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Thyroid and heart rate
I'm 28f (5f7, 141lb). I'm seeing a gynecologist to treat my irregular periods and he gave me some blood work to do and these are some of the results:
- TSH: 3.601 ulU/mL (range: 0.27 to 4.20)
- FT3: 5.21 pmol/L (range: 3.10 to 6.80)
- FT4: 16.30 pmol/L (range: 12.00 to 22.00)
My doctor said that my levels are normal and we should look for other causes. The problem is that I did other hormonal tests and everything's in order. The only ones reaching the max levels are my thyroid hormones. also I have a mix of hyper and hypothyroidism symptoms:
Hyper:
- Appetite change (only eat twice)
- Difficulty sleeping (insomnia)
- Heart palpitations
- Heat intolerance
- Shortness of breath
- Tremor/shakiness
- Fatigue
Hypo:
- Dry hands
- Icy cold feet
- Constipation
- Memory loss
- Decreased libido
How can this be possible? to have both conditions? Can anyone see my results and tell me if I do have Thyroid disorder or I'm just imagining things.
- TSH: 3.601 ulU/mL (range: 0.27 to 4.20)
- FT3: 5.21 pmol/L (range: 3.10 to 6.80)
- FT4: 16.30 pmol/L (range: 12.00 to 22.00)
My doctor said that my levels are normal and we should look for other causes. The problem is that I did other hormonal tests and everything's in order. The only ones reaching the max levels are my thyroid hormones. also I have a mix of hyper and hypothyroidism symptoms:
Hyper:
- Appetite change (only eat twice)
- Difficulty sleeping (insomnia)
- Heart palpitations
- Heat intolerance
- Shortness of breath
- Tremor/shakiness
- Fatigue
Hypo:
- Dry hands
- Icy cold feet
- Constipation
- Memory loss
- Decreased libido
How can this be possible? to have both conditions? Can anyone see my results and tell me if I do have Thyroid disorder or I'm just imagining things.
Have you also had Cortisol and sex hormones (Testosterone!, Estradiol & Progesterone)?
It is possible that you may be low on Progesterone and possibly tesosterone. Yes testosterone is extremely important to be present in the PROPER amount.
Low testosterone is commone symptoms is sleep disruptions as well as decreased libido. It is also extremely underdiagonsed in women because they do not even test for it often times.
My wife is low Testosterone. It took almost 4 full YEARS to convince my wife and our doctor that this was a major contributor to her symptoms.
My wife also has high heart rate. That cannot be explained by anything else. Other people report heart rate and breathing difficulties and abnormalities with low Testosterone.
Low T would not really explain too much the whole temperature intolerance. But as Barb135 stated above, hashi's (testing for antibodies) might. As swinging between Hyper to Hypo is not unheard of with the initial phases of Hashimoto's. As your slightly low Thyroid levels would also sort of lean towards only the potential of the early stages of Hashi.
Also check out your iron and Ferritin levels. Ferritin is needed for the proper metabolism of Thyroid hormone.
You may also wish to consider taking Selenium. It helps with the conversion from T4 to T3. However it is your FT4 that may be limiting your FT3. and since your FT3 is higher in the range than your FT4 level, it also suggests that you're converting pretty well. There may simply not be enough FT4 avaialable to convert fast enough for its use.
It is possible that you may be low on Progesterone and possibly tesosterone. Yes testosterone is extremely important to be present in the PROPER amount.
Low testosterone is commone symptoms is sleep disruptions as well as decreased libido. It is also extremely underdiagonsed in women because they do not even test for it often times.
My wife is low Testosterone. It took almost 4 full YEARS to convince my wife and our doctor that this was a major contributor to her symptoms.
My wife also has high heart rate. That cannot be explained by anything else. Other people report heart rate and breathing difficulties and abnormalities with low Testosterone.
Low T would not really explain too much the whole temperature intolerance. But as Barb135 stated above, hashi's (testing for antibodies) might. As swinging between Hyper to Hypo is not unheard of with the initial phases of Hashimoto's. As your slightly low Thyroid levels would also sort of lean towards only the potential of the early stages of Hashi.
