Heart Palpatations Due to Thyroid Med??

[tsaku00]

Hi everyone,

I am currently taking Nature Throid and have been on 1.25 grains for 6 days now. (Previously levothyroxine and then switched to Nature Throid 3/4 grain. Dr. raised to 1.25 grains after lab results came back.) Anyways, I was feeling tired a few days ago and yesterday I felt pretty good.

Today however, my heart beat raised to 90 beats per minute for a short time. (that's high for me.) Right now my heart beat is a more normal 65 beats per minute (that's normal for me) but I have this weird feeling that I am very aware that my heart is beating. (If that makes sense.)

I was going to email my Dr on Monday in regards to Nature Throid anyways, but in the mean time will I be okay if I take my dose of Nature Throid  tomorrow morning? She told me to call or email her if I had heart palpations, but of course, this stuff always happens on a week end.

Help! Does anyone have any experience with this sort of thing? I want to make sure I'll at least be okay until Monday and not die in the middle of the night or something. :-(

[tsaku00]

Thanks Barb for all your help and insight. I greatly appreciate it! :-)

[Barb135]

Okay, I just wanted to make sure you didn't think there was a value in splitting the T4 med.

I understand what happened over last week and the weekend. I guess, both, your doctor and I would say that maybe you didn't give the desiccated med long enough for your body to get used to it, even at a week, but you know what you can handle and what you can't.  

My thoughts on Hashi's symptoms are that Hashi's, itself, doesn't really "cause" the symptoms, other than swelling/inflammation of the thyroid in early stages but if you've been hypo since 2002, your thyroid is probably pretty close to being burned out; Hashimoto's causes hypothyroidism, which is what causes the symptoms that we're all so familiar with and our thyroid replacement med alleviates those.

[tsaku00]

Hi Barb.

Thanks for your comment.

I'm sorry. I should have worded that sentence differently. I know that you don't split a T4 med. I meant that even though I am going back to levo for the time being, next time I see my Dr, I will ask if she is familiar with the concept of split doses for Nature Throid and other T3 type medicines. Maybe she never heard of it and it would be insightful for her. From what I have seen on the thyroid forum  reading other comments and problems, a lot of Dr.s have never heard of it. :-(

My Dr was really trying to get me to ride out the Nature Throid as well. I had my first racing heart/palpitation episode the first day I took it, which was on Monday the 11th. I almost called her again on Thursday the 14th and told her to" scap it....I want back on levo." But I did want to give it a chance. Friday I felt reasonably well, although not 100% so I decided to keep at it. The weekend was the nail in the coffin. I gave it a try at least. Perhaps I'll re-evaluate and go with 1 grain of Nature Throid in October when I get my new set of labs back. I don't know yet. It depends on how I feel then and how my labs come back.

I was advised to go gluten free because of Hashimoto's. I don't have any gluten sensitivities. (That was in March. That I found out I had Hashimotos. I have been hypo since around 2002 or 2003. Was never told about the Hashimotos back then. Never even tested for it until I saw this new Dr in March.) I know going gluten free won't cure me, but I thought it wouldn't hurt. What are your thoughts on how to help alleviate Hashi symptoms?

[Barb135]

"I will most definitely bring up the concept of split doses to my Dr too, even though I will be back on levo."  There's no reason to split doses on T4 med, because it takes it so long to reach potential anyway.  The T4 in your blood now, is what you took days ago.  It's T3 that's fast acting and only stays in your system for a few hours that needs to be split into multiple doses.  Of course, with Armour, where both the T4 and T3 are in the same pill, you have to split them both.  When taking a T4 only med, it's not done that way.

I'm sure that the rapid heart rates and palpitations were scary... they were when I had them, too, but I knew that if I rode it out, I'd be okay.

I agree that you might not have had such a profound reaction, had your doctor increased your med more slowly.   It's always best to increase at the slower rate and get used to each increase before going to another, but even at that, it's not unusual for symptoms to get worse or for new ones to appear while our body adjusts.  

Don't let the levo scare you, at this point.  You were on it before, with no adverse effects.  

If you went gluten free only because you have Hashimoto's and are hoping for it to help/cure your Hashimoto's, you'll be disappointed.  If you did it because you're sensitive to gluten, that's another issue.

