms (I have so many) to help them! That does not work either.
I think I will at my next appointment. I was quite angry when I read the letter saying all was fine regarding symptoms when I’d explained it wasn’t.
I feel at a loss as I posted on a FB forum and was told I’m hypothyroid by the only admin and should get a new doctor. I’m with the NHS and it’s not that easy or quick. I’ve fond exactly that for my sleep apnea.
I don’t want to end up in hospital again due to AF.
It appears you are dealing with Graves and Hashimoto's - both thyroid auto immune diseases - as you have positive and over range TRab antibodies for Graves and positive and over range TPO antibodies for Hashimoto's :
This is not unusual when the thyroid malfunctions as there can be some overlap in various antibodies -
Graves treatment takes precedence as with Graves the T3 and T4 can keep rising higher and higher and is considered life threatening if not medicated with an Anti Thyroid drug - and if the heart is involved - a beta blocker.
With Hashimoto's - you tend to experience ' temporary swings ' in symptoms and T3/T4 levels, with the T3/T4 falling back down into range by themselves and longer term with further swings and thyroid AI attacks your thyroid becomes disabled with you becoming hypothyroid and needing the support of medication - thyroid hormone replacement.
So this may have just been a temporary ' swing ' in higher T3/T4 levels - which is common with Hashimoto' s but I would have thought the AT drug would have been at a sufficient level to block such a swing.
Some people are also prescribed a beta blocker when the heart becomes involved - if suitable for you - the preferred drug is Propranalol - as it also tends to slow down the conversion of T4 into T3 - as it is generally too high a level of T3 for you that causes all the symptoms -
just as too low a level of T3 for you - though likely in the range - can lead to symptoms of hypothyroidism.
In order to understand and read thoroughly any thyroid blood test we need to see a TSH, Free T3 and Free T4 drawn and taken from the same blood draw.
I’m on propanalol since April and am taking 1-2 doses per day at the moment (40mg). But what I’ve noticed since Monday is the palpitations starting again within 3 hours of the tablet which is new to me since starting the high dose back in April (4 x 40mg a day back then until I started Carbimazole).
I’m wondering if I should go for an ECG as this was how my AF was picked up. I thought I was fine and it was anxiety.
Your T4 is now low in the range and it could be that your T3 is now too low in the range and causing these symptoms - but without the T3 and T4 blood test - its just a guess -
Maybe the Propranalol was reduced down by too much too soon - going from 4x 40mg in April to 1/2 x 40 mg now :
Maybe the AT drug was reduced by too much too soon - going from 20 mg to 5 mg - mid August -
Were both these drugs adjusted down at the same time ?
it's difficult to know as we haven't the full blood test results -
and dealing with Graves can feel a bit like dealing on a roller coaster but without any of the fun
and yes, if it puts your mind at rest, ask for an ECG :
So looking back your T4 dropped dramatically in August.
In August your T4 @ 11 was below the bottom of the range and we have no T3 reading :
Was your dose of the AT drug reduced down at this point in time ?
In October your T4 @ 12.50 is just 3% in the range with a T3 at 4.50 and around 38% through its range.
I think we should now be looking to try and maintain both your T3 and T4 at around mid point - say around 50% - and think a dose decrease in the AT drug the next step.
Also very important that ferritin, folate, B12 and vitamin D are maintained at good solid levels since non optimal levels can compound your health issues further than necessary.
Have you been checked for pernicious anemia and celiac disease as these tend to run alongside many other AI diseases ?
Blood tests tend to run a couple of weeks behind symptoms being tolerated so you may feel as though you are playing catch up - take notes of the symptoms being tolerated and make sure you get to discuss these with your current symptoms rather than just be a mathematical equation.
Thank you. Yes my Carbimazole was decreased from 20mg to 5mg in August following the August blood test.
No I haven’t been tested for celiac disease or pernicious anaemia although I don’t seem to be having any celiac symptoms.
I’m going to ask for the vitamins to be tested when I have my GP appointment tomorrow. Does having a thyroid condition affect your vitamin levels? Sorry I’m new to all this and the brain fog makes it difficult to remember.
I’ve been keeping notes of the heat intolerance including the temperature outside so it can’t be dismissed as due to the heat next time. Will keep notes on all.
Sorry for delay but my Alert icon seems ' on the blink ' !!
It 's not so much that a thyroid condition affects vitamins and minerals -
but that your thyroid controls your metabolism and when running too fast as in hyperthyroid or too slow as in hypothyroidism - your body then struggles to extract key nutrients through your food no matter how well and clean you eat - and why many of us find we need to supplement same to stay well and healthy.
The trouble is - we all have our own unique set point where our T3 and T4 need to sit for us to metabolise and feel well - but likely never question or know where in the T3 and T4 ranges this is - until it's too late and lost it - but you may well find your thyroid resets itself after this phase of ill health without the need for any drugs and this episode, hopefully, just a blip.
Thank you. That’s really helpful. I felt quite overwhelmed and finding this all too much to understand and tackle on Friday but today I’m feeling more in control.
I went on the celiac website and based on questions it asked, it recommended I asked for testing for celiac but it said you need to have eaten gluten in two out of three meals every day for six weeks before testing.
I only usually eat two meals a day and don’t think I have eaten gluten in every meal so will have to start that from today. I also don’t have diarrhoea although have in the past for an episode which I believe was IBS related. I’ll speak to my doctor tomorrow.
Yes I think you just need to eat as you would normally eat and not exclude anything - as then the test should be as thorough as possible.
Worth doing as with Hashimoto's stomach and gut intolerance to certain foodstuffs seems to be a ' given ' -
I think I've sent you research for Graves - but can't remember if I sent you anything for Hashimoto's - many forum members follow the research and suggestions of Dr Izabella Wentz - who writes as thyroidpharmacist.com
Do you know you can find all your previous posts and all you have ever written on the forum - if lost - by just pressing the Profile icon on this page and facing me top right on my laptop - sitting alongside My Hub - Chat - Post - Alerts and Menu icons so maybe somewhere else on a different gizmo.
Ferritin (iron stores) and/or serum iron could be low in thyroid disease whether you are hypo or hyper.
Low iron/ferritin can cause palpitations and fast heart rate (tachycardia).
When my iron and ferritin were extremely low my heart rate would (sometimes) rise a lot. My personal record is 170 beats per minute which was incredibly uncomfortable, but beta blockers slowed it down.
I’ve been assuming it’s related to hyperthyroidism and nothing else as wS the case in April this year when I was admitted into hospital.
But having been convinced my tiredness was just down to sleep apnea and then finding out I was hyperthyroid, I’m trying not to rule anything out now. I’m hoping the doctor will run proper blood tests to ensure I’m checked thoroughly. Soo tired I’m ready for bed 😆.
My palpitations have felt very uncomfortable although I’ve no idea how many bpm. Thankfully the propanalol does seem to be controlling them a bit better since Friday and I’m trying to avoid stress.
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