Also check out your iron and Ferritin levels. Ferritin is needed for the proper metabolism of Thyroid hormone.
You may also wish to consider taking Selenium. It helps with the conversion from T4 to T3. However it is your FT4 that may be limiting your FT3. and since your FT3 is higher in the range than your FT4 level, it also suggests that you're converting pretty well. There may simply not be enough FT4 avaialable to convert fast enough for its use.
2 Comments
Here's the other results:
FSH: 6.95 ul/l (range: 3.5 to 12.5)
Testosterone: 1.32 nmol/l (range: 0.22 to 2.90)
Progesterone: 4.70 nmol/l (range: 3.81 to 50.5)
Prolactin: 9.61 ng/ml (range: 3.34 to 26.72)
FSH: 6.95 ul/l (range: 3.5 to 12.5)
Testosterone: 1.32 nmol/l (range: 0.22 to 2.90)
Progesterone: 4.70 nmol/l (range: 3.81 to 50.5)
Prolactin: 9.61 ng/ml (range: 3.34 to 26.72)
I also forgot to mention that my resting heart rate is 90 bpm and my blood pressure is 110/70
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Ask your doctor to order the thyroid antibodies, Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb). These are the antibodies that are needed to diagnose Hashimoto's Thyroiditis. Hashimoto's is an autoimmune condition in which the body sees the thyroid as foreign and produces antibodies to destroy it. If one has Hashimoto's, it's possible for symptoms to appear long before the thyroid hormone levels actually go out of range.
In addition, with Hashimoto's, it's possible to swing between hyper and hypo for long periods of time before finally settling into a permanent hypo state.
Along with all that, some symptoms can "cross over" or apply to either/both hyper or hypo, though many people don't realize that. For instance, I had difficulty sleeping and shortness of breath when I was very hypo, so those aren't just hyper symptoms. Fatigue is another one that applies to both hyper and hypo... almost anyone that has a thyroid condition will list fatigue as a symptom.
On the flip side, decreased libido and memory loss can also apply to either hyper or hypo...
All of that said, your Free T4 is less than 50% of range and your Free T3 is at 57% of range, so neither of them are at max level. Most of us feel best when Free T4 is maintained at midrange and yours is at 43%, which indicates that your thyroid output may be less than optimal. We also tend to feel best when Free T3 is maintained in the upper half to upper third of range; yours is at 57% of range, which is okay, but with Free T4 less than optimal, it may be a matter of time before your Free T3 will no longer be adequate either.
You might also ask to get tested for Vitamins B-12 and D, along with Ferritin, which is the iron storage hormone. Many of us with thyroid conditions are deficient in the nutrients which are necessary for proper metabolism/conversion of thyroid hormones.
In addition, with Hashimoto's, it's possible to swing between hyper and hypo for long periods of time before finally settling into a permanent hypo state.
Along with all that, some symptoms can "cross over" or apply to either/both hyper or hypo, though many people don't realize that. For instance, I had difficulty sleeping and shortness of breath when I was very hypo, so those aren't just hyper symptoms. Fatigue is another one that applies to both hyper and hypo... almost anyone that has a thyroid condition will list fatigue as a symptom.
On the flip side, decreased libido and memory loss can also apply to either hyper or hypo...
All of that said, your Free T4 is less than 50% of range and your Free T3 is at 57% of range, so neither of them are at max level. Most of us feel best when Free T4 is maintained at midrange and yours is at 43%, which indicates that your thyroid output may be less than optimal. We also tend to feel best when Free T3 is maintained in the upper half to upper third of range; yours is at 57% of range, which is okay, but with Free T4 less than optimal, it may be a matter of time before your Free T3 will no longer be adequate either.
You might also ask to get tested for Vitamins B-12 and D, along with Ferritin, which is the iron storage hormone. Many of us with thyroid conditions are deficient in the nutrients which are necessary for proper metabolism/conversion of thyroid hormones.
8 Comments
I forgot to mention that irregular menstrual cycles are also a very common symptom of hypothyroidism/thyroid malfunction.
It's very hard to get doctors to admit that thyroid malfunction is possible when levels are seemingly "good"...
It's very hard to get doctors to admit that thyroid malfunction is possible when levels are seemingly "good"...
