Tachycardia

[Mozzymoo22]

I've recently had a mitral valve replacement and I'm struggling to get my heart rate under control. It's averaging around 115. I've just done my bloods and they are normal. My ft4 is at the very top of the range even though my tsh is normal. Any suggestions?

[waveylines]

Really need to know what your ft3 is. What has cardiology said about your heart rate?

Are you on any heart meds?

[Mozzymoo22 in reply to waveylines]

My ft3 is 3.4. I rang cardiology and ended up in a&e , they increased my bisoprolol to 2.5 and my heart rate went back to normal for a while, but it's gone up again 😔

[waveylines in reply to Mozzymoo22]

Bisprolol lowers conversion of T4 to T3. T3 level od 3.4 is rather low. You might be having palpitations because its too.low..

I struggled with all the beta blockers.... propranolol cardivilol and bisoprolol . They made me wose. Cardiology gave up on them with me.

I did better on a calcium channel blocker. Verapamil.

[Obsdian in reply to waveylines]

I thought it was propranolol not bisoprolol that affects t4 to t3 conversion.

[Mozzymoo22 in reply to Obsdian]

I was on amiodarone for 2 years. That definitely does

[waveylines in reply to Obsdian]

Thay all do. It's alleged Propsnolol is the worst. But thry all work by lowering ft4 to ft3 to slow heart rate. Calcium chanel blockers do you....but the one I was on was heart specific. Private Endo I saw to help me deal with the very nasty Amiodarone explained all of this to me.

Thankfully not on any heart meds now!

[humanbean]

This might not be relevant to you but I've found that my heart rate rises quite dramatically if I eat simple carbs e.g. chocolate or other sugary food.

Like you, I take Bisoprolol. 2.5mg

Do you take Amitriptyline or Nortriptyline? If you do, please be aware that a known side effect of both drugs is fast heart rate/tachycardia.

If you take any other drugs it is always worth reading the Patient Information Leaflets to see if thyroid or fast heart rate is mentioned.

Amiodarone is bad news for thyroid patients. It isn't something I've ever taken and I don't know anything about it but I know it has been mentioned on the forum quite recently by  waveylines .

[waveylines in reply to humanbean]

Thanks Humanbean. Yes you don't want Amiodarone! I doubt that would be suggested for you. Amiodarone is known as the "drug of last resort". NICE state it is contrary indicated for patients with pre existing Hypothyroidism. I was put on ut post heart surgery....one month. Over 15months to stabilise my thyroid hormones.....just about getting thee now! Sigh....

Treatment for heart follows set pathways for Tachycardia/Afib... usually beta blockers, then calcium channel blockers, then your into some serious drugs!

[humanbean in reply to waveylines]

Your posts on the subject of Amiodarone sounded absolutely appalling. I hope I never need to take it!

[waveylines in reply to humanbean]

Thanks Humanbean. What really appalled me is being given it with no monitoring......& no one has followed me through. I've had to work it out for myself! Even purchasing my own thyroid blood tests to check- Despite being under a nhs endo!! The lack of care is appalling.

However the op was sucessful. I'm still Afib free 16months later. Am very grateful for that as I was deteriorating.

My ndt script has not been reinstated so no treatment from nhs for my thyroid though nhs endo recommends it.....no gunding in place still.

I doubt I will ever forgive the nhs for what they've put me through.... and am mystified how you can have nhs endo paid for my your ICB but kot get the medication recommended. It's often said the law is an ass.....I think the same applies to the nhs.

[Mozzymoo22 in reply to humanbean]

I was on amiodarone. It's really messed me up. I'm off it now but it can take months to recover from the effects.

[waveylines in reply to Mozzymoo22]

Ahhhh we're you? How long have you been off it. Have you recovered now?

[Mozzymoo22 in reply to waveylines]

I've been off them since November. I'm well on my way to recovery now

[waveylines in reply to Mozzymoo22]

1/2 life of Amiodarone is 147 days....so it's still in your system. And it takes many months to fully leave the body. I could only take 25% of my usual thyroid dose......very slowly increased over 15months. I was diagnosed hypo 20yrs ago and was stable for many years. With Amiodarone it and it's by product (think its called DEA) affects the receptors as well as lowering conversion. So you may find you can only tolerate a lower dose than you really need.

Is your hypothyroidism a consequence of Amiodarone or was it pre existing?

[Mozzymoo22 in reply to waveylines]

It's pre existing

[waveylines in reply to Mozzymoo22]

OK. And we're tou stable and happy on your pre Amiodarone dose of levothyroxine? What was the dose?

Amiodarone according to NICE is contrary indicated for pre existing hypothyroidism. There is another drug called Dromadarone that can be used.....specialist endo I saw said many headt surgeon ignore this as the prefer Amiodarone for post surgery. This because Amiodarone is better at regulating irregular heart rhythm than Dromadarone. Dromadarone doesn't affect thyroid.

[Mozzymoo22 in reply to waveylines]

I was stable and happy on 75mcg before.

[waveylines in reply to Mozzymoo22]

You probably will be again. It will be the Amiodarone and it's by product. And am afraid be cause Amiodarine affects not only conversion but up take into the cells the only option me and others found was to reduce the dose until it starts to wear off then very slowly increase.

I saw an Endo in London who knew all about Amiodarone....and he agreed that I had done the right thing lowering. What happens is the cells cant absorb very much so it tends to accumulate and not be used so you feel heart racing like your over treated mixed in with under treated symptoms. It's confusing.

I hope this makes sense. It does correct in the end but takes a long time. Many endos do not realise this!!

[Mozzymoo22 in reply to waveylines]

Thank you

[Sparklingsunshine in reply to humanbean]

I tried both Amytriptyline/ Nortriptyline early on in my migraine investigations, both gave me tacycardia and the shakes. The numpty doctor I saw insisted I was taking too much Levo, funnily enough the symptoms stopped after I stopped the meds. Funny that. I have a naturally fast heart rate anyway. Even when I was really fit, but having EDS makes it more common.