Heart rate bouncing about daily

[Andrew36]

Hi there i have just recently about 2 weeks ago had my levothyroxine increased by 25mcg to a total of 175mcg and daily I am getting like a irregular heartbeat beat a few times per day to the point where I am considering tapering off them all together and just seeing how I go without levothyroxine to see if the heart situations resolve themselves but I don't want to end up in a worse situation so any advice is welcome please

[Jaydee1507 Administrator]

You were saying the same thing 7 months ago when you were on 150mcgs.

Have you restarted B complex and managed toraise your low ferritin level yet as per this previous reply to you: healthunlocked.com/thyroidu...

Low iron & ferritin is often responsible for odd heart rate symptms.

What are your most recent vitamin levels - ferritin, folate, B12 & D3?

[Andrew36 in reply to Jaydee1507]

I know I was but since then I have had to have blood tests to determine if my tsh is still high before they would agree upon a medication increase and I was told that my tsh still been high I needed a dose increase , but since my dose increase my palpitations have become more often and to be honest I don't feel like I am getting the constant support from the doctor that I need to be able to figure this out so that's why I'm considering tapering off them and taking my chances, regarding vitamin levels like b12 vitamin d and iron or ferretin etc I have had my blood work done and have been told they are all normal even though they seem on the low end of acceptable , they class them as normal , regarding iron levels I have pleaded with them to do a full iron panel but they disagree to the point where I just don't know where to turn next it becomes so exhausting to deal with that I shut myself off without continuing to deal with it and it's just a vicious circle , the doctor even said the palpitations was because of my tea bags and to drink decaff , which I did for a while and it made no difference so I went back to my usual

[Jaydee1507 Administrator in reply to Andrew36]

Many members here take control of their vitamin levels by buying private tests and their own supplements.

What your GP says is OK will not be optimal & where you need your level to be, firstly for your thyroid hormone to work well and secondly to alleviate symptoms from suboptimal vitamin levels.

Suggest you buy a private iron panel test and then begin supplementing iron if required. Start a new post when you have the results.

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.

I know its a lot of effort when you're feeling rough with no energy but worth focussing on this to get better results.

About the last thing you need to do is stop Levo because you might feel better for a few weeks but then you will be so much worse for a long period of time, even a year or more. better to fine tune where you are now with vitamins and more Levo as required.

[Lalatoot]

Don't taper off altogether. I tried that and made myself very ill. Became bedridden and took years to recover. It is important to note that if you drastically reduce or come off your levo dose many folks report feeling better. This feeling better doesn't last! Once the hormone levels drop you become very hypo. I cut down to 25mcg per day and felt fab for 3 months until you know what hit the fan.

I haven't looked at your profile to see what your levels are - add them to your post if you have recent ones as it helps get better replies to the situation.

You could:

go back to your previous dose and increase more gently either by splitting tablets or by taking different amounts on different days - maybe the increase is too big all at once

try splitting your dose. You can take levo at any time as long as it is away from food and drink for optimal effect. I have always taken a split dose either morning and bedtime or morning afternoon and bedtime. The doses don't need to be of equal size. Some folks find the spike as a full dose enters the system is too much for them.

[Andrew36 in reply to Lalatoot]

Yeah I was thinking the extra 25mcg could of brought them on more than they was but I still have the issue that I was getting them before my dose increase and the doctor said I can get palpitations when my dose isn't high enough so surely they should slow down with an increase , the thing that's always confused me is over the years when I have had dose increases is my t4 raises but even though my tsh reduces slightly it's like it doesn't do anything other than make me feel like I'm overactive . Il try get my previous 2 blood tests and put them on here , I've not had one yet since my dose increase

[Lalatoot in reply to Andrew36]

I get palpitations when I am hypo. The symptoms of hypo and hyper or undermedicated and overmedicated can be similar. When I was undermedicated hypo my resting heart rate was 78 to 82 beats per minute. Now I am better medicated it is 65 to 69 beats per minute. I also lose weight when I am undermedicated which again isn't what you might expect.

[Mazza44 in reply to Andrew36]

Just to add that I get palpitations when I am under, rather than over. I get upset stomach and weight loss too. All things you would expect to be the other way around. Confusing!

[radd]

Andrew36,

I had terrible heart issues with high FT4 levels, but any lower FT4 levels exacerbated fatigue, brain fog, muscle pain, anxiety, etc. eg, there was no right dose.

We all need an “individualised sufficient’ amount of iron and nutrients for good thyroid hormone function, eg for meds to work effectively, but although I had optimised these levels I still felt as if I were sinking.

The majority of us require an individualised ratio of FT4:FT3 which optimises conversion to further FT3 (active hormone for well being). However, to attain enough conversion each person has to have enough T4 but each person also has an individualised T4 ceiling after which meds start working against us. This means many of us no matter how much or how little Levothyroxine is medicated it will never bring well-being.

If you have managed to optimise essential nutrients required for the good functioning of thyroid hormones, then it might be time to think of adding some T3 meds. My heart issues disappeared and have never returned since I added a little bit of T3 to my T4 meds.

[Singwell in reply to radd]

Hello - there's several of you here mentioning this - adding T3 to your medication. How did you go about getting your GP to look into this? My T3 has remained stable at the mid low end since before I started taking levothyroxine. I'm convinced that my AFib started up again after a successful procedure due to thyroid function not being optimal. I'm managing OK but I'd like to be better.