Thank you so much for the detailed explanation. Yes, my doctor is telling me that everything is in order and we should look for something else, even though my other results are all in order.
I won't wait for my doctor to get a diagnosis and I'll go see an endocrinologist as soon as possible.
Again, thank you for confirming my doubts
I won't wait for my doctor to get a diagnosis and I'll go see an endocrinologist as soon as possible.
Again, thank you for confirming my doubts
Hi sam2889,
I'm sorry that you are going through this - it can be difficult to diagnose a thyroid problem, especially when you have symptoms but hormone levels in the normal range. I was recently diagnosed with Hashimoto's (last week!). My thyroid hormone numbers are within the normal range:
TSH 3.44 (0.450-4.500)
FT4 1.44 (0.82-1.77)
FT3 3.2 (2.0-4.4)
but I have had mild hypo symptoms for years including irregular periods. The only reason why I caught it now and am seeking treatment is I have an enlarged thyroid with lots of nodules and knew something was very wrong with my thyroid. It is a good idea to follow up and get the thyroid antibody test, especially if you are having symptoms.
Is your resting heart rate 90 when measured in a doctor's office or at home? Both my blood pressure and heart rate spike at the doctor's (heart rate usually in a 100-110 bpm range and they tell me that is bad). I wear a fitness watch that has a heart rate monitor (because I go on runs and it helps me monitor how much I'm exerting myself while running), but it also monitors my heart rate throughout the day without my knowledge and gives me a "average resting rate" each day. I have never seen my heart rate below 90 bpm at a doctor's office, but my watch claims my average resting for the day is between 55 and 65 bpm each day. Yesterday it said 53 bpm, which is on the low side for me (low heart rate is a hypo sign, but I also do endurance running so not sure which one is causing it to be so low - probably both factor in). Anytime I know the measurement is being recorded on my watch, it will go up to the 70-80s range. I've also seen it as low as 57 on an at home blood pressure monitor, so I'm thinking those average resting rates are pretty accurate. I've started monitoring my blood pressure at home too and it's around 105/65 most days. I would not panic if they say you have a high resting heart rate, this could be part of "white coat syndrome", or at least it is for me. Icy cold feet suggest blood is not circulating well to your extremities which is a hypo symptom - I get freezing cold hands within minutes every time I sit down to relax on the couch - probably because my heart rate is slowing way down compared to standing/walking around.
Good luck and I hope you figure out what is wrong - your TSH is so close to mine and your symptoms do suggest a thyroid issue! Irregular periods could be an estrogen/progesterone imbalance, but hypothyroidism frequently causes menstrual irregularities and it's impossible to rule out a thyroid problem at this point, even with your thyroid hormone test results.
I'm sorry that you are going through this - it can be difficult to diagnose a thyroid problem, especially when you have symptoms but hormone levels in the normal range. I was recently diagnosed with Hashimoto's (last week!). My thyroid hormone numbers are within the normal range:
TSH 3.44 (0.450-4.500)
FT4 1.44 (0.82-1.77)
FT3 3.2 (2.0-4.4)
but I have had mild hypo symptoms for years including irregular periods. The only reason why I caught it now and am seeking treatment is I have an enlarged thyroid with lots of nodules and knew something was very wrong with my thyroid. It is a good idea to follow up and get the thyroid antibody test, especially if you are having symptoms.
Is your resting heart rate 90 when measured in a doctor's office or at home? Both my blood pressure and heart rate spike at the doctor's (heart rate usually in a 100-110 bpm range and they tell me that is bad). I wear a fitness watch that has a heart rate monitor (because I go on runs and it helps me monitor how much I'm exerting myself while running), but it also monitors my heart rate throughout the day without my knowledge and gives me a "average resting rate" each day. I have never seen my heart rate below 90 bpm at a doctor's office, but my watch claims my average resting for the day is between 55 and 65 bpm each day. Yesterday it said 53 bpm, which is on the low side for me (low heart rate is a hypo sign, but I also do endurance running so not sure which one is causing it to be so low - probably both factor in). Anytime I know the measurement is being recorded on my watch, it will go up to the 70-80s range. I've also seen it as low as 57 on an at home blood pressure monitor, so I'm thinking those average resting rates are pretty accurate. I've started monitoring my blood pressure at home too and it's around 105/65 most days. I would not panic if they say you have a high resting heart rate, this could be part of "white coat syndrome", or at least it is for me. Icy cold feet suggest blood is not circulating well to your extremities which is a hypo symptom - I get freezing cold hands within minutes every time I sit down to relax on the couch - probably because my heart rate is slowing way down compared to standing/walking around.
