Managing Hyperthyroidism: Do I Still Need Heart Medication?

Q: Managing Hyperthyroidism: Do I Still Need Heart Medication?

Dear Mimi： 1. You should see an endocrinologist, as the thyroid is part of the internal medicine specialty of endocrinology. 2. If you have hyperthyroidism, medication adjustments can be made based on thyroid function tests and clinical presentation. Do no

Hyperthyroidism

Dear Dr.
Zhou,
I visited the emergency department in early March due to severe palpitations and arrhythmia, initially thinking it was a heart issue.
After being referred to cardiology, my blood tests indicated that hyperthyroidism was the cause of these symptoms (I do not have a goiter).
I underwent cardiac evaluations, and it was determined that my heart itself should not have any issues.
The physician prescribed Methimazole and Digoxin for me to take.
My most recent blood tests showed T3 at 37.15, T4 at 1.31, and TSH at 2.28, all within normal ranges.
The physician has continued to prescribe these two medications (with a slight reduction in dosage).
I would like to ask if I still need to take the heart medication or if I should see an endocrinologist.
Thank you for your guidance!

Mimi, 60~69 year old female. Ask Date: 2016/04/26

Dr. Zhou Jiazhen reply Breast and Thyroid

Dear Mimi:
1.
You should see an endocrinologist, as the thyroid is part of the internal medicine specialty of endocrinology.

2.
If you have hyperthyroidism, medication adjustments can be made based on thyroid function tests and clinical presentation.
Do not stop the medication on your own; please discuss it with your endocrinologist.

Reply Date: 2016/04/26

More Info

Managing hyperthyroidism, particularly when it has led to symptoms such as palpitations and arrhythmias, can be complex. In your case, it appears that your hyperthyroidism was the primary cause of your heart issues, which is not uncommon. When thyroid hormone levels are elevated, they can significantly affect heart function, leading to symptoms like rapid heart rate, palpitations, and even arrhythmias.
Given that your recent blood tests show that your T3, T4, and TSH levels are within normal ranges, it suggests that your hyperthyroidism may be under control. However, the fact that your physician has prescribed both methimazole (甲硫咪唑) and a heart medication (心利正膜衣錠) indicates that they are taking a cautious approach to ensure that your heart remains stable while your thyroid levels normalize.

Do You Still Need Heart Medication?
1. Assessment of Heart Function: Since your heart was initially affected by hyperthyroidism, it is essential to monitor its function even after thyroid levels have stabilized. If you are still experiencing symptoms like palpitations or irregular heartbeats, it may be necessary to continue the heart medication until you are symptom-free and your doctor feels confident in your heart's stability.

2. Consultation with a Cardiologist: It would be prudent to follow up with your cardiologist regarding the necessity of continuing heart medication. They can evaluate your current symptoms, perform any necessary tests (like an EKG or echocardiogram), and determine if the heart medication is still required.
3. Monitoring: If you are feeling well and your heart rate is stable, your doctor may consider tapering off the heart medication. However, this should be done under medical supervision, as abrupt discontinuation can lead to a resurgence of symptoms.

Should You See an Endocrinologist?
Given that hyperthyroidism can have long-term effects on your health, including potential impacts on your heart, it may be beneficial to consult with an endocrinologist. They can provide specialized care regarding your thyroid condition and help manage any ongoing treatment or monitoring you may need.
1. Long-term Management: An endocrinologist can help you understand the long-term implications of hyperthyroidism and ensure that your thyroid levels remain stable. They can also discuss other treatment options if necessary, such as radioactive iodine therapy or surgery, depending on the underlying cause of your hyperthyroidism.

2. Holistic Approach: Managing hyperthyroidism often requires a holistic approach, considering not just the thyroid but also how it interacts with other systems in your body, including cardiovascular health. An endocrinologist can provide insights into lifestyle changes, dietary recommendations, and other factors that can help manage your condition.

Conclusion
In summary, while your thyroid levels are currently normal, it is essential to continue monitoring your heart health and consult with both your cardiologist and endocrinologist. They can provide tailored advice on whether you should continue heart medication and how best to manage your hyperthyroidism moving forward. Always communicate any new symptoms or concerns with your healthcare providers, as they can help adjust your treatment plan accordingly.

Similar Q&A

Managing Hyperthyroidism: Key Questions on Medication and Recovery

Hello, Doctor! My heart rate increased from 70-80 to around 100 due to hyperthyroidism, and my systolic blood pressure rose from 88 to about 103. After taking thyroid medication and the beta-blocker Inderal (propranolol) for two weeks, my systolic blood pressure is around 94, hea...

Dr. Chen Taicheng reply Family Medicine
● Entacapone can lower heart rate and partially suppress thyroid function, generally used when the heart rate exceeds 90 beats per minute; if the heart rate returns to normal and there are no other discomforts, it is acceptable to discontinue the medication directly. ● Antithyroi...

Understanding Thyroid Disorders: Managing Hyperthyroidism and Hypothyroidism

The patient has been receiving treatment for hyperthyroidism (without exophthalmos) for many years and is taking medication for both hyperthyroidism and hypothyroidism. Recently, he has experienced increased shortness of breath. The original physician believes this is unrelated t...

Dr. Li Jian reply Internal Medicine
Some physicians may allow patients with thyroid autoimmunity to take both antithyroid medications and thyroid hormone replacement therapy simultaneously. This approach varies from person to person. If respiratory symptoms are present but cardiology evaluations show no significant...

Managing Hyperthyroidism: Medication Choices and Surgical Considerations

Dear Dr. Yang, I hope this message finds you well. My mother was diagnosed with hyperthyroidism this year. Initially, it seemed that this condition could be well-managed with medication, but unfortunately, it was discovered too late (almost eight to nine years). We had previousl...

Dr. Yang Hongzhi reply Internal Medicine
The cited option is a choice; however, the use of iodine preparations before surgery is not widely adopted in Taiwan, and generally, the original antithyroid medications continue to be used.

Can I Manage Hyperthyroidism Without Medication?

Hello doctor, I have a history of hyperthyroidism. I took medication for about two years, and it improved slightly, so I stopped the medication. However, recently I've been under a lot of work stress and staying up late every day, which has caused my hyperthyroidism to relap...

Dr. Yang Hongzhi reply Internal Medicine
It is quite common for hyperthyroidism to relapse after discontinuation of medication, and there is no direct correlation with high work-related stress. If a relapse is confirmed, it is advisable to seek medical attention. There are several treatment options to consider, and life...