High heart rate

[Chittleham]

Around 12 years ago after taking Levothyroxine for some years before that, my heart rate suddenly went up quite high 100+ per minute in the evenings. I will keep these details as short as possible. After many visits to endo’s locally to where I lived and London Endo’s too it was decided that it was my thyroid and eventually I was put 100mcg Levothyroxine and 10mcg Liothyronine daily. I now find the same thing happening and looking for help from anyone who has experienced the same. One more thing I experienced when this was as it’s worst something called toothpick headaches which are sharp short pains to the head. An odd mixture here folks I do hope it makes sense to someone…..

[SlowDragon Administrator]

as per my reply in your previous post 6 days ago

healthunlocked.com/thyroidu...

You need to get FULL thyroid and vitamin testing done

Private test is only realistic option

What vitamin supplements are you taking

When were vitamin D, folate, ferritin and B12 last tested

Restless legs often low ferritin or magnesium

Make sure you test correctly

ALWAYS test 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)

T3 ….day before test split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test

[Chittleham in reply to SlowDragon]

These are my private blood results as on 10/04/2025.

Ferritin 176ug/L. Folate Serum 10.6nmo/L. Vitamin B 104pmol/L. Vitamin D 80nmo/L TSH 0.294miU/L. FreeT3 6.5pmol/L. Free Thyroxine 18.6pmol/L Thyroglobulin Antibodies 940 Klu/L. Thyroid Perexidose Antibodies 123klu/L. These results do not cover all you suggested, my limited understanding is that they are all ok except for the antibodies. Whether any of these results will explain why my heart rate is going very high in the evenings I am taking a beta blocker which eventually brings it down. The fact though still remains my thyroid has gone rogue and I am not at all sure what to do as most GP’s know little about thyroid function and getting to see an Endo will take a long time. Thank you for your information…….

[SlowDragon Administrator in reply to Chittleham]

I was put 100mcg Levothyroxine and 10mcg Liothyronine daily.

Which brand Levo

Which brand T3

Do you normally split your T3 as 2 x 5mcg

On day before test was last 5mcg dose T3 approx 8-12 hours before test

was CRP tested (inflammation)

What vitamin supplements are you taking

If taking anything with biotin in, eg vitamin B complex you need to stop this 3-5 days before test

What’s range on folate

High thyroid antibodies confirms Hashimoto’s

Are you on gluten free and/or dairy free diet

[SlowDragon Administrator in reply to Chittleham]

Free T4 (fT4) 18.6 pmol/L (12 - 22) 

Ft4 66.0% through range

Free T3 (fT3) 6.5 pmol/L (3.1 - 6.8) 

Ft3 91.9% through range

Assuming you tested as recommended……you might need to reduce T3 dose a little…..

Do you get 10mcg tablets?

If yes…..you could cut into 1/4’s and take 3 x 1/4 tablet 3 times a day = 7.5mcg daily

[Chittleham in reply to SlowDragon]

Thank you for your information and help………

[SlowDragon Administrator in reply to Chittleham]

So how long before test was last dose T3

Do you always get same brands of levothyroxine and T3 at each prescription

And what vitamin supplements are you taking

[Chittleham in reply to SlowDragon]

I always get the same brands on my thyroid meds. Because T3 is a capsule with powder in it is difficult to split. I take B12 and D and because I suffer with RLS I also take an Iron supplement. Do you have anymore recommendations…….

[SlowDragon Administrator in reply to Chittleham]

Roma capsules

Request 2 x 5mcg capsules

Or request 10mcg tablets

Price is a bit cheaper for 2 x 5mcg capsules compared to 1 x 10mcg tablets

current prices to NHS

healthunlocked.com/thyroidu...

[SlowDragon Administrator in reply to Chittleham]

I take B12 and D and because I suffer with RLS I also take an Iron supplement.

Iron you need to take 4 hours away from Levo and T3 and 2 hours away from other supplements apart from vitamin C

Folate Serum 10.6nmo/L.

Vitamin B 104pmol/L.

You’re not currently taking a daily vitamin B complex ?

Just taking a B12 supplement

If so look at adding daily vitamin B complex

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)

This can help keep all B vitamins in balance

Now your serum B12 is over 500 (or Active B12 level has reached 70), you should be able to reduce then stop the B12 and just carry on with the B Complex.

Start by adding B complex …..then after 2-3 weeks reduce and eventually stop separate B12

B vitamins best taken after breakfast

Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose and may need 2 per day and/or may need separate methyl folate couple times a week

Post discussing different B complex

healthunlocked.com/thyroidu...

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) Thorne can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg)

[Chittleham in reply to SlowDragon]

Thank you for that very comprehensive message because I have severe and chronic RLS my focus tends to be on that because it so debilitating and so it is very important to spend time understanding what I can do to help my thyroid function.

[CreakingGate47]

You may mean ‘ice pick’ headaches

webmd.com/migraines-headach...