Good luck and I hope you figure out what is wrong - your TSH is so close to mine and your symptoms do suggest a thyroid issue! Irregular periods could be an estrogen/progesterone imbalance, but hypothyroidism frequently causes menstrual irregularities and it's impossible to rule out a thyroid problem at this point, even with your thyroid hormone test results.
Thank you for your kind words. I will ask my doctor for more blood tests (my appointment is next week) and if he refuses to acknowledge the issue I'll go to an endocrinologist.
I measured my blood pressure and resting heart rate at home with an automatic bp & hr monitor. I wasn't stressed or anything but I got 106/62 (now I get ~110/70) with a rhr of 90. Now every time I try to remeasure it I panic and get 110 to 130! I don't have a smart watch or a fitbit so I can't check if it's my actual resting heart rate.
The reason why I posted here is to check if I should go to an endocrinologist or a cardiologist. If my elevated heart rate, shortness of breath and fatigue is due to a heart condition, then it's an urgent matter that I need to check instead of wasting time with my gynecologist doing more blood tests.
I wish you luck too and I hope things go well for you!
I measured my blood pressure and resting heart rate at home with an automatic bp & hr monitor. I wasn't stressed or anything but I got 106/62 (now I get ~110/70) with a rhr of 90. Now every time I try to remeasure it I panic and get 110 to 130! I don't have a smart watch or a fitbit so I can't check if it's my actual resting heart rate.
The reason why I posted here is to check if I should go to an endocrinologist or a cardiologist. If my elevated heart rate, shortness of breath and fatigue is due to a heart condition, then it's an urgent matter that I need to check instead of wasting time with my gynecologist doing more blood tests.
I wish you luck too and I hope things go well for you!
Having a panic attack when you go to check your blood pressure and/or heart rate, will definitely drive up the readings, but even a blood pressure of 110/70 is not overly high and normal heart rate is 60-100, though 90 is on the high side, but if you're having panic attacks, it's not a surprise that your heart is higher. Shortness of breath, along with fatigue are common symptoms of a thyroid condition.
While you may not need a cardiologist or endocrinologist, your gynecologist is not qualified to deal with the situation, either. If you have a primary care doctor, I'd suggest you make an appointment to see her/him as soon as possible to get a thorough check-up.
All of that said - you are the only that knows how you feel, so if, at any time, you feel you're in medical distress... don't hesitate to call 911 or go to the nearest ER.
While you may not need a cardiologist or endocrinologist, your gynecologist is not qualified to deal with the situation, either. If you have a primary care doctor, I'd suggest you make an appointment to see her/him as soon as possible to get a thorough check-up.
All of that said - you are the only that knows how you feel, so if, at any time, you feel you're in medical distress... don't hesitate to call 911 or go to the nearest ER.
sam2889,
I've always triggered my own pulse to go sky high whenever I get it tested, this started when I learned how to take pulse in 9th grade! I've given blood exactly twice, and that is because they will not take your blood donation if your pulse is over 100 - I always worry about failing the heart rate test and then I do.
Do not hesitate to go to the ER if you think you are really having a heart problem.
Heart attack symptoms and anxiety symptoms can sometimes be hard to tell apart. I ended up in the ER the first time I had a panic attack - not because I thought I was having a heart attack but I just wanted to rule out that something was wrong with my heart - EKG was perfectly fine in my case, but it is good to get it checked out. Anxiety can even cause chest pain that can be confused for a heart attack, but if you are not sure it is from anxiety, get it checked out!
