Increased HR...reason enough to lower Synthroid?

[Wirewaist2]

TSH 0.049 (0.450-4.500)
FT4 1.17  (0.82-1.77)
FT3 3.4    (2.0-4.4)
Med increased (Synthroid 100mcg) on 9/8/14. Endo wants to decreased med to 88mcg due to low TSH.  For the last two days I've experienced increased HR.  The normal for me is 60-70 bpm.   I'm now fluctuating between those 2 numbers and going as high as 87 bpm.  I am really concern.  Could this be the beginning of hyper symptoms?  The normal HR for adults is 60-100bpm.  This is still within normal range.  87bpm however, is really uncomfortable for me.   It feels as though my heart is beating right out of my chest.  I am not sure how to proceed, decreasing meds will lower FTs and I'm only just starting to experience symptom relief.      

[Barb135]

"But maybe it's the pituitary gland that's trying to get to that equilibrium that it's used to? That it feels when something is shifting. Or maybe it's the hypothalamus, or both."  Wishful thinking... LOL  

It's what your "body" (the individual cells) needs and that changes as we change, with age and other circumstances.

If your legs are swelling, it's possible that some of the weight you've gained is fluid retention, but since your med was decreased, probably not all of it is.

No, it's not healthy to increase/decrease med all the time.  Like I said, it keeps your body on a roller coaster that's really hard to get off.  You're constantly trying to adjust to "enough"/too little thyroid hormones.  It can, ultimately, put too much stress on the adrenals, which try to take up the slack whenever you don't have enough thyroid hormones.  Then when you get more thyroid hormones, the body has to readjust again... that's what causes the roller coaster.  

[Guppy70]

You're right,we shouldn't have to compromise. And if my endo wants me to lower/quit my meds again down the road I will flat out refuse.
I'm acctually taking photos of how I look now, my eyes looks like I've been crying for hours and hours. And my legs are really big and I've gained even more weight since last Wednesday, over 2 kilo!!! Which I think (want it to be) is mostly fluids.

And I was wondering about that; it can't  be very healthy to lower and raise the meds, the body is obviously protesting.

Well, you're right, the TSH doesn't have memory. But maybe it's the pituitary gland that's trying to get to that equilibrium that it's used to? That it feels when something is shifting. Or maybe it's the hypothalamus, or both.

[Barb135]

No, TSH doesn't have a "memory" and it has no idea what your personal range for thyroid hormones is.  

It's true that not everyone needs their FT3 at 75% of the range - in fact, most of us don't need it that high... rule of thumb is upper half to upper third (not upper quarter) of its range; however, you see in your own circumstance, that lowering your dosage just because of your TSH brought back your hypo symptoms and you have to start over again.  Decreasing and increasing med dosages because of TSH levels keeps you on a roller coaster that ends up being extremely difficult to get off from and it ends up keeping you ill far longer than you need to be.

Doctors freak at low TSH because they're taught in med school that it's the gold standard for thyroid testing.  AACE and ATA won't give up that fallacy, even though study after study has proven it wrong.

You should not have to compromise with substandard levels of actual thyroid hormone levels and accompanying symptoms for a textbook TSH - some of us (like me) could easily die before that would happen.  You may have to ride out some uncomfortable symptoms while your body adjusts to higher levels of the hormones again, but once you get past that, you might be surprised at the difference it makes.

As I noted above, we always want to err on the side of caution, so whenever on feels that they may be in medical distress, they should always contact their doctor, go to the nearest ER or call an ambulance, regardless of what anyone on a forum, such as this tells you.

[Guppy70]

I know what you mean, anything above 80 bpm and I feel aweful.

This spring I started to go hyper and I felt it way before my thyroid hormones were above the referensranges. I think my FT3 was 4,6 (top range 5,0) and my FT4 was somewhere in the middle and my TSH was too low at 0,12. And my first symptoms was a terrible hard heart beat around 80 bpm.
When my doctor asked me what my heart rate was and I told him 80 I could see on him he thought I was nuts, lol. But if you're used to 60 bpm or lower, a 20+ increase is a lot.

I wonder if the TSH have "memory" so to speak. If the individual goes outside its own personal range, that the TSH will respond.
If the levels rise fast, as it did with me, the TSH will drop very low.
It sounds as if the FT3 optimal level is around 75% but I think that's not my personal optimal level, I need lower. Since my heart beat started to go crazy before that.

I just had to lower my meds too for pretty much the same reason as you. And my T4 and T3 are nowhere near the top range. She dropped me with 38 mcg and I now feel terrible and puffy. So I was increased again with 25 mcg, it's like everything I had worked up to feel better in a long time was just pulled away from under my feet and I have to start all over again.
And just because my TSH was "too low". (0.1)

If the TSH in itself have nothing to do with symptoms I just don't get it why they freak out when it's too low. Do we have to compromise? Substandard levels of the actual thyroid hormones and all the symptoms is causes, for a textbook TSH? In that case I'm willing to live "on the edge", lol, because I sure can't get used to feeling sick.

