Heart Palpitations and Cold Symptoms in Hypothyroidism

Hypothyroidism

Hello Doctor: I am currently a patient transitioning from hyperthyroidism to hypothyroidism.
My doctor has adjusted my medication to once daily, which includes Methimazole and Cardizem.
However, I have been experiencing palpitations 1 to 2 times daily, so I take Cardizem again at night to manage it.
I would like to understand why hypothyroidism can cause palpitations and lower body temperature.
I have cold sensations in my limbs, head, and back, occasional fever, and my temperature fluctuates to normal.
My hemoglobin level is 9, I feel weak, have a slight cough, a hoarse voice, and facial swelling, among other symptoms.
I am deeply concerned that my palpitations may lead to heart disease.
I kindly request your prompt response.
🙏🙏

You-Chen, 30~39 year old female. Ask Date: 2020/04/26

Dr. Yuan Tianmin reply Breast and Thyroid

If you are just starting to reduce your medication, it is inevitable that there may be fluctuations, so it might still be necessary to rely on blood tests to monitor the status of the medication and determine if it is suitable for you.
In the initial phase, there may still be symptoms of hyperactivity, so adjustments to the medication should be made based on the blood test results.

Reply Date: 2020/04/26

More Info

Understanding heart palpitations and cold symptoms in the context of hypothyroidism is crucial, especially for patients transitioning from hyperthyroidism to hypothyroidism. Your symptoms, including palpitations, cold extremities, and fluctuations in body temperature, can be interconnected and indicative of underlying thyroid dysfunction.

Firstly, hypothyroidism can lead to a slower metabolism, which often results in a lower body temperature and cold intolerance. The thyroid hormone plays a significant role in regulating metabolism and energy production in the body. When thyroid hormone levels are low, the body may struggle to maintain normal temperature, leading to sensations of coldness in the extremities, such as your hands and feet. This can also explain the feelings of coldness in your head and back.

Heart palpitations, or the sensation of a racing or irregular heartbeat, can occur for several reasons in hypothyroid patients. While hypothyroidism typically slows the heart rate, fluctuations in thyroid hormone levels during treatment can lead to periods of increased heart rate or palpitations. Additionally, the use of medications like Carvedilol (Cardil) can help manage these symptoms by controlling heart rate and blood pressure, but they may not completely eliminate palpitations, especially if thyroid hormone levels are not yet stabilized.

Your symptoms of fatigue, low hemoglobin levels (anemia), and a hoarse voice can also be linked to hypothyroidism. Anemia can cause fatigue and weakness, which may exacerbate feelings of palpitations and overall malaise. The hoarseness and facial swelling you describe could be due to myxedema, a condition associated with severe hypothyroidism, where the skin becomes thickened and puffy.

It's important to monitor your thyroid hormone levels closely during this transition. Regular blood tests to check TSH (Thyroid Stimulating Hormone), Free T4, and Free T3 levels will help your healthcare provider adjust your medication dosage appropriately. If your symptoms persist or worsen, further evaluation may be necessary to rule out other potential causes of your heart palpitations, such as anxiety, electrolyte imbalances, or even cardiac issues.

In terms of your anxiety about developing heart disease, it's understandable to be concerned, especially with a history of thyroid dysfunction. However, while palpitations can be alarming, they are not always indicative of heart disease, particularly in the context of thyroid issues. Maintaining a healthy lifestyle, managing stress, and adhering to your medication regimen can help mitigate these risks.

In conclusion, your symptoms of heart palpitations, cold extremities, and other related issues are likely interconnected with your thyroid condition. It's essential to work closely with your healthcare provider to monitor your thyroid levels and adjust your treatment as necessary. If you experience any new or worsening symptoms, such as chest pain, severe shortness of breath, or fainting, seek medical attention promptly. Your health and well-being are paramount, and addressing these symptoms with your doctor will help ensure you receive the appropriate care.

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