[radd in reply to Singwell]

Singwell,

I was so ill and desperate after four years medicating Levothyroxine that I paid to see a private specialist. He prescribed T3 meds that my GP was happy to continue (until they were stopped by local health authority twice! But that’s another story).

[SlowDragon Administrator]

Is 25mcg tablet different brand of levothyroxine?

what were your results that prompted dose increase?

Try initially increasing by on 12.5mcg for 6-8 weeks

Meanwhile it’s ESSENTIAL to improve low vitamin levels

It’s catch 22 …..low thyroid levels results in low vitamin levels

Low vitamin levels results in poor conversion of Ft4 (levothyroxine) to Ft3 (active hormone)

What were most recent vitamin D, folate , ferritin and B12

Exactly what vitamin supplements are you taking

It’s down to you to self treat and maintain GOOD vitamin levels It’s catch

NHS will only test for and treat vitamin deficiencies

Test folate, ferritin and B12 at least annually

More regularly if low

Test vitamin D twice year when supplementing

[jgelliss]

There are a few suggestions from my personal journey. One have you had your Iron/Ferritin tested? Iron in my case was one of the reasons that I experienced palpitations. In addition fillers in thyroid hormones caused my palpitations as well. Acacia for me was a large cause in the Synthroid and there are more fillers many of us have side effects from.

Did you run labs with FT3 and FT4? For me adding a small dose of T3 was very helpful. The heart had a large receptor sights for T3. If you are not a good T4 to T3 converter that can very likely cause palpitations. Don't give up just try to be a detective and see which one of these apply to you.

Wishing you a fast resolution.

[Litatamon]

When I first was on thyroid hormones I had so many heart issues. There was one time I thought someone had their bass too high. 🤩 Then I realized it was my heart. I am now higher than ever on monotherapy (300 mcg) with zero heart issues. Telling you that to show you it might night be what you think.

I am not 💯 I know why, but I do know I am a believer of going through more than eight weeks (I like three months) at every increase. Sometimes the nonsense that comes in the first weeks simply dissipates.

Also, I am now on 6 x 50s. Here with Synthroid it is the one pill with the lowest amounts of additives.

.Hope you work it all out soon

[crimple]

Andrew36 I used to have palpitations when taking T4, levothyroxine only and my T3 levels were always in range but at the very low end. Once I started to add some t3, Liothyronine, the palpitations stopped. It is really important to test all 3 TSH, T4. andT3 and to have good levels of vit D, B12, folate, iron and ferritin. Medichecks can test all of those with finger prick test.

[duckie21]

If I am overmedicated I get palpitations, if I'm undermedicated I get palpitations. I'm afraid thyroid issues definitely cause heart issues. I have just increased my beta blocker which has stopped the palpitations . Hopefully it lasts . I take all the supplements for thyroid and blood tests for ferritin etc are all good . Are you on meds for heart issues.

[Katherine1234]

Andrew my palpitations were due to an electrolyte imbalance and dehydration. As soon as I got that sorted they went. Apparently I am someone that burns through magnesium, salt and potassium when under stress. Potassium was a big one for me. I think hypothyroid puts our bodies under stress and we have to rely on the fight, flight or freeze mode.

Because I had a raised heart rate when I stood up too. My heart would beat very fast and I would be dizzy. I took extra thiamine B1, B2 and B5. Everything seems to be ok now. If I start to get it back a bit I up my electrolytes. It is a common thing with runners and other athletes. I do think our thyroid problems make our bodies feel like we are running a race all the time.

[Singwell]

Hi I have known heart arrhythmia (AFib) which is usually well controlled. But when I started uploading levothyroxine after about a decade of being subclinical hypo, my heart starting kicking up all over the place. You'll need to titrate upwards super gradually in my experience. My GP got very cross with me initially because I cut my first dose in half. Then when I tried to increase to 25mcg and my heart went crazy, she told me to cut back. However - as others will have said - coming off altogether isn't the solution. When the thyroid isn't working, your heart can't work properly either. Heart arrhythmia is associated with both hypothyroidism and hyperthyroidism.

So - maybe go back to your previous dose and see if the heart settles down. You need to getyour GP on board ideally. I'm guessing you have a device that tracks your HR? Make sure your GP gets those readings. Hopefully they'll support you in making a plan for slow titration. I think I adjusted mine after a month each time. Get yourself a pill cutter so you can control the increase.

Hope that helps!

And BTW I have a nice breathing sequence for calming palpitations that I can share if you'd like it.

[Poniesrfun]

hi Andrew ~

If your levo keeps increasing without lowering your TSH, you likely have what we call in the U.S. as “wired and tired” - too much T4 and not near enough T3. The first step to fixing this is to tests full thyroid panel - TSH, Free T4 and Free T3, which apperently the NHS won’t do so you will need to do private testing as already suggested. It’s a sorry state when the folks here know more than the doctors - and it’s important you learn about thyroid and what it does for you. The admins here will give you great information; they understand it may be difficult but it is up to you to follow through in their suggestions. It’s worth taking the time it takes now as it is for the rest of you life — your choice.

Patti in AZ