# Can't take these palpitations anymore. Can anyone help?



## starfire (Jun 10, 2014)

My FT4 and FT3 are normal range, T3 is even low-normal. My TSH is very suppressed. I am on 88mcg Synthroid, 7.5mcg Cytomel.

I get palpitations no matter what I eat, whenever I eat. Drinks don't make it happen. I've cut back to one meal a day...and sure enough, after I eat anything for that meal, my palpitations start and last for several hours. Usually about 4 to 5 hours. It feels like my heart is POUNDING out of my chest. Heart rate is usually anywhere from 90-140 BPM. It leaves me feel exhausted and shaky and scared.

I'm so desperate for them to stop that I'm lowering my thyroid medication, as I cannot handle this anymore. I've tried the anti anxiety meds they put me on, I have tried the acid block medication. Nothing is helping.

Is it possible that the TSH needs to come up for these to stop? All that said, I'm flipping exhausted since lowering my meds and it's only been like 2 days.

Does anyone have any insight? I'm miserable.


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## Andros (Aug 26, 2009)

You should lower your Cytomel and make an appt. to see your doctor. Many things can cause this including low ferritin, adrenals, allergic reaction to foods, liquor and much more including another med.

Sending hugs,


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## starfire (Jun 10, 2014)

Andros said:


> You should lower your Cytomel and make an appt. to see your doctor. Many things can cause this including low ferritin, adrenals, allergic reaction to foods, liquor and much more including another med.
> 
> Sending hugs,


I feel like the Cytomel is the only thing that gets me through the day. Could I just not be tolerating the Cytomel well?

Should I instead be increasing Synthroid? I'm so lost.

I should edit to say that out of 3 docs&#8230; one says lower both Cytomel and Synthroid, one says stay put, and one say lower just Synthroid. My primary says come off Cytomel entirely.

I don't know what to do.


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## joplin1975 (Jul 21, 2011)

Remind me, have you had TSI tested?


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## webster2 (May 19, 2011)

Maybe lowering your cytomel will help. Do you take it in 2 doses? I had palpitations on 10mcg of cytomel. I cut the afternoon dose in half for awhile and the palpitations stopped. I haven't added it back. I, too, feel like the cytomel keeps me among the living.


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## starfire (Jun 10, 2014)

joplin1975 said:


> Remind me, have you had TSI tested?


Yes, I did! TSI was at 89.


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## starfire (Jun 10, 2014)

webster2 said:


> Maybe lowering your cytomel will help. Do you take it in 2 doses? I had palpitations on 10mcg of cytomel. I cut the afternoon dose in half for awhile and the palpitations stopped. I haven't added it back. I, too, feel like the cytomel keeps me among the living.


I try taking 5mcg in the AM and have no problems&#8230; then 2.5 in the afternoon (around 1PM), which just barely keeps me upright. My last FT3 lab showed I was almost off the charts low. I am feeling it, too. I'm a total wreck.

Anyhow, I was taking 15mcg Cytomel. I felt best on 25mcg, but they told me no because my TSH was nonexistent.


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## starfire (Jun 10, 2014)

Could the after eating palps be from too LOW cytomel? I know that sounds nuts.

Too low of T3 causing palps?

I don't know anymore 

I had palps after eating before I even started on medicine, but only rarely. Now it's every dang time.


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## joplin1975 (Jul 21, 2011)

I'd bet the TSI is your problem. I never had palps until I was on Levo...and that only was did a week before surgery. It can be very, very hard to be on any replacement meds, but especially t3 meds, with TSI.


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## starfire (Jun 10, 2014)

Should I try coming off the T3 then? Or is that just damaging?

Are the palps dangerous? If I knew I was okay, I wouldn't mind them. But they feel so freaking scary.


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## Lovlkn (Dec 20, 2009)

I had horrible palpitations when I started taking Cytomel - it forced me to stop for several years but I continued to struggle with fatigue.

Fast forward... I tried Cytomel again and now take 12.5mcg split over 3 doses approx 6 hours apart.

All I can say is - give it time - in the mean time stop and try to reintroduce with a very tiny dose several times a day until you do not have the palpitations. I was taking 1/4 of a 5mcg pill at times several times a day. I also find that eating food when taking the pill seems to help soften the impact of it as well


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## joplin1975 (Jul 21, 2011)

Yup, good advice. With TSI in the mix, you are in a very tough situation and it will be hard to stabilize. I hate to beat the surgery drum so often, but if anyone ever offers you surgery, take it.