As for a high pulse - as I said I've always had a rapid heartbeat when it is measured at the doctor's office, and only when I have no idea it's being taken can I get it lower. If I am dealing with a lot of anxiety at the time it skyrockets, so 110-130 could definitely be a sign of anxiety (sometimes my blood pressure is normal at the doctor's office, last time it was something like 153/103 which is very high for me).
Do you feel like you have a rapid heartbeat all the time, or only when you are trying to measure your pulse? This may be hard to tell because in general I do not notice my heart rate when it is between 55 and 90, but when I am at the doctor's office and it is up to 100-115, I can tell that something is wrong and I feel anxious because it feels like adrenaline has just flowed through my body in a wave, and I can feel my heart thudding in my chest. Basically it feels the same as what I feel when I've had a panic attack, but now that I know what it is, I just tell the doctors that my heartrate is going to be high and I don't panic about it anymore (well at least not mentally/outwardly).
I just now took my pulse from my carotid by hand. It started out nice and slow, and then suddenly I can feel it speeding up like usual (ended up with 80 bpm). I then checked it with my watch, and watched it come down on my watch from 72... 68... 65... 60... 57. Checked again with carotid by hand and it was 60, but this time stayed nice and slow and steady (I'm not feeling anxious at the moment, and my watch already told me it was low so maybe I tricked it into not increasing this time :-) ).
When I am running, my heartrate is way higher but doesn't feel like an adrenaline rush. I can tell when my heartrate is in the 140-165 range - I can comfortably maintain about 155bpm for 2+ hours, if it ticks up to 170-180 I can usually tell because it's harder to breathe, I start to feel a little light headed, and I will slow down because I don't want to keep it so high. My heartrate at 165-170 while exercising still feels perfectly normal to me, while 110 in the doctor's office sitting down feels like I'm having an adrenaline rush that I can't control. If you think it is only high when you are taking it, it might just be a sign of anxiety (or pulse taking anxiety). If you are worried that anxiety is putting stress on your heart, get it checked out to make sure your blood pressure and heart are functioning ok, this may help calm your anxiety to know that you are not having a heart problem.
If you are feeling dizzy, light-headed, chest pain, rapid heartbeat, hard to breathe and are then able to calm yourself down, these symptoms should go away in minutes if it is anxiety. If they are heart symptoms, they may be reduced but still occurring even when you are calm. (That being said, I've been in positions where I can't easily calm myself down).
Nothing you have mentioned makes me think that you do have a heart problem since I have similar symptoms when I am feeling anxious, but as Barb135 said, you know your body better than anyone else and if this is a concern get it checked out ASAP, especially if you have heart attack symptoms that persist even when you are calm. Do symptoms get worse or better when you exercise/go up stairs etc.? My anxiety symptoms (especially mild chest pain) actually decrease when I start to exercise, which is the main indicator that mine is caused by anxiety and I don't worry about my heart now.
I hope you are feeling better - if what is triggering your panic is the high heartrate, it can be a vicious cycle and hard to get calmed down. My PCP would probably tell you to "meditate" and see if that helps, but for me just time and knowing that eventually my anxiety will calm down helps.
I've always triggered my own pulse to go sky high whenever I get it tested, this started when I learned how to take pulse in 9th grade! I've given blood exactly twice, and that is because they will not take your blood donation if your pulse is over 100 - I always worry about failing the heart rate test and then I do.
Do not hesitate to go to the ER if you think you are really having a heart problem.
Heart attack symptoms and anxiety symptoms can sometimes be hard to tell apart. I ended up in the ER the first time I had a panic attack - not because I thought I was having a heart attack but I just wanted to rule out that something was wrong with my heart - EKG was perfectly fine in my case, but it is good to get it checked out. Anxiety can even cause chest pain that can be confused for a heart attack, but if you are not sure it is from anxiety, get it checked out!
As for a high pulse - as I said I've always had a rapid heartbeat when it is measured at the doctor's office, and only when I have no idea it's being taken can I get it lower. If I am dealing with a lot of anxiety at the time it skyrockets, so 110-130 could definitely be a sign of anxiety (sometimes my blood pressure is normal at the doctor's office, last time it was something like 153/103 which is very high for me).
