High TSH, But High Heart Rate/ Lower Weight

[kitcurious]

Hi. I am currently on an event monitor to track my heart rate because it often seems a little high (110-130 quite often without any exercise being involved)and they just want to be sure when I have an episode of it running fast that it's normal sinus rhythm. I'm sure it is normal rhythm, as it has been almost two weeks on it and I haven't heard otherwise.

The cardiologist also ordered routine blood tests (same ones I'd just had last summer for a regular physical which were normal then) and my TSH came back last Friday slightly elevated at 6.1, lab reference was 5.5 at the top. T4 was in normal range and the rest of the metabolic panel was normal.

I also have noticed a slight decline in my weight, to the point I am wearing a size 1 (had been a size 4).

This is quite confusing, if anything, don't I have symptoms  of hyPERthyroid not hyPOthroid ?

Is this a common contradiction?

Should they repeat the TSH test, test for something else or just wait and see?

[gogoheidi]

I am new to this forum.  I am 35 years old and over the past couple of years have had symptoms of foggy head, dizzy, hypolgecemic symptoms (but not), trembling hand, memory issues.  Never had thyroid tested until things went crazy!  

In January of 2007 I had a sudden onset of:

Rapid heart rate over 100
Trembling
Dizzy Spells
So weak could not walk
naseau
upset stomach
skipped heart beats
Adrenal Rushed all the time

After 5 trips to the ER room in 2 months they finally decided I wasn't crazy and figured out I had thyroiditis.  My first TSH was 5.6 but I have mostly all hyper symptoms mixed with hypo symptoms.  

I have been on Levoxyl for 6 weeks now and my heart rate is slowly calming down.  I was very scared to add more thyroid into my system because my heart rate is already high.

In you guys opinion, when should my heart start to normalize? Will it normalize?  Will I feel like this forever? When should the dizzy spells go away?  I am currently on .25 of levoxyl.

My current Endo says he can't explain my high heart rate and asked me about anxiety.  

Thank you!

[EmpatheticJenny]

Thank you for telling me about your pulse and blood pressure experiences. As someone else said in a recent posting, it is so comforting to know that my body is not uniquely strange.  It also is comforting to me to know that you are doing well, because reaching the "doing well" point took awhile after your hypothyroidism finally was diagnosed...am I remembering right?

It is very kind of you to ask about where I am in my own medication adjustment. I am not yet doing well in a predictable way. The latest chapter was feeling my best-yet at 75 mcg. of Levothroid, but with each dosage increase, I have had a distinct plunge in well-being just after the 28-day mark. Doggone if it did not happen with 75 mcg., too, beginning on Day 31. By the time I saw my endo, ten days later, I was ready to beg for mercy.

Unfortunately, I have not had a single spell of reasonably good well-being on 88 mcg. I am ready to try Cytomel. As for why I am having a difficult time: I wonder if it is because my hypothryoidism went for sevral years undiagnosed. The odd twist in my story is that I did not feel unwell during those years--not at all. I see hypothyroidism in hindsight, though, because strange symptoms were developing one at a time that--once a person knows what the symptoms of hypothyroidism can be--no longer seem strange at all.

Most of all, I wonder if I can count on ever getting back to feeling as well as I did a year ago. I have been afraid to post a question at the forum asking if anyone ever has taken the downward plunge in well-being and never bounced back to normal again, but there are times when I wonder.

At any rate, thank you for your question and for your concern. I am VERY glad that you are doing well. You had a very rough time of it before you finally were diagnosed, so your well-being is hard-earned and well-deserved.

[thyroid man]

I too have seen my pulse and blood pressure go down within an hour or so after taking thyroxine. I'm doing good thx. Hope your doing well too. So are u adjusted to the right dose yet?

[thyroid man]

yes, hypo can cause a higher pulse in some people and weight loss. If my thyroid is low i get a higher pulse than when it is normal. The last time my tsh was 5.9 The doc thought i was hyperthyroid because i was jittery acting. My movements get jerky when i'm hypo. It's not as easy as saying... if your hypo your pulse is low  and your tired and if your hyper your pulse is high and your nervous. But this is the knowledge of your average doctor. Thyroid problems has got to be one of the most misunderstood conditions there is.

[EmpatheticJenny]

Hey, man--

I had forgotten until I saw your post that you are another person who has had a rapid heart rate with hypothyroidism. If you mentioned being jittery in a previous post, I have forgotten it, but I zeroed in on it this time because being jittery is one of my symptoms, too. I usually take my dose of Levothroid in the late afternoon; I sleep better if I do. One day when I was sitting quietly at home doing paperwork all day, which meant that I could pay closer attention than usual to my symptoms, I saw a pulse of 96 and a bad case of the jitters both be "cured" by the day's Levothroid dose. Two hours after the medication, my pulse was 76, and I had been sitting the entire time.

