Hypothyroidism and atrial fibrillation

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I suffer from Hypothyroidism and take Natural thyroid hormones. I also get spells of Atrial Fibrillation.

How many of you taking just T4 experiance Atrial Fibrillation. An Endocrinologist felt I might be harming myself by taking NDT, but has not said how I might be harming myself, so it would enlighten me to know if those of you taking T4 also experiance irregular fast heart rate.

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  • Posted

    Kathleen, it is my understanding that too high a dose of any thyroid medication can cause this.  Are your TSH etc levels in the normal range?

    and PLEASE. Tell us why your endocrinologist thinks NDT may be harmful...

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  • Posted

    Hi Kathleen, can you post your numbers for your TSH, T4 and T3 and the dose of NDT that you are taking? 

    As a first approximation and not having any of the above numbers I would say your NDT dose is probably too high. Long ago before blood tests the patients would monitor their pulse rate to determine if their dose was too high. If it was, they would reduce thier dose a little and then another little until the fast pulse became normal - I still do this.

    The thing Endo's worry about with NDT is that it has T3 and T3 is the active hormone which will give you energy - too much will give you a fast pulse and possibly palpitations. However, the good news is that T3 only has a half life of 6 +/- 2 hours so if you have a racing pulse, miss out the second dose of the day - if that is the way you take NDT.

    But anyway, first let us know the numbers so that we can give a more accurate assessment.

    Oh, and Dave, another aspect of Endo's and NDT is that Endos do not measure T3, so the patient could be manufacturing thier own T3 via a periferal organ (e.g. the liver). But then the Endo does not measure T3 so they do not know how much T3 their patient ends up with - so it could be  a lot, that which they convert themselves and the T3 dose from the NDT. It all takes a lot of measuring via blood tests and for some reason Endos are reluctant to measure. They are flying blind, that's why they could run into a harmful condition.

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    • Posted

      LAHS, I have just got back from having private thyroid tests done where I normally go. These are the ref ranges--- FT4 12.22 pmo/L, FT3 3.1-6.8 pmo/L, TSH 0.27-4.20 IU.L

      March 17th results---- FT4 13.65, FT3 5.94, TSH L <0.01

      November 19th results----FT4 14.82, FT3 5.89, TSH L<0.005

      It appears that the FT4 has gone up since last time and the FT3 has gone down and the TSH even more suppressed.

      Is it possible that I need to decrease the NDT and add a little T3.

      At present I am taking 3 grains of NDT (Thyroid-s) and did not take any before the test this morning.

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    • Posted

      Hi Kathleen, In my humble opinion and from my own experience I would suggest that you reduce your dose a little bit to begin with and see what changes. Your FT4 is over max, so there is room for a reduction there and your T3 is fine, i.e. near the top end of the range.  Although on se ond thoughts your T3 is probably very high due to the fact that you (quite correctly) did not take your meds before the blood test.

      Now I realize that we are two different human beings but my dose is 1.5 grains of NDT (and I had a thyroidectomy due to Th Cancer) and anything over this makes me a bit hyper (and that is bad). 3 grains is considered very high here in the US and I would seriously tell you that this is a high dose and that it is probably causing your atrial fibrilation. Try 2.5 and assess your symptoms, that would be my sugestion.

      Does your heart fibrilate just after you have taken your meds? Well, up to 3 hours after, and then calms down? I ask this because T3 has a half life of about 4-6 hours and you are giving your all ready adequate T3 level a big temporary boost just after your pill.

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    • Posted

      LAHs what I find odd is that I am constipated and now having to use suppositries and my temp is low in 35 degrees c. This is not in keeping with taking too much Thyroid-s. Wouldn't my temp be high and wouldn't one more likely to not suffer from constipation if on too much thyroid medication.

      Yesterday I had only taken one grain of NDT after my test and had also been to my photo club in the afternoon, but there was no Afib on getting back but it was noted  at 10.00pm.On going to bed I still had Afib and as temp was low at 35.6cc I decided to take another grain of NDT, but as I still had Afib at 3.20am but temp had dropped lower at 35.00cc but I took half the 3.75mg Bisoprolol, but Afib contined until I had my bowels open, but the Bisoprolol had left me with a low BP of 114/55 bpm66 which in turn causes me to be out of breath. I have not taken any NDT this morning and will proceed at 2 grains a day, but I am somewhat confused that my tests indicate too much NDT, but symptoms indicate not enough.

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    • Posted

      Wow Kathleen, I can only agree with you that your observations do concur with Hypo but your symptoms look like Hyper. I do not know where constipation fits in exactly - although it is usually associated with Hypo. Would your doctor give you an EKG? Perhaps the AF is due to some independent cause. If the AF is not fixed by lowereing your very high dose of NDT I hardly know what to suggest.

      It's a difficult one Kathleen. I would get with your doc again and see what s/he suggests is the next move.

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  • Posted

    Hi kathleen, was it you that was in hospital recently (last couple of months) where the doctors refused to let you have your NDT? If so, I'm wondering whether your body became stressed by this and started producing RT3 (reverse T3)? Wouldn't this explain why you are having odd symptoms?

    Or could it be your adrenal glands playing up (stress/body trauma is reported to cause this)?

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    • Posted

      Hi Barbara, Yes it was me in fact I ended up in A&E three times but not kept in the third time, and they could not get blood so did not even bother to get somebody else to take it.