[Barb135]

Of course you can have high blood pressure and high HR when hyper but your labs, other than TSH, do not indicate that you're anywhere near hyper.  We know that TSH does not cause or alleviate symptoms.

Your higher blood pressure could very well be caused by anxiety, and of course, the more frightened we get the worse the symptoms get.  7 weeks isn't a long time to be on a new dosage, so your body could still be adjusting to that.  Are you actually checking your HR throughout the day?  Mine would sometimes "feel" like it was racing really fast, but when I'd check it, it wouldn't be racing at all; I just had a "super awareness" that really exaggerated the feelings.  I don't think your feelings of increased HR would be coming and going like they are if you were really hyper.

Of course, you always want to err on the side of caution, so any time you feel that you are in any type of medical distress you should always contact your doctor, go to the nearest ER or call an ambulance, regardless of what myself or anyone on this forum tells you.  

Maybe it's time ask for another heart work up, just to satisfy your mind.

[Red_Star]

I has high pulse pressure and high blood pressure with hyperthyroidism.

[Wirewaist2]

Really at wits end.  Feeling discouraged. Not feeling any pain, but do have some chest tightness along with increased HR.  Not sure if it is anxiety.  BP has also risen from 120/70 since I started on meds.  It now lingers between 130/90 and150/98.  Had cardiac workup done last year, even had one of those 24 hr. monitor.  Everything came back normal.  Did have some palp and increases HR when I was first diagnosed as Hypothyroid.  Went away after I started meds.  Have been taking the 100mcg for the last 7 wks.  The increased HR started a few days ago.  Its on and off throughout the day.  Sorry about the threads, will try to keep them together.

[Wirewaist2]

Thanks for the info.   BP has also increased, after being placed on Synthroid.  The normal for me was 110/70.  It is now at 130/90 sometimes going as high as 150/98.  I wanted to avoid taking BP meds.  I think the Synthroid is keeping it elevated.  I was hoping for the opposite effect.

[Barb135]

I don't agree that you specifically need to decrease your dosage because of rapid HR.  I had rapid HR, along with pounding heart beats, really bad when I was horribly hypo.  It would feel like my heart was going to jump right out of my chest.  I do admit that it was very scary, since I was used to a HR in the low 30's to 60's.

A complete heart work up showed that there was nothing wrong with my heart (other than leaky heart valves that had nothing to do with that situation and were causing no problems).  

Looking at your thyroid labs, your FT4 is only at 37% of its range.  Rule of thumb is for FT4 to be about mid range, so you have quite a ways to go, there.  In addition, your FT3 is at 58% of its range; rule of thumb is for FT3 to be upper half to upper third of its range, so you're fine there, as well.  

You posted another thread not long ago and it's difficult to keep things straight with too many threads going, but if my memory serves me, you haven't been on the 100 mcg terribly long, correct?   It's not unusual for symptoms to worsen or for new ones to appear when changeing med or increasing dosage.  Again, I think your doctor is reacting on on that low TSH, more than anything else.

The rapid HR can also be a symptom of anxiety, which played a role in my issue - also caused, partially by hypo, partially by circumstances beyond my control.

What, if any, other symptoms do you have?

[Red_Star]

Sounds like you need to cut back your dosage. A few excerpts from an from Harvard health Publications - Increase in resting heart rate is a signal worth watching...

"Your heart rate changes from minute to minute. It depends on whether you are standing up or lying down, moving around or sitting still, stressed or relaxed. Your resting heart rate, though, tends to be stable from day to day. The usual range for resting heart rate is anywhere between 60 and 90 beats per minute. Above 90 is considered high."

"In today’s Journal of the American Medical Association, researchers from Norway report the results of a large study looking at changes in resting heart rate over 10 years. They recruited more than 29,000 people without any history or heart disease, high blood pressure, or any other type of cardiovascular disorder, and measured their resting heart rates when they started the study and again 10 years later.

Compared to people whose resting heart rates were under 70 beats per minute at the study’s start and its end, those whose resting heart rate rose from under 70 to more than 85 were 90% more likely to have died during the course of the study. The increase in risk was slightly less for those with resting heart rates of 70 to 85 at the study’s start and who had a greater than 85 at the study’s end.

Although 90% sounds like a huge and scary increase, let me put it in perspective. Among the group whose heart rates stayed under 70 throughout the study, there were 8.2 deaths per 10,000 people per year. Among those whose heart rates rose above 85, there were 17.2 deaths per 10,000 people per year."