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## starfire (Jun 10, 2014)

Lovlkn said:


> I had horrible palpitations when I started taking Cytomel - it forced me to stop for several years but I continued to struggle with fatigue.
> 
> Fast forward... I tried Cytomel again and now take 12.5mcg split over 3 doses approx 6 hours apart.
> 
> All I can say is - give it time - in the mean time stop and try to reintroduce with a very tiny dose several times a day until you do not have the palpitations. I was taking 1/4 of a 5mcg pill at times several times a day. I also find that eating food when taking the pill seems to help soften the impact of it as well


I am trying tiny doses throughout the day today&#8230; I've busted a 5mcg pill into 4 pieces, and I am going to try to make it up to 10mcg today. I am recognizing that palpitations are actually worse on less T3 (they've gotten most intense since coming off 15mcg of Cytomel to 7.5). So I've armed myself with atenolol from the doctor, and some magnesium supplements. Plus, I guess I just need to have the knowledge that the palpitations won't kill me. The panic makes them worse. I've already had an ECG and everything was okay.,


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## starfire (Jun 10, 2014)

joplin1975 said:


> Yup, good advice. With TSI in the mix, you are in a very tough situation and it will be hard to stabilize. I hate to beat the surgery drum so often, but if anyone ever offers you surgery, take it.


Thank you very much! This goes back to just needing to be "OK" with these new weird aspects of my body. I know I had some palps after eating before I even started medicine for thyroid, or before I even KNEW I had thyroid problems. So, I'm sure it will be okay in the long run&#8230; it's just so scary feeling.


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## webster2 (May 19, 2011)

I agree with Joplin, if surgery is an option, you might want to consider it. At my last endo appt., we discussed the cardiac implications of cytomel.


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## starfire (Jun 10, 2014)

webster2 said:


> I agree with Joplin, if surgery is an option, you might want to consider it. At my last endo appt., we discussed the cardiac implications of cytomel.


What were the implications? And, without surgery, wouldn't I need Cytomel more than ever? I don't seem to convert T4 to T3 easily.


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## webster2 (May 19, 2011)

I don't convert either. I have no thyroid. I take Levothyroxine and cytomel. He said cytomel increases the possibility of palpitations, high blood pressure, and a lot of symptoms associated with being hyper thyroid and that I would need to be aware of any changes. I've been on T4 only, desiccated thyroid medication and the current meds. I did not convert on the first 2 medications so cytomel was added.


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## starfire (Jun 10, 2014)

Not converting is a total pain.  I feel you on that one. I am keeping a close eye on BP and such... Though long term implications are obviously what I would need to watch out for, huh.

And even on natural thyroid with T3, you didn't convert?? That's good for me to know. I was gonna ask my doc about it, but if you need converting skills, I don't have them lol.


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## starfire (Jun 10, 2014)

Is anyone else here on a beta blocker? Any thoughts on them when one is hypothyroid (but suppressed TSH and positive TSI)?


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## Lovlkn (Dec 20, 2009)

> I've busted a 5mcg pill into 4 pieces, and I am going to try to make it up to 10mcg today.


I would not rush it until you can tolerate the entire 5mcg for a few days - then increase with 1/4 pill more etc until you are on your full dose without palp's

I also agree that if anyone ever offers surgery - take it. You may also be a candidate if you simply ask for a surgeon referral. History of inability to stabilize often helps the surgeon make their decision to remove. Don't forget - surgeon's only get paid when they operate.


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## webster2 (May 19, 2011)

I would not push it either. I started out taking 2.5 twice a day and then moved up to one 5 mcg in the am and a 2.5 in the afternoon. When that seemed to be okay, I added the whole pill in the afternoon and for awhile that was great but then I started to have palpitations. Even on the natural thyroid medication my FT3 was in the basement, even now it is barely at half of the range. I feel good, so I am happy. I have become less focused on being at a certain % of the range and more so on how I feel. My endo is okay with that so long as nothing dips into dangerous territory. I never thought I would feel good again so I am delighted and, life is good.


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## lainey (Aug 26, 2010)

I get palpitations no matter what I eat, whenever I eat. Drinks don't make it happen. I've cut back to one meal a day...and sure enough, after I eat anything for that meal, my palpitations start and last for several hours. Usually about 4 to 5 hours. It feels like my heart is POUNDING out of my chest. Heart rate is usually anywhere from 90-140 BPM. It leaves me feel exhausted and shaky and scared.

