I'll try another.

[laladrew]

My recent blood were TSH 1.75 (range 0.35- 4.50)
FT4 16.4 (range 11.0 - 26.0)
FT3 3.6 (range 3.8 - 6.0)

My endo advised to reduce from 100mcg Levothyroxine to 75mcg daily to see if palpitations/tachy reduced. He said he saw no problem with trying this as my FT4 was in the upper half of the range.

Now, am I being thick here to think that my FT4 of 16.4 is actually NOT in the upper half of the range but in the bottom half?

[talkhealth]

Please see our response here - viewtopic.php?f=185&t=2276

[laladrew]

That was not a response to my question about T4 levels. I have replied to your response already on the other question.

[ipman]

My recent blood were TSH 1.75 (range 0.35- 4.50)
FT4 16.4 (range 11.0 - 26.0)
FT3 3.6 (range 3.8 - 6.0)
My endo advised to reduce from 100mcg Levothyroxine to 75mcg daily to see if palpitations/tachy reduced. He said he saw no problem with trying this as my FT4 was in the upper half of the range.
Now, am I being thick here to think that my FT4 of 16.4 is actually NOT in the upper half of the range but in the bottom half?

You are right of course, your T4 IS in the lower part of the range. However, you might want to put a bit more info into your question - for instance at what level of T4 did your palpitations kick in? Do you take any other medication that might be causing it? In this context, my wife takes blood pressure tablets (Amlodipine). She started on amlodipine besylate but was switched to maleate (the generic version) when the NHS required all GPs to do so. Not long after she started getting severe palpitations and underwent various tests including 24 hour monitoring. Eventually, her GP asked she could think of anything that had changed in her life that might be a factor; fortunately she recalled the switch to maleate and so mentioned it. The GP didn't think that could be anything to do with it but nevertheless thought it would be a good idea to switch back to the besylate to see what happened (how's that for keeping an open mind - not all GPs are the same). Guess what. The palpitations cleared up within a couple of days!

The point I'm making is: have a think about any other medications you're taking and make sure they're not the problem. You can do that by reading the leaflets that accompany the medication.

In any event, if you don't get a (satisfactory) expert reply on this forum, I recommend you visit one of the online sites and raise the question there. Google thyroid and advocacy and you'll find the site we hold in high regard.

ipman

[laladrew]

Thanks ipman. My question was not intended to be about why I have the palpitations though, that is in another, as yet unanswered question. I was simply concerned that my endo had made a mistake in saying I was in the top half of T4 acceptable range. It seems he has.

I was on a host of other meds, amatriptyline, tramadol, bisoprolol, alfacalcidol. Amatrityline and Tramadol were prescribed by a rheamatologist two years after thyroidectomy, for fibromyalgia. I don't believe i have it though, the symptoms are of underactive thryoid, which I DO have. Palpitations began about six months after op and on 100mcg thyroxine. I was concerned it was this giving me them. I saw cardiologist who ran lots of tests and said I was tachycaria but didn't know why. He didn't seem to think thyroxine could cause this.

So, I have experineced tachy/palpitations for almost five years, way before other meds were prescribed. All I was taking was thyroxine and calcium/alfacalcidol for broken parathyroid glands, damaged by emergency surgery. I have had the 24 hour monitor and numerous ECGs. They show no arrhythmia, thankfully, but tachy with ectopic beats.

I stopped taking the amatriptyline/tramadol over a year ago as I really did feel like I was dying. The GP then prescribed Zopiclone to help me sleep, the tachycardia seemed to keep me in a state of constant allertness. These stopped working and made me feel worse the next day. I can barely look after my child/husband/home as it is.

So, all I take is the levo/calcium/alfacalcidol and the beta-blocker (bisoprolol 5mcg) for the tachycardia. The endo last month suggested I could double the dose of Beta Blocker but I was unhappy with that. I want to get to the root of what is causing it. Fair enough if taking it gave me relief but I still feel like a dead man walking and my quality of life is almost zero.

[auto_immune]

Hi laladrew,
Have you tried magnesium for the palpitation? 400 - 600 mg per day of chelated Magnesium Citrate might help.
I am not a friend of betablockers, but without knowing your history it's difficult to comment. Read up about Magnesium ...
http://www.henryspink.org/magnesium.htm
http://blog.imva.info/medicine/stress-magnesium-disease
Best wishes

[ipman]

<SNIPPED> Thanks ipman. My question was not intended to be about why I have the palpitations though, that is in another, as yet unanswered question. I was simply concerned that my endo had made a mistake in saying I was in the top half of T4 acceptable range. It seems he has.

