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Heart pounding on low dose of Levothyroxine!
I'll try to be concise, but thank you to all; this site has been a huge relief and reassurance! My blood was tested 3 weeks ago due to weight gain and other symptoms I thought were menopausal; TSH 4.18, T4 .97. I was put on Levothyroxin 25mcg (generic for Levoxyl). It puzzled me: how can I be hypo when I have heart racing and pounding at night? I had nodules and part of my thyroid removed a few years back, but no need for meds at that time. A day after I started the Levothyroxin (that's the spelling on my script), my heart was pounding out of my chest all day long, blood pressure up, heart racing - I was going crazy. Went back in to my doctor and she put me on a Holt monitor for 24 hrs. She didn't think it was the meds because the dose was so low. I wore and returned the monitor. The following morning my b/p was 153/83 and pulse 94, and I had numbness and tingling on the left side of my body. I didn't take my thyroid meds, convinced they were the problem, and called my Dr. again. She said it was probably anxiety, gave me a prescription for Lorazepam, and told me to stop the Levothyroxin until my next appointment in 11 days, when we review the results of the monitor. The Lorazepam helps, but pounding and racing is still happening throughout day. I'm sure it's exacerbated by anxiety; my heart pounding out of my chest makes me anxious! My Dr. doesn't seem to be too concerned as I have always been healthy. Now I am living on this Lorazepam until I go back next week for results from the monitor. I looked up the half-life of the medication, and it is about 7 days. I feel like I have gone from fairly healthy to a basket case in 2 weeks. Where do I go from here if such a low dose of thyroid medicine puts me into hyperthyroidism? Appreciate any insights into how to be my own best advocate!
100 mcg is WAY, WAY, WAY too much to start out on if you have a history of tachycardia.
Here's an excerpt from the dosing instructions on Synthroid's website:
“For most patients older than 50 years or for patients under 50 years of age with underlying cardiac disease, an initial starting dose of 25-50 mcg/day of levothyroxine sodium is recommended, with gradual increments in dose at 6-8 week intervals, as needed.
The recommended starting dose of levothyroxine sodium in elderly patients with cardiac disease is12.5-25 mcg/day , with gradual dose increments at 4-6 week intervals. The levothyroxine sodium dose is generally adjusted in 12.5-25 mcg increments until the patient with primary hypothyroidism is clinically euthyroid and the serum TSH has normalized.
In patients with severe hypothyroidism, the recommended initial levothyroxine sodium dose is 12.5-25 mcg/day with increases of 25 mcg/day every 2-4 weeks, accompanied by clinical and laboratory assessment, until the TSH level is normalized.”
Here's the link:
http://www.rxabbvie.com/pdf/Synthroid.pdf
Print it off and bring it to your doctor and tell her to start you on a reasonable dose.
How old are you? Have you been hypo for quite some time (think back to when your symptoms started)?
You have to start out low and increase slowly.
My PCP did the same thing to me, and it was miserable. You can take it, but you can't go from nothing to 100 mcg. I can totally identify with what you're going through. I'm sorry your doctor did this to you.
Here's an excerpt from the dosing instructions on Synthroid's website:
“For most patients older than 50 years or for patients under 50 years of age with underlying cardiac disease, an initial starting dose of 25-50 mcg/day of levothyroxine sodium is recommended, with gradual increments in dose at 6-8 week intervals, as needed.
The recommended starting dose of levothyroxine sodium in elderly patients with cardiac disease is12.5-25 mcg/day , with gradual dose increments at 4-6 week intervals. The levothyroxine sodium dose is generally adjusted in 12.5-25 mcg increments until the patient with primary hypothyroidism is clinically euthyroid and the serum TSH has normalized.
In patients with severe hypothyroidism, the recommended initial levothyroxine sodium dose is 12.5-25 mcg/day with increases of 25 mcg/day every 2-4 weeks, accompanied by clinical and laboratory assessment, until the TSH level is normalized.”
Here's the link:
http://www.rxabbvie.com/pdf/Synthroid.pdf
Print it off and bring it to your doctor and tell her to start you on a reasonable dose.
How old are you? Have you been hypo for quite some time (think back to when your symptoms started)?
You have to start out low and increase slowly.
My PCP did the same thing to me, and it was miserable. You can take it, but you can't go from nothing to 100 mcg. I can totally identify with what you're going through. I'm sorry your doctor did this to you.
i have had tachacardia my whole life and only get it right around my period but i started on levothyroxine monday and i thought i was gonna die heart punding pulse racing head felt weird so tired but anxious! i stopped taking it i was on 100 mg dr told me to cut it in half but im not taking it at all it scared me !! how long does it take to get out of your system??