This is only when you eat? My suggestion would be to get an inexpensive blood glucose meter and some test strips at Walmart or Target. Personally, I get palpitations with wide swings in blood sugar levels--insulin and other hormones are released immediately when you eat, so there could be something going on there.

That said, if your TSH is suppressed, the logical thing to do, as most have said, is back off on the cytomel first and see what that does for you.


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## ssMarilyn (Nov 15, 2013)

*What is TSI?

I used to have horrible palps. Sometimes they were so bad I would sit on the edge of my bed, afraid to move, and just cry. Many days I could not even leave the house. I increased my magnesium citrate and that helped a little. Then a small dosage of COQ10 seemed to help, but I still had the palps. Switched from Synthroid to Armour last January and the palps stopped the second day I took Armour and I have not had them since!! SEVEN MONTHS PALP-FREE!!*


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## JasonJay (Oct 27, 2013)

Starfire, have you tried taking Magnesium Citrate? i as well have pounding fast heart beats after i eat every single time. I take 100% dose of magnesium citrate and crush it in my mouth into dust and swalled it with a glass of water and within 10-15 minutes the palps stop and my heart rate is normal. I would definitely try it if i were you and you wont regret it!


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## starfire (Jun 10, 2014)

lainey said:


> I get palpitations no matter what I eat, whenever I eat. Drinks don't make it happen. I've cut back to one meal a day...and sure enough, after I eat anything for that meal, my palpitations start and last for several hours. Usually about 4 to 5 hours. It feels like my heart is POUNDING out of my chest. Heart rate is usually anywhere from 90-140 BPM. It leaves me feel exhausted and shaky and scared.
> 
> This is only when you eat? My suggestion would be to get an inexpensive blood glucose meter and some test strips at Walmart or Target. Personally, I get palpitations with wide swings in blood sugar levels--insulin and other hormones are released immediately when you eat, so there could be something going on there.
> 
> That said, if your TSH is suppressed, the logical thing to do, as most have said, is back off on the cytomel first and see what that does for you.


Thank you, lainey! Per my endo, I am trying less Synthroid and staying put on the Cytomel for now. I don't really want to say on cytomel, per se, as it scares me&#8230; but I feel I don't have a choice. I get very ill when I try to come off of it. At least for now.

But yes, it's only when I eat. I borrowed one of my mom's blood sugar meters, as she is diabetic&#8230; but my sugars are normal, before and after eating. I tested 30 minutes, 1 hour, and 2 hours out. The highest I ever went was 129 after dinner. The lowest, 72.

What other hormones are released upon eating? Do you know?


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## starfire (Jun 10, 2014)

ssMarilyn said:


> *What is TSI?
> 
> I used to have horrible palps. Sometimes they were so bad I would sit on the edge of my bed, afraid to move, and just cry. Many days I could not even leave the house. I increased my magnesium citrate and that helped a little. Then a small dosage of COQ10 seemed to help, but I still had the palps. Switched from Synthroid to Armour last January and the palps stopped the second day I took Armour and I have not had them since!! SEVEN MONTHS PALP-FREE!!*





JasonJay said:


> Starfire, have you tried taking Magnesium Citrate? i as well have pounding fast heart beats after i eat every single time. I take 100% dose of magnesium citrate and crush it in my mouth into dust and swalled it with a glass of water and within 10-15 minutes the palps stop and my heart rate is normal. I would definitely try it if i were you and you wont regret it!


Hi Marilyn and JasonJay! I actually picked up some Magnesium 4 days ago, and have been taking 500MG a day. My palpitations tonight were MUCH better. I don't know if it's getting better for real, or maybe if I have just had bad anxiety or what is happening&#8230; But I will keep taking it. My doctor swears that my TSH being suppressed cannot cause any symptoms, and my Frees are normal range. So I don't know.

Also, Marilyn, TSI is short for thyroid stimulating immunoglobulin. It's an antibody that contributes to thyroid dysfunction.


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## starfire (Jun 10, 2014)

webster2 said:


> I would not push it either. I started out taking 2.5 twice a day and then moved up to one 5 mcg in the am and a 2.5 in the afternoon. When that seemed to be okay, I added the whole pill in the afternoon and for awhile that was great but then I started to have palpitations. Even on the natural thyroid medication my FT3 was in the basement, even now it is barely at half of the range. I feel good, so I am happy. I have become less focused on being at a certain % of the range and more so on how I feel. My endo is okay with that so long as nothing dips into dangerous territory. I never thought I would feel good again so I am delighted and, life is good.