Hi laladrew

My wife had a hemithyroidectomy. Eventually she was prescribed thyroxine once it became apparent that the surgeon's idea was not working, namely that the remaining thyroid would generate enough thyroxine to compensate for the missing thyroid tissue. She reached a dose of 100 T4 which still hadn't got her back to anything like normal but her GP was reluctant for her to go further with T4 because her TSH had become suppressed. GPs quite rightly get twitchy about this because they have to have regard to the edicts laid down by the British Thyroid Association and the Royal College of Physicians (over which there is some controversy for various reasons I won't go into but which the experts should be well aware of even if not prepared to admit it). At that stage, apart from all of the usual symptoms associated with hypothyroidism, she started getting palpitations. To cut a long story short, by the time her medication had been progressively switched from 100 T4 to 50T4/30T3, the palpitations had gone. Of course, none of this may be applicable for your case - but you do have to wonder whether some people (you for example) are unable to tolerate higher doses of T4, not because of fillers etc but because their body cannot convert T4 efficiently with the consequence that the T4 builds up to a level that is toxic for them.

I do know that one of the private doctors (the one recently exonerated by the GMC) finds that patients who have had a partial thyroidectomy tend to fare better on natural desiccated thyroid medication (Armour or Erfa) than on synthetic T4. The natural product does contain some T3 as well as T4 and other components (T1, T2 and calcitonin) that are present in human thyroid secretions. Interestingly, no-one seems to know why the thyroid produces T1 and T2. They may just be by-products of T4 and T3 synthesis which are simply excreted without doing anything or, as some people speculate, they may have a role that has not yet been identified but which might be a reason why some people do better on the natural products than on the synthetic ones.

In summary, my wife's experience is that T4 was the likely culprit for her palpitations and reducing T4 while introducing T3 eliminated the palpitations. You may want to explore that with your GP although your GP will probably want you to see an endo about introducing T3. Many endos will not want to get involved with natural desiccated thryoid but some are prepared to recognise its benefits - see
http://www.endocrine-abstracts.org/ea/0 ... 13p316.htm

Like many others, you are obviously in an awful state and need effective advice and guidance. Let's hope that coming to this online clinic will see things improving from this point on.

ipman

[laladrew]

Thanks auto_immune. What a fascinating link. I have all the signs of magnesium defficiency, including fast trigger point, twitching and insomnia!

I did read on another forum something about iron, B12 and magnesium a few weeks ago and so incorporated some into my diet and took a good multi with these in. I know it's early days and I'm very cautious of being optimistic but have slept a lot better and do indeed have a somewhat slower resting heart rate. Definately going to keep this up. Thanks again.

[laladrew]

Thankyou so much ipman for going the extra mile for me, I really do appreciate it.

I agree, it's just plain to me I am not tolerating thyroxine at this dose and there is a build up, plus my below range T3. I fear my diagnosis of Fibromyalgia muddied the waters further and somewhat absolved the endo/gp of further treating my symptoms, they were outwith their remit if I was Fibro.

I too had a partial thyroidectomy with the hope the remainder would function, to no avail. I feel toxic. I felt worse on all the other gubbins like amatriptyline and Tramadol though. I have indeed taken advice from the doc you may be referring to and am awaiting my GP's response. I have a little hope left but really wanted to disregard that for the purposes of this clinic, still aiming to do this things 'by the book' even after five years of declining health doing it their way.

Last night my son was at a sleepover and my husband and I should have gone out to dinner and a movie, made the most of the child free time. Instead I took a bath and lay on the bed with an open window, a cold compress on my head for nausea, trying to calm my heartrate down. At 44 I live the life of a geriatric. That's how I roll...


We can't all be screaming harpies obsessed with T3, ERFA, Armour, for no good reason. Prior to my surgery, I never dreamed I would post on forums asking, nay, pleading, for advice and help. Why are we all in this state, if not for the simple reason we are being left to rot in poor health? And it does seem to be worse for Hypo patients rather than Hyper. Do the endos really believe hypo patients are just born belligerent and bothersome? That we are just that type? Or can it be that they are treating us less than optimally? Hmm.

Many thanks again ipman, it really is appreciated.