      I also had a dizzy spell at the sink on Friday and held onto the sink to stop myself falling and put my head down which helped and then held onto what I could until I reached my bedroom to take my BP and my BP was up and not in Afib but I had taken Bisoprolol in the early hours of that morning. I have cut down the NDT to 2 grains a day and no Afib but my hair is falling out still.

      They were also weening me off Prednisolone but I reached 2mg a day and the pain in my muscles and joints got too much and could not get appointment with my GP so increased the Prednisolone myself and now taking 10mg a day. The pain is better than it was and Prednisolone is supposed to help the adrenals.

      Before I was diagnosed with HYPO my hair used to fall out then so bad that I had to wear a bonnet to stop it going in the food on cooking.

      I have wondered myself if it might be due to RT3 and if to go back to taking just T3 for a bit.

      I was none too pleased about them refusing me NDT or even T4 with no explanation and the ENDO I saw said she felt I was harming myself by taking NDT but no explanation as to how. I received a response but still no explanation so have gone back to ask for an explanation again and they have agreed to investigate.

      I am not taking Bisoprolol all the time only when in Afib

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    • Posted

      Hi kathleen, I'm glad you've managed to avoid A&E recently!

      So this prompts the question: did the hair loss start after your spell in A&E with no NDT?

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    • Posted

      It was falling out before going into A&E, but I had also cut down on the NDT in readiness to change NDT for the T4 and a little T3 as the Endo had wanted, so I am wondering if it is due to cutting down on the NDT now which is causing more to fall out. I have to a 24 hour heart monitor test next week. The drawback to these 24 hour monitor tests is that it cannot know what you are doing at the time or know at what time you have taken any medication. It cannot tell what is causing the heart to go into Afib. On the last occasion on going to A&E and not kept in I had the 3.75mg Bisoprolol in the morning and that did not help so I wastold to go to A&E. It  took it out of me getting to the bus stop and having missed the bus, so as I had not had any NDT in the morning and the Bisoprolol had not helped I decided to take one grain of NDT. Is it posible that taking the NDT settled the Afib down by the time I was seen.I also passed the first memory test I was given but can they be reliable as on three occasions I have forgotten something. Friday for a start after the dizzy spell and on making my way to the surgery to deliver the records on BP etc and picking up my prescription. I had intended to do some shopping but realised I had not picked my bag with money in up.

      Before being diagnosed with HYPO I had, had spells of passing out plus having a fall on a bus when having problems with T4. In fact the muscle and joint pains started when taking T4. How can they blame the T3 in the NDT as causing harm and also the test this time for T3 has gone down. My views on T3 is that it can be more rapidly controlled that T4 can although you have to take it several times a day due to its half life. I don't think my hair was faling out when taking T3 only. Could the rise in T4 have caused the TSH to drop so much as it could not be due to the T3.

      Could RT3 cause the TSH to fall.

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    • Posted

      One brief comment. RT3 is more of an indicator than a hormone which "causes things to happen". Your RT3 goes up when you have too much T4 and you are not converting it to T3. The T4, insted of making more T3 dumps it as RT3.

      Now if you have an excess of T4 then you will probably have low TSH, but low TSH is not caused by high RT3. Low TSH and high RT3 are both results of excess T4.

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    • Posted

      The answer then is to change to taking all T3 to get rid of the RT3 caused by to much T4 in the NDT for me to convert. Despite lowering the Thyroid-s from 3 grains to 2 grains yesterday I did a bit of drilling to put some screws in to finish the ramp I have been making. Ity meant bending and in turn it started off this painful groin pain followed by a spell of Afib and I took half of the 3.75mg Bisoprolol. The Afib did not last as long as usual, but what I find is that my BP has dropped but the pulse is OK. The T3 I used to take one can no longer purchase. The ENDO I went to see continually blames T3 for the Afib. If its due to too much T4 its a good job I did not take much of the T4 I was prescribed. I  could not understand how the TSH could have got so low.
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    • Posted

      Gosh Kathleen you really need a good Endo who understands all of this. Getting rid of RT3 is not simple and yes, many people think that T3 only therapy is the answer, but high T3 definitely affects the heart. You need very careful monitoring to get all of this in balance. I have a similar problem, for what it is worth, I need the high T3 for energy but it does send my blood pressure (BP) up. I am exercising almost to destruction to keep my BP down. There are no easy solutions to all of this until we get good doctors who can synthesize all of the data correctly, instead of ones who will not admit they don't know what to do and stick you on some slightly wrong drug at an absurd dose just to cover their ass's.
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    • Posted

      LAHs when I was very bad with Afib gasping for breath and almost collapsed I was taking T3 only but had to go into hospital for a tooth extraction and I ask not to be given adrenaline, but all I got was that she new what she was doing and gave me two shots of adrenaline. The Endo blamed the T3 but I am sure it was caused by the adrenaline, as immediatley after I had a bad headache. I am taking 10mg Prednisolone, but not sure if that increases or decreases the adrenaline. I have cut the Thyroid-s down further today to 1.5 grains.

      My inclination is not to go through surgery to remove the mesh TVT until they get me in a better state.

      There is also adenal fatigue that Doctors refuse to admit exists.

      I feel positive that the antipsychotic drug I was put on for 13 years prevented the T4 from converting to T3 and the reason my weight went up and up despite being prescribed more and more T4.

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