[flyingfool]

I too think it was too much NT all at once in the morning.  The fact that the heart rate issue went away later in the day and the fact that we know T3 is used up inhours indicates to me or is at least consistent with the T3 being used up by later in the day.  Which suggests that too much T3 was hitting you all at once in the morning and earlier in the day.

i think it is at least possible to think that if you took the NT in a split dose with half in the morning and half about noon ot 2 PM or so that you may have been fine.

I too think given your labs that you likely need to have some T3.  

i might still talk to your Dr and see about going to the split dose.  T4 only takes WEEKS to stabilize so a couple of days of T4 only won't throw things off too much.  So going back to NT with half in the morning and half mid-day to early afternoon might work out.

Toatally up to you.

[Barb135]

I'm on the run, but have a couple of comments when I get back this afternoon...

[tsaku00]

Thanks Barb. The synthetic T3 was a thought I had too. I'll certainly ask about it at my next appointment. (I will take new labs before that appointment So depending on new results.)

I will most definitely bring up the concept of split doses to my Dr too, even though I will be back on levo.

  This weekend just frightened me. I couldn't even wipe the counters in my kitchen without my heart pounding and heart rate souring up high. It was compounded by the fact that all my health issues happen on the weekend it seems with no Dr  in sight. We have an urgent care open from 12-5 with a minimum 2 hour wait. And the nearest ER is an hour away.  I'm alone most of the time with two small kids (hubbies job has lots of travel) and so fear over took me.

Perhaps my Dr should have had me go from 3/4 grain to 1 grain instead of strait to 1.25? I am almost certain that had I started with the split dose that would have helped too. Now I am a little fearful of the levothyroxine too. I guess the next Dr appointment will be telling. I'm trying hard not to be anxious and remembering that  before I switched I felt the best I had in years. (Found out I have hashimotos and so I went gluten free.)

You have helped me so much this last weekend Barb135. Thank  you so much for being a calm voice of reason and giving me a lot of great info.

[Barb135]

It's unfortunate that I wasn't able to get that first message to you in time for you split your dosages for a couple days so you could see how that worked.  You're right; the weight gain was the tip off.  With your FT3 as low as it is, I think you need added T3, but perhaps you'd do better with a low dose of synthetic T3 added to your T4

Good luck.

[tsaku00]

It's funny, because I originally went to Nature Throid because I wanted to try and raise my T3 a little. I was starting to feel great with the Vitamin D supplements, but suspected something was going on because I gained 3 pounds and could not shake it off. Because of this weekend though, I'm scared of nature throid.
Perhaps if my T3 comes back low next time I will have the courage to try it again and split the dose as you suggested. This weekend really freaked me out.

[tsaku00]

No problem Barb. Thanks for responding back.

I had heart palpitations several times yesterday afternoon. I was at my sister's house.  I  almost went to urgent care. My heart rate was rapid all day yesterday too. By around seven or eight in the evening, I started to feel better. I was able to sleep through the night.

I called my Dr as soon as their office opened up at 9am. I told her what had happened Saturday and Sunday and she told me to stop taking Nature Throid 1.25 grain dosage right away. (I didn't take it this morning) She advised me to take nothing at all today.
I told her that I felt better on Levothyroxine so she advised me to start my old dosage of Levo tomorrow morning.

I am feeling so much better right now as opposed to this weekend or even this morning. The only thing is that my throat feels a little weird, and that concerns me a tad bit. I am supposed to have a thyroid ultra sound in mid September. No particular reason. My Dr just wants too see what is going on in there. (That was arranged long before I switched to Nature- Throid.)

So starting tomorrow I will be on my 75mg of levothyroxine again. I'll take labs for how I am doing on levo again in early October.

[Barb135]

Sorry I didn't respond last night; my time zone is 3 hrs ahead of you, so I'm sure I was in bed long before you, last night.

Your FT3 on levo, alone, certainly looks hypo, but some people do very well with their levels lower in the range and not everyone needs the high amounts of T3 present in desiccated hormones.  I don't feel that I would be able to take them.  

While vitamin D isn't needed directly for thyroid hormones, deficiency can cause a lot of hypo-like symptoms.  

Your heart beat, at 90 bps is not really going out of the normal range and I'm sure it feels much worse than it really is.  That said, I can't say, often enough... whenever you feel in medical distress call 911 or go to the nearest ER or urgent care center.

How did you take your med this morning?  All at once or did you split it in half?  I would recommend that you try that for a few days and see how it works before you change, but of course, you can/should discuss it with your doctor.

