Hypothyroid adn heart rate

[amerfattal]

I have been diagnosed with hypothyroidism since Aug 2008.  The TSH level was 5.66 and the doctor put me on 25mcg pill.  After few months did the tests (tsh ft2 and ft4) again and the level went up to 6.9. The doctor increase the doe to 50 mcg then all sorts of problems started for me.  Panic attacks, palpitations etc...  
After 3 months on 50 mcg I did the tests again and the result was ok  tsh 3.8 so the doctor ask me to stay on 50 mcg and refused to listen to my problems saying that nothing to do with the meds.  
This is when I started to take things into my own hands, reducing intake to  25 mcg and back to 50 mcg.  

Last test done shows TSH level 1.9 however the heart rate is fast and palpitations as well.

What should I do

[goolarra]

I read the article...very interesting.  

It sounds very preliminary.  I found one comment very interesting:  Yersinia is more common outside the U. S.  I recently read an article that said that Hashi's is much more prevalent in the U. S. than in Europe.  I don't know how those two are reconciled (especially since this was a European study on Yersinia).  

Thanks so much for passing it on.

[goolarra]

No cure for Hashi's, just treatment.  Once you have it, you have it for life unless your thyroid is completely removed.

I'll check ou the article.

[amerfattal]

Is there a cure for Hashi?

go thru this

http://www.thyroid-info.com/articles/yersinia.htm

sounds interesting

[amerfattal]

Thanks a lot for your help.  I agree with you 100% the goal is to feel better and this is what I am concentrating on now.

Taking BB is my last option because I heard that if has an effect on sexual potency.  I am seeing my doc next week and I am giving him an ultimatum this time around, either he understands or I'll seek another.

Thanks again

[goolarra]

First of all, let me say that I think your doctor is completely wrong that your palps, rapid HR and panic attacks are not related to your meds.  I spent a year with a doctor who insisted my tachycardia wasn't related to the thyroid meds and I would have to he hyper (according to classic lab standards) before meds would cause tachy.  Wrong, very wrong...

Your labs are interesting.  Since you have Hashi's, you have to realize that you are chasing a moving target.  The antibodies are destroying more of your thyroid all the time, so it is able to put out less and less of its own hormones.  For that reason, those of us with Hashi's have to keep increasing meds until our thyroids are completely destroyed, and we are on total hormone replacement when everything gets a bit more stable.

In addition, our thyroids go into periods of "overdrive" and periods of virtual shutdown, complicating things even further.  This is what I'm thinking might be the reason for some of the strange fluctuations you're seeing in the labs.  Your FT4 has gone down, but so has your TSH...TSH should rise as FT4 goes down and vice versa.  In the last two labs, FT3 went down considerably, and so did TSH...oince again TSH should move in the opposite direction.  Have your palps, etc, improved at all since your FT3 went down as of the last bloodwork you posted?

All of us are comfortable at different levels.  As long as my FT3 is within range, I am symptom free.  If FT3 gets off the floor of the range, I start feeling hyper...tachycardia, can't sleep, restlessness, etc.  Your FT3 on the third test was fairly high, and maybe too high for YOU.  

Since both FT3 and FT4 are in range, and have been right from the very beginning, I think you should have stopped increasing as soon as all symptoms were alleviated and monitor FT3 and FT4 levels every three months (sooner if hypo symptoms return).  The fact of the matter is that feeling good is the goal, not getting the numbers "right".  Doctors have a tendency to want to push us all into the "ideal" lab ranges, ignoring symptoms, both hypo and hyper.

It's a tough battle to convince many of them.  I ended up having to get a new doctor (endo) who understands all the relationships.  He has me on a beta blocker to control the tachy and palps and lower HR.  Have you considered trying a beta blocker?  They do help and almost immediately.  

[amerfattal]

By he way I am taking Euthyrox (Levothyroxine)

[amerfattal]

All hypo symptoms gone away.

First test in august 2008
Second Feb 2009
Third April 2009
Fourth  July 2009

[goolarra]

Have your hypo symptoms all gone away?  (I'm not considering the palps, rapid HR and panic attacks to be hypo symptoms, but hyper or meds sensitivity related.)

How far apart were each of the tests you posted above?

[amerfattal]

at night I feel is is ponding so hard and sometimes during the day.  When I measure the rate is around 85

[amerfattal]

Thanks,

During one of my panic attacks, I though there is problem with my heart and I saw a cardiologist.  I did all the tests and everything is normal.  I did an echo to the thyroid and the shape and size are normal.

[Barb135]

With your TPOab so high, it would appear that you have Hashimoto's, which is autoimmune.  Have you had an ultra sound or anything?  

How rapid is the heart rate?  Have you had any kind of work up to make sure your heart is okay?  

My heart often FEELS like it's extremely rapid, but when I check it, it almost never is too high.  I DO have palps, though and it feels like my heart is beating extremely HARD.  My endo has told me that if it continues, I may have to go back to my cardiologist. I just had a heart work up in Dec and I do have one valve that is leaking, but nothing to be concerned about.  Cardiologist wants to check it in a year - which is now 6 months away.  

Maybe some other members who are more experienced will have some ideas for you.

[amerfattal]

Thanks for your reply

first tests results before taking any medication:
tsh: 5.66 mlU/ml       range: 0.27 - 5.4 mIU/ml
ft4: 1.31 ng/dl           range: 0.9 - 2.1 ng/dl
anti-tpo 500 IU/ml     range: up to 50 IU/ml

second test results taking 25 mcg:
tsh: 6.9 uIU/ml         range: 04 - 4
ft4: 1.4  ng/dl           range: 0.8 - 1.9
anti-tpo: 8730 U/ml  range: to to 60

third test results taking 50 mcg:
tsh: 3.64                range: 0.4 - 5
ft3:  2.8 pg/ml         range: 1.68 - 3.54
ft4: 0.89                 range: 0.71 - 1.85

fourth test  results taking mix of 50 and 75 (75 two days a week)
tsh: 1.89               range: 0.4 - 5
ft3: 1.98                range 1.68 - 3.54
ft4: 1.07                range 0.7 - 1.85

[Barb135]

Do you know what your Free T3 and Free T4 levels were at each of those tests?  Regulating thyroid med based just on TSH is not a good idea.  TSH is a pituitary hormone, not a thyroid hormone, so is not really indicative of what your thyroid is really doing.  

If you can post your Free T4 and Free T3 results, along with their ranges, members can give a much better idea of what is going on.  Have you had any other tests done?  Such as testing for antibodies, ultrasound, etc?