Thanks, webster! I am actually wondering if my FT4 is too high? It's not out of range, but it's getting closer to the top part. I have noticed after taking my Synthroid, I get very anxious/heart races, etc. My doctor says that Synthroid can't change how you feel quickly, but I don't know&#8230; it seems to affect me? I have been advised to not take it for 2 nights right now. I didn't take it last night&#8230; slept like a baby lol.


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## JasonJay (Oct 27, 2013)

the best brand to take is by Olympian Brands inc. Magnesium Citrate 400mg. Excellent quality magnesium does the job the fastest. Other brands have not been quite as good for the palps after eating, i definitely reccomend you get this brand.


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## ssMarilyn (Nov 15, 2013)

I'm glad to hear that you are getting some positive results. Approx. 75% of the US population is magnesium deficient due to our poor diets. Be sure you only use magnesium citrate as that is the most easily digestible. I take 400mg mag citrate in the morning about 11am and then another 400mg at night along with my D3. Helps me sleep!


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## starfire (Jun 10, 2014)

Well I am frustrated!! I've been off my Synthroid for 2 nights, as doc recommended. Slept well...no palpitations last night. Was going to start up at 88mcg of Synthroid tonight and stay on my 10 mcg of Cytomel. But here I am with palps tonight!! I haven't even eaten anything!  Is it possible that the Cytomel is causing it?? But I didn't have palps last night and I was on the same dose!


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## starfire (Jun 10, 2014)

Does anyone know -- is it possible to develop palpitations after several weeks on a drug? I used to take 25 mcg with no issues at all.


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## Thyroiddiseasefighter (Aug 5, 2014)

My doctor said that in general people should start out the Cytomel with a low dose of .5mcg and at the same time they should lower their Synthroid otherwise you can become hypothyroid. I believe that thyroid disease varies greatly from person to person and you should be very careful. You may want to also change your diet (e.g. soy, gluten and sugar). There are many foods that supposedly don't play nice with thyroid issues.

I was incorrectly given 50mcg''s of Cytomel while on 100mcg of Synthroid. I had the racing heart but I stopped taking my meds when it happened. All my health issues tripled when I was on the large dose of medication. I would work very closely with a doctor you trust to get the right dose. Don't mess with your meds on your own. If you don't feel the warm and fuzzy with your current doctor search for a doctor until you find someone who gets this disease.

What does it mean when you say "convert"?


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## Andros (Aug 26, 2009)

What I take the word convert to mean is the process of peripheral deoiodination. This is where T4 converts to T3 or more importantly Free T3 which of course is the unbound portion of the hormone T3 which is available for cellular uptake.

You asked a very good question. And you also give good advice. It is always good to err on the side of caution!


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## Viv22 (Sep 3, 2013)

I had serious problems for over a year and a half which included palpitations, dry eyes etc etc. I ended up in A&E a couple of times too. I eventually saw a magnificent specialist who put me on an elimination diet. After 6 weeks of eating non-inflammatory foods, the auto immune sounds literally switched off - I subsequently found out that I was having an allergic reaction to sugar, sweeteners, eggs and gluten - I have never had an allergic reaction to anything in my life before I was diagnosed with Hashimotos. I now have a very limited diet - mainly meat and potatoes, whole foods and fruits and my life has transformed.

I was in a meeting the other day at work and there were little boxes of fruit and nuts so I ate some thinking it would be okay and immediately my eyes went dry and my heart started racing... guess what... sweeteners! I literally have zero tolerance. Sugar/sweeteners are like adding fuel to the fire. The focus should be on an anti-inflammatory diet.

Anyway, this is my experience - I went to hell and back to find out what was happening. I think I saw 10 specialists and was told that my blood tests were "normal" etc etc but my ESR levels were chronically high (a sign of inflammation in the body). Good luck.


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## CA-Lynn (Apr 29, 2010)

But what you DON'T know is if the inflammation died down on its own. That is, it would have died down without any elimination diet.

I'm happy that you seem to be on the right track, but as someone with multiple autoimmune diseases I can tell you that way, way too many patients who've tried "elimination" diets felt no difference.


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