How are you feeling today?

[tsaku00]

Any insight or suggestions you may have are greatly appreciated Barb135. You have been so helpful.

[tsaku00]

I was going to tell her I prefer to go back on levothyroxine. Here were my labs on levo before I changed over to Nature Throid:

Free T3-   2.7          reference range 2.3-4.2 with 3.2 being optimal
Free T4-   1.11        reference range .84-1.51
TSH- 1.835             reference range .400-4.00

My labs also showed that I was deficient in Vitamin D and ferritin. As soon as I started taking Vitamin D suppliments I felt 100% better.

Before I decided to switch over to Nature Throid, In hindsight, I feel that I should have had updated labs done with the supplements to see if that helped.

But I didn't and switched to Nature Throid on June 26th and I have not felt good since I switched. It's just that these rapid periods of heart beats and palpitations are the straw that broke the camels back. The bad medical things always happen to me on weekends when nobody is around. :-(

[Barb135]

Your FT3 is right at mid range and your FT4 is actually very low in the range; neither of these results indicates that you are hyper.  Rule of thumb is for FT4 to be mid range and FT3 to be upper half to upper third of its range.

I think your rapid heart rate is simply from taking all of the med at one time AND I'm sure that anxiety is exacerbating the situation, at this point.  I know it's easy for me to say, but do try to remain as calm as possible.

What else were you planning to talk to your doctor about?

[tsaku00]

The free T3 is 3 and the reference range is 2.3-4.2
Free T4 is .89 and the reference range is .84-1.51
TSH  is 5.292 and the reference range is .400-4.00

Tomorrow morning before I call my Dr I will definatley split dose and see what she says and how it goes.

Thanks so much.

[Barb135]

What are the reference ranges for the Free T3 and Free T4?  Ranges vary lab to lab and have to come from your own report.  I can certainly see why she increased your dosage, as your levels appear quite low.  Many doctors aren't aware of a need to split meds with T3 in them into multiple doses/day.  My own endo wasn't, until I told him that works best, then he wrote the script that way.  

I'd almost guarantee that if you split your dosage, your symptoms would be greatly decreased, if not gone.

[tsaku00]

The only hormone levels I have were my last testing a couple of weeks ago when she raised my prescription. I was taking 3/4 grain and the labs came back Free T3 was at 3, Free T4 was at .89, and TSH was at 5.292. That's when she raised my dose from 3/4 grain to 1.25 grains. I have been taking it for 7 days now with various symptoms. Some days I am okay, other days no energy at all. the last three day I have felt fine except for the rapid heart beat and awareness of heart beat yesterday and so far today. Also, I don't know if it's related, but I got my period today. It's extremely early.

[tsaku00]

Thanks.

I made it through the night. However, I didn't know what to do and took a full dose of my Nature throid this morning. (Why do these things always happen on a weekend when I can't call or email my Dr? Uuuugg!)
I wish I would have gotten your advise in time to spit dosage. Maybe that's what I will do tomorrow morning since I will be taking my medication before the Dr. Office opens. (I wonder why my Dr. did not tell me to split dosage?)

I am still trying to decide if my heart beat warrants a trip to my local urgent care or not. Just cleaning the counters a little while ago gave me a heart rate of 94. It finally has settled down to 74, I may wait a while and decide since they don't open until 10:00am anyways.

[Barb135]

What are your actual thyroid hormone levels?  I had palpitations when I was still hypo.  I also had the "awareness" of my heart beating.  It was caused, mostly, by anxiety.

Sometimes, when changing med or dosage, symptoms reappear or worsen for a short time, then go away again and isn't usually anything to worry about.

Are you splitting your dose of NatueThroid or taking it all at once?  Most of us taking a T3 med, find that we have to split the dosage into a couple doses throughout the day, in order to keep levels more stable.  That also keeps us from getting one huge dose all at once, which sounds like what might be happening to you.

For instance, I take generic synthetic T3 5 mcg T3 in the morning with my Levoxyl, then another 5 mcg around noon.  T3 is fast acting and doesn't stay in your system very long, so by doing this, I'm only getting half the dose each time, which doesn't cause the palpitations or rapid heart rate, but it does help make sure I have enough T3 in my system for all day.

It's unlikely that you're going to die in the middle of the night or anything like that, but of course, if, at any time, you feel that you are in medical distress, don't hesitate to call 911 or go to the nearest ER.