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What Causes Heart Palpitations While On Levothyroxine?
Question: Hi, I've just seen a cardiologist because of skipped heartbeats. He's mainly reassured that they're probably benign but has agreed for me to have an echocardiogram to be sure. However I'm wondering whether I am showing symptoms of peri menopause. The heart skips are usually before my period, but in the last two months my period was delayed. I get facial flushing. Not often, and again if it happens it's before my period. I'm not getting feelings of being hot yet, but when my face flushes, the skin is burning.
My main concern is the heart skips because I witnessed my father's death to a heart attack (myocardial infarction. logically that's different but emotionally it's all still 'the heart' to me). For information I do also have hypothyroidism which is treated with levothyroxine, my TSH was recently in the range of about 1....and I tend to feel better when it's around this figure and worse when it is at 2....Curious if you think this all could be peri menopause, which would be reassuring....I'm 46, my mum had symptoms at 37. thanks
My main concern is the heart skips because I witnessed my father's death to a heart attack (myocardial infarction. logically that's different but emotionally it's all still 'the heart' to me). For information I do also have hypothyroidism which is treated with levothyroxine, my TSH was recently in the range of about 1....and I tend to feel better when it's around this figure and worse when it is at 2....Curious if you think this all could be peri menopause, which would be reassuring....I'm 46, my mum had symptoms at 37. thanks
Brief Answer:
In echo cardiology look for MVP along with other routine parameters
Detailed Answer:
Hello ,
I am Dr Mody and I would be addressing your concern.
I went through the details of the problem you described .
My observations are .
1) A good probability is the hormonal changes causing the extra beats , if they are seldom and doesnt cause any problem and on ekg which was reviewed by your cardiologist they werent having any features of underlying heart problem. You can be reassured that they are never going to be a problem. Many a times just age related stiffening of the heart may give rise to extra beats .
2) Over treatment with thyroxine ,
Generally Tsh is maintained at range of 2 ( Nomral valve .5 to 5 - Maintain tsh at midrange , which suggests adequate thyroid hormone . extra circulating thyroxine may cause extra beats and tachycardia.
However the trade of here is your symptoms .
Ideally get Free t3 / Free T4 next time along with Tsh . if the prior is high , consider decreasing dose .
3) You said your mother too had such a problem . An Echocardiology particularlyto look for MVP ( Mitral valve prolapse) would help .
again this just helps us find the cause , because if till 46 you didn't have problem , MVP is not going to trouble you ever . It may sometimes just result in benign extra beats .
The above should cover all probable heart related causes.
It important to note that anxiety itslef may result in some extra beats due to increased adrenaline in circulation. So if your cardiologist is sure its benign , do not think about it as ots very Normal to have some extra beats after 45 years of age .
Regards Dr. Mody
In echo cardiology look for MVP along with other routine parameters
Detailed Answer:
Hello ,
I am Dr Mody and I would be addressing your concern.
I went through the details of the problem you described .
My observations are .
1) A good probability is the hormonal changes causing the extra beats , if they are seldom and doesnt cause any problem and on ekg which was reviewed by your cardiologist they werent having any features of underlying heart problem. You can be reassured that they are never going to be a problem. Many a times just age related stiffening of the heart may give rise to extra beats .
2) Over treatment with thyroxine ,
Generally Tsh is maintained at range of 2 ( Nomral valve .5 to 5 - Maintain tsh at midrange , which suggests adequate thyroid hormone . extra circulating thyroxine may cause extra beats and tachycardia.
However the trade of here is your symptoms .
Ideally get Free t3 / Free T4 next time along with Tsh . if the prior is high , consider decreasing dose .
3) You said your mother too had such a problem . An Echocardiology particularlyto look for MVP ( Mitral valve prolapse) would help .
again this just helps us find the cause , because if till 46 you didn't have problem , MVP is not going to trouble you ever . It may sometimes just result in benign extra beats .
The above should cover all probable heart related causes.
It important to note that anxiety itslef may result in some extra beats due to increased adrenaline in circulation. So if your cardiologist is sure its benign , do not think about it as ots very Normal to have some extra beats after 45 years of age .
Regards Dr. Mody
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Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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