[Chittleham in reply to CreakingGate47]

Yes I did mean ice pick headaches I could blame autocorrect but to be fair I should have checked it. Thank you for bringing it to my attention…….

[CreakingGate47 in reply to Chittleham]

Sort of thing I might have done 😉

I’ve got one of those now and the pain is indescribable. These are new in my migraine / headache repertoire and I hope they’re not thinking of joining the club 😵‍💫

[DippyDame]

Please add reference ranges....and follow SlowDragon's advice re testing

High antibodies suggest thyroid autoimmune disease/ Hashis where thyroid levels fluctuate during a hashi flare when one can temporarily become hyperthyroid as the thyroid releases more hormones into the system during the attack (Frees rise)

It is typically a temporary phase, usually lasting a few weeks/months, and is often followed by the development of hypothyroidism.

The temporary increased hormone level may be causing the sudden cardiac symptoms, requiring a temporary dose reduction

But we need those all important ref ranges to verify.

thyroiduk.org/if-you-are-hy...

Consider a gluten free diet it helps many Hashi patients

The "same thing is happening again" most likely because you are experiencing another "flare" ....levels will eventually fall back to the hypothyroid state

The thyroid will eventually reduce in size/ atrophy as a result of the antibody attacks and will fail to produce adequate hormone .....more replacement hormone will be required

Hashis/ thyroid autoimmune disease is a common cause of hypothyroidism

Have you established your T4 to T3 conversion rate. (high in range FT4 with low FT3?)

If you have followed all testing protocol then based on latest labs you need to change your dose

Your vit D is too low....should be at least 100

[Chittleham in reply to DippyDame]

Thank you for your reply it is really helpful to know about the Hashi’s flare ups. Was diagnosed with Hashi’s some 12 years back but wasn’t aware of the flare ups and the fact that it could cause the system to go temporarily hyperthyroid that does explain a lot to me. I am temporarily reducing T4 and T3 just a little to see how that works. I have been on beta blockers for years to keep the heart rate from going to high. As it is Easter will have to wait until next week to contact the doctor but I think now I understand to ask for a more in depth blood test to understand what I need to do. Thank you again.

[SlowDragon Administrator in reply to Chittleham]

I have been on beta blockers for years to keep the heart rate from going to high

Which beta blocker?

Propranolol reduces uptake and conversion of levothyroxine

[DippyDame in reply to Chittleham]

I have a form of Thyroid Hormone Resistance needing high dose T3-only....

I read in a research paper, several years ago, that a low dose of Atenolol would help maintain a steady heart rate in this circumstance. My RHR sits at 65bpm

I'll try and find that Paper!

Which beta blocker are you taking?

You should be able to raise your hormone dose again after the flare ends

Medics should explain all of this but sadly thyroid education is poor in med schools, patients suffer and the lucky ones find this forum!

[Chittleham in reply to DippyDame]

I am on propranolol and have been for some years, it would seem that it is not helping very much at all. If you do come across that paper the info would be helpful as you say medics are not very well informed about thyroid problems and so I have found if you go armed with some solid information they are more likely to support you. I will mention Atenolol and hope I get a response. Thank you once more for your help.

[SlowDragon Administrator]

So are you on Gluten Free diet

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 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.

Post discussing gluten

healthunlocked.com/thyroidu...

Restless legs and gluten intolerance

healthline.com/health/restl...

A 2023 systematic reviewTrusted Source linked celiac disease and gluten intolerance to RLS. The researchers propose that cutting out gluten from your diet may help manage symptoms.

glutenfreesociety.org/glute...

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

Recent research in China into food intolerances with Hashimoto’s

healthunlocked.com/thyroidu...

More interesting Chinese research on Hashimoto’s and leaky gut

nature.com/articles/s41598-...

[SlowDragon Administrator]

also get tested for SIBO for restless legs

SIBO & autoimmune thyroid disease

palomahealth.com/learn/link...

pmc.ncbi.nlm.nih.gov/articl...

thyroidpharmacist.com/artic...

[Chittleham in reply to SlowDragon]

Well Slow Dragon thank you for information a great deal to digest, but very interestingly really does apply to me in many ways to be honest am not sure which bit to tackle first. I am gluten free and almost dairy free but I do fall off the wagon you have given me much to look into, I thought the report from Italy very interesting as I suffer with IBS and pretty sure leaky gut there is lots to get my head around thank you once more……….

[SlowDragon Administrator in reply to Chittleham]

Which brand of Levo

If on dairy free diet you need lactose free levothyroxine

Many of us do well on Vencamil as is lactose free and Mannitol free

How to get prescription written for Vencamil

healthunlocked.com/thyroidu...

How to get Vencamil stocked at your local pharmacy

healthunlocked.com/thyroidu...

Posts discussing Vencamil

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu....

Thybon Henning is lactose free