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increased heart rate

I had my thyroid removed a year ago.  After being hypo and hyper, we finally have the meds stabilized.  My TSH is 2.38.  At night, I experience a pounding and increased heart beat intermittently.  It comes and goes.  I will be fine for a few weeks, and then it starts again. Occasionally I notice it during the day, too. Is this related to my thyroid medication or something else perhaps?  I am also being treated for sleep apnea now with a CPAP machine.  I am 60 and did have my heart checked out, and after wearing a monitor for 3 weeks, the MD said I was fine.  
6 Responses
Avatar universal
It could be related to your thyroid meds.  Palps and tachycardia can be caused by both under- and over-medication.  Do you have recent free T3 and free T4 results?  If so please post those with their reference ranges...ranges are lab specific and have to come from your own lab report.  FT3 and FT4 are the actual thyroid hormones and much more important than TSH in diagnosis and treatment fo thyroid disorders.  

Do you have any other symptoms, either hypo or hyper?
Avatar universal
Thank you, Goolarra.  I do not have recent T3 and T4 results. When I was hypo for several months, heart was racing and pounding frantically away.  Once I appeared to get balanced on 88 mcg of levothyroxine sodium (Tirosint), my heart seemed to settle down and energy was better.  Now, it's going back to square 1.  I have an app't with my PCP tomorrow, so I will request lab tests for T3, T4 and TSH. Do you think I should request parathyroid level and any other tests?  This is so frustrating.  I am feeling like a slug too, so maybe I am getting hypo again. No other hypo symptoms, tho.  How long does it take to get a normal level?  It's been close to a year.  Is this what I can expect for the rest of my life now?
Avatar universal
Totally agree with goolarra.  Just wanted to be sure you got some additional info before your appointment tomorrow.  

A good thyroid doctor will not have the "Immaculate TSH Belief", by which only TSH seems to be all important.  Neither will a good thyroid doctor only use "Reference Range Endocrinology", by which they think that any test result that falls within the so-called "normal" ranges is adequate, even if you are still having hypo symptoms.  

My definition of a good thyroid doctor is one that will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 levels as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.     Test results are valuable mainly as indicators during diagnosis and then afterward to monitor FT3 and FT4 levels as meds are revised to relieve symptoms.

You can get some good insight into clinical treatment by reading this link.  It is a letter written by a good thyroid doctor for patients that he consults with from a distance.  The letter is went to the PCP of the patient to help guide treatment.

Avatar universal
It sounds like you might need a slight tweak in your dose.  I think parathyroid testing would be worthwhile...they often get damaged during surgery, so checking their function would offer some valuable information.

It can be frustrating finding an "ideal" dose.  It took me over a year to increase to a therapeutic level (which I've now been at for well over two years).  Also, we often require different amounts of thyroid hormones at different times of our lives.  Many factors, from other meds to life events to stress, can make you require more or less hormone.  It takes a while, but many of us have managed to reach a stable point.  Of course, you (and I) are going to have to monitor levels regularly for the rest of our lives.

Hang in there...due to the intermittent nature of your symptoms and the lack of others (except maybe a little fatigue), I'm guessing your meds are not too far off, and a little "fine tuning" might do the trick.  However, if you post your FT3, FT4 and TSH results (be sure to get reference range as well since ranges vary lab to lab), we'll be able to comment more.  Be sure to ask for FREE T3 and FREE T4.  If you're not specific, you're apt to get total T3 and total T4, which don't give nearly as much useful information.
Avatar universal
Thank you for your comment and the link.  It is very helpful.  Both my Endo and my PCP seem to think the TSH is the one to look at.  I'll get the Free T3 and T4 done and will focus on urging them to use all 3 in evaluating my thyroid status.
Avatar universal
Thank you for reminding me that it is a long process to find the "ideal dose." The surgeon who removed my thyroid told me afterwards that he accidentally removed one of my parathyroids, so maybe the other ones got some "rough treatment."  After my surgery, I ended up in the ER a few days later due to low calcium level problems.  I have scheduled an Endo app't in July, so I'll get the lab work and the reference ranges for the tests you have identified.  I'll get back to you when I have the results.  And I will be careful to request the Free T3 an T4.
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