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Thyroid treatment and eradication of Arrythmia
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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Thyroid treatment and eradication of Arrythmia

I was diagnosed with an underactive thyroid about 2 years ago, following the diagnosis of coeliac disease and dermatitis herpetiformis. Within a year I had persistent arterial fibrillation. My TSH is around 15. A tiny amount of levothyroxin (levothyroxine) exacerbates the arrythmia (0.25mg); it sends the heart into further stress. If I can improve the situation of the thyroid might the arrythmia disappear? But without thyroxin I don't know how to do it. What would you suggest?

Past history includes: no oxytocin in labour 27 years ago - possible developing pituitary problem? Hypersensitivity of all senses but especially hearing. Adrenal failure has been suggested supported by negative DHEA on testing. Failure of thyroid uptake suggested - high ALT level now 79iu/L - lowish platelet count 188 - lowish free T4 14.4.

I am taking a good mix of vitamin supplements plus minerals which include some iodine.
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Sounds like autoimmune conditions are affecting you.  Key to get the adrenal issue sorted out -- ie, make sure you don't have Addison's (adrenal insufficiency).  The HYPOthyroidism is likely Hashimotos and one study suggested an inc'd A-Fib rate in HYPO (but this is much more associated with hyperthyroidism).

Doubt its a pituitary problem, but the endocrinologist should be able to sort this out.  

Once pituitary disease is excluded, then would slowly introduce levothyroxine to get the TSH normalized.  But if you have Addison's, this often is difficult due to adrenal insufficient symptoms which need to be treated with steroids before introducing the thyroid med....
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