Do you feel like you have a rapid heartbeat all the time, or only when you are trying to measure your pulse? This may be hard to tell because in general I do not notice my heart rate when it is between 55 and 90, but when I am at the doctor's office and it is up to 100-115, I can tell that something is wrong and I feel anxious because it feels like adrenaline has just flowed through my body in a wave, and I can feel my heart thudding in my chest. Basically it feels the same as what I feel when I've had a panic attack, but now that I know what it is, I just tell the doctors that my heartrate is going to be high and I don't panic about it anymore (well at least not mentally/outwardly).
I just now took my pulse from my carotid by hand. It started out nice and slow, and then suddenly I can feel it speeding up like usual (ended up with 80 bpm). I then checked it with my watch, and watched it come down on my watch from 72... 68... 65... 60... 57. Checked again with carotid by hand and it was 60, but this time stayed nice and slow and steady (I'm not feeling anxious at the moment, and my watch already told me it was low so maybe I tricked it into not increasing this time :-) ).
When I am running, my heartrate is way higher but doesn't feel like an adrenaline rush. I can tell when my heartrate is in the 140-165 range - I can comfortably maintain about 155bpm for 2+ hours, if it ticks up to 170-180 I can usually tell because it's harder to breathe, I start to feel a little light headed, and I will slow down because I don't want to keep it so high. My heartrate at 165-170 while exercising still feels perfectly normal to me, while 110 in the doctor's office sitting down feels like I'm having an adrenaline rush that I can't control. If you think it is only high when you are taking it, it might just be a sign of anxiety (or pulse taking anxiety). If you are worried that anxiety is putting stress on your heart, get it checked out to make sure your blood pressure and heart are functioning ok, this may help calm your anxiety to know that you are not having a heart problem.
If you are feeling dizzy, light-headed, chest pain, rapid heartbeat, hard to breathe and are then able to calm yourself down, these symptoms should go away in minutes if it is anxiety. If they are heart symptoms, they may be reduced but still occurring even when you are calm. (That being said, I've been in positions where I can't easily calm myself down).
Nothing you have mentioned makes me think that you do have a heart problem since I have similar symptoms when I am feeling anxious, but as Barb135 said, you know your body better than anyone else and if this is a concern get it checked out ASAP, especially if you have heart attack symptoms that persist even when you are calm. Do symptoms get worse or better when you exercise/go up stairs etc.? My anxiety symptoms (especially mild chest pain) actually decrease when I start to exercise, which is the main indicator that mine is caused by anxiety and I don't worry about my heart now.
I hope you are feeling better - if what is triggering your panic is the high heartrate, it can be a vicious cycle and hard to get calmed down. My PCP would probably tell you to "meditate" and see if that helps, but for me just time and knowing that eventually my anxiety will calm down helps.
@Sarahjogs
I think my heart beats faster than normal all the time. I thought it was ok at first, I mean a young person should have an active heart which leads to a higher rate (stupid analogy I know). Little did I know it was actually the opposite! An efficient heart beats slower and make less effort to pump blood everywhere.
I tried to measure my heart when I woke up and it's 68_72, but it always goes up to 88~90 as the day progresses. I measured it with an app called "Instant heart rate+" , I know it's not accurate but it gives me and idea about my range.
Sure I know my body best, but I have multiple symptoms that overlap with multiple causes and it's confusing. I think I'd go to a cardiologist to rule out any heart problems first, then tackle my thyroid and hope for the best.
I think my heart beats faster than normal all the time. I thought it was ok at first, I mean a young person should have an active heart which leads to a higher rate (stupid analogy I know). Little did I know it was actually the opposite! An efficient heart beats slower and make less effort to pump blood everywhere.
I tried to measure my heart when I woke up and it's 68_72, but it always goes up to 88~90 as the day progresses. I measured it with an app called "Instant heart rate+" , I know it's not accurate but it gives me and idea about my range.
Sure I know my body best, but I have multiple symptoms that overlap with multiple causes and it's confusing. I think I'd go to a cardiologist to rule out any heart problems first, then tackle my thyroid and hope for the best.
Sounds like a good plan! 90 is not too high (anywhere 60-100 is considered normal), but it is good to get it checked out, especially if you are having anxiety about your heart.
Best of luck!
Best of luck!
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