Needless to say, I could not agree with you more about thyroid problems. They must be the most misunderstood of conditions. Matching symptoms to problems is not easy, as you insightfully said. One of the big values of this forum is its being a place where people with know-too-little physicians can find out that they are "normal" after all.

With hopes that you are doing well,
Jenny

[EmpatheticJenny]

Dear Kit,

I am sorry if I seemed to misunderstand, and I did misunderstand in one regard. I thought that your cardiologist had said your TSH level was normal. Three cheers for him for not drawing any conclusions and also for giving you a heads-up.

The part that I did understand accurately--and I am sorry if it seemed otherwise--was that you were asking on your own about the seeming contradiction with the "standard" symptoms of hypothyroidism you've been reading and my current condition. Not long ago, the cognitive fuzziness that my hypothyroidism has caused would have been a good excuse for misunderstanding something. I am doing enough better, however, to leave me with no excuse but an everyday failure to communicate clearly. ;o)

Your question about contradictory symptoms is an excellent question. After I had seen an endocrinologist for the first time, I had a sense that he was thinking "thyroid," so I began to read. Several items in the standard list of HYPERthyroidism fit me beautifully. The standard list for HYPOthyroidism did not fit at all. Since my one and only complaint--which was the one that led me to the endocrinologist's office--was an ever-growing difficulty with middle-of-the-night insomnia, you could have knocked me over with a feather when I was handed a diagnosis of hypothyroidism. I was scared out of my wits at the thought of taking medication for the condition.  I feared being half-dead from no sleep at all within a week.

Now, as I am seeing strong evidence that my thyroid gland's struggles have been involved in my problems with sleeping, I really wish it were easier for a seeker of information to stumble over the fact (and it does seem to be a fact) that it is not rare to have hyperthyroidism symptoms when the underlying problem is hypothyroidism. It would have been reassuring to me to have had that knowledge several months ago when I was having spells of a rapid heart rate and a proneness to weight loss along with my problems with sleep.

Needless to say, I know just what you mean when you say the "standard" symptoms of hypothryoidism. A person sees the same list over and over again, and it includes only the most common symptoms. There are many more that are uncommon, but not at all rare, but it takes some digging to discover them.

I am glad to hear that you are researching endocrinologists in your network. People who take your sort of activist's approach to medical care seem to get the best outcomes. Now here's hoping you can persuade your PCP that an endocrinologist's office is the next stop you should make.

With best wishes,
Jenny

[kitcurious]

Thank you so much for your response. The cardiologist just ordered the test, he did not draw any conclusions other than he was concerned about the elevation, and faxed the result to my Primary Care Physician and told me to see him about it. The PCP hasn't contacted me but I made an appointment with him for next week.

I was asking, on my own, about the seeming contradiction with the "standard" symptoms of hypothyroidism I've been reading and my current condition.

Sorry it looked like the cardio doc was at fault, he wasn't. His ordering the test was actually helpful. However, the Primary Care doctor told me repeating the test less than a year later wouldn't be much different and my good friend told me I was "nutzo" if I saw my PCP ever again.

I have to though. :-/
Today I have been reseraching endocrinologiusts in my network though.


Thanks again for your reply.

[EmpatheticJenny]

I do not know how common it is to have contradictory symptoms, but it certainly is possible. I have seemed to specialize in them!

According to up-to-date guidelines for TSH levels, 5.5 is too high an upper limit for "normal," and your TSH level of 6.1 is definitely elevated. If your cardiologist does not realize that, then it shows how difficult it is for any specialist to stay up-to-date in any field of specialty other than his or her own. I have seen many stories at this forum of non-endocrinologists who looked right at a case of hypothyroidism and did not know what they were seeing. It happened to me, too, with more than one highly competent physician.

You could take a "wait and see" attitude instead, but just in case my situation is a cautionary tale, let me describe it. A year ago, I was having symptoms like yours while feeling mostly quite well. Then my well-being fairly suddenly took a striking turn for the worse. When it did, I was profoundly glad that I already had found and was becoming acquainted with a good endocrinologist who had diagnosed my hypothyroidism (and my TSH level was lower than yours). A one-time visit with an endocrinologist could not hurt. He or she could look at your lab results, exam you, and tell you what it all seems to mean in a way that was much more insightful than what I think a cardiologist possibly could do.  If you decide to pursue a one-time assessment, look for an endocrinologist who treats quite a few people with thyroid problems, not just people with diabetes.

Good luck!