I'm afraid it is wisdom born of pain. My PCP started me on 88 mcg of levo when i really should have been started on 12.5-25. I ended up backing off to 25 mcg when I knew it was time to try something else (beta blocker). To this day, I have never taken 88 mcg again...I leveled off at 75 mcg, and I've been on a stable dose and felt well for three years now. Can you imagine what that 88 mcg right off the bat did to my poor hypo body? LOL
Some people aren't as sensitive to meds as others, but, usually, yes, there is a lot of fine-tuning. It all takes so much patience because you have to wait 4-5 weeks between each dose change.
Good luck with your appointment...let us know how it goes.
Some people aren't as sensitive to meds as others, but, usually, yes, there is a lot of fine-tuning. It all takes so much patience because you have to wait 4-5 weeks between each dose change.
Good luck with your appointment...let us know how it goes.
Thanks, you are a wealth of knowledge! Wisdom born of pain, right? Are you stable now? This is all so new to me; I am doing a ton of research, I can just imagine how thrilled my doctor will be. I will take your suggestion and push for the smallest dose, and also for a brand, not generic. I'm feeling hopeful; also have had no symptoms yesterday and today and feel normal. I really don't want to go back to where I was, but clearly there is a lot of fine tuning with this condition. Appreciate sharing your experience with me!
i think I understand now. You started having the racing and pounding heart last summer after being sick, but only at night. When you started taking levo, you then started experiencing that day and night.
So, this is not really a new symptom. The levo really just exacerbated what was already there, which it quite often does.
In fact, I have a congenital heart defect that's caused me to have tachycardia almost all my life. It was under control, without meds, until I started levo. I had been having a few episodes a year before levo, and those went to 20-30 per day after. Suffice it to say that with my history, age and having been hypo for a long time before diagnosis, my doctor arted me on way too high a dose of levo.
If I were you, I'd ask my doctor about starting at a lower dose (maybe 6.25-12.5 mcg). It takes your body a while to get used to having thyroid hormones available again, and there's definitely a re-balancing period in your endocrine system. Baby steps...start out low and increase as tolerated. You're not really going hyper; you're having hyper-like symptoms from starting meds.
The increased heart symptoms will probably be temporary as you get used to the meds, but if they're really annoying, you could ask your doctor for a beta blocker to help you get through the adjustment period. I've been taking a beta blocker ever since I've been on levo just about, and it does wonders.
Although it sounds contradictory, palpitations and tachycardia are quite frequently symptoms of hypo. Part of that may because when thyroid hormones are low, the adrenals try to compensate, raising your adrenal levels.
So, this is not really a new symptom. The levo really just exacerbated what was already there, which it quite often does.
In fact, I have a congenital heart defect that's caused me to have tachycardia almost all my life. It was under control, without meds, until I started levo. I had been having a few episodes a year before levo, and those went to 20-30 per day after. Suffice it to say that with my history, age and having been hypo for a long time before diagnosis, my doctor arted me on way too high a dose of levo.
If I were you, I'd ask my doctor about starting at a lower dose (maybe 6.25-12.5 mcg). It takes your body a while to get used to having thyroid hormones available again, and there's definitely a re-balancing period in your endocrine system. Baby steps...start out low and increase as tolerated. You're not really going hyper; you're having hyper-like symptoms from starting meds.
The increased heart symptoms will probably be temporary as you get used to the meds, but if they're really annoying, you could ask your doctor for a beta blocker to help you get through the adjustment period. I've been taking a beta blocker ever since I've been on levo just about, and it does wonders.
Although it sounds contradictory, palpitations and tachycardia are quite frequently symptoms of hypo. Part of that may because when thyroid hormones are low, the adrenals try to compensate, raising your adrenal levels.
Hi, thanks for responding! I was on 25mcg of Levothyroxine for one week. I go back next week for results from the Holter monitor. I was sick for 2 weeks with a stomach bug last summer, and that is when I noticed the pounding in my ears when I went to bed. I told my Dr. about it and she said that was common from dehydration during sickness. But it continued every so often at night after that. But never during the day. No history of any heart issues. The racing and pounding heart, occuring all day as well as night, with high pulse and bp, started a day or so after beginning the Levothyroxin. It's been a week that I have been off it, and the heart issues seem to be calming down. I'm trying to formulate the right questions for next week...thanks for your imput!
You were only on 50 mcg of levo for a couple of days, is that correct?
Have you gotten the results from the Holter monitor yet? Any history of heart arrhythmia? How old are you? Thinking back to when your symptoms began, was it more than a few months ago?
Sorry for all the questions, but the answers will really help narrow it down.
Have you gotten the results from the Holter monitor yet? Any history of heart arrhythmia? How old are you? Thinking back to when your symptoms began, was it more than a few months ago?
Sorry for all the questions, but the answers